Application For Change of Elementary School Placement

This change of Elementary School Placement Form is to be filled out by the parent. The principal of the sending and receiving schools will then review. You will receive an email updating you on the status of your request.

REQUEST FOR ELEMENTARY SCHOOL TRANSFER

Date: * +

Student's First Name *

Student's Last Name *

Grade: *

Parent or Legal Guardian's Name *

Parent or Legal Guardian's Street Address *

City *

State *

Zip Code *

Parent or Legal Guardian's Phone Number *

Parent's Email Address: *

Reason for Request *

Sending/Current School *

Sending Principal: *

Receiving School *

Receiving Principal: *

Effective Date of Transfer * +

CONDITIONS UNDER WHICH THIS TRANSFER IS APPROVED:

1. Change of elementary school placement form must be completed and submitted to current

principal by June 15.
2. Change of school placement will continue as long as there continues to be room in the school.

Annual renewal of this change will be reviewed by Superintendent’s Office each year before a

final determination is made about placement.
3. If change of school placement is granted, parents are responsible for transportation to and from

the requested school.

4. Parents will receive notification of action from the Office of the Superintendent of Schools by

early August.

5. A sudden influx in the grade enrollment of the school for which attendance is desired may result

in withdrawal of approval prior to the end of the first full week of school.

6. School enrollment of each sibling in the family will be reviewed individually before a determination

is made about change of elementary school placement.

7. The signature of the principal is only to make them aware of the transfer request not to approve

the request.

8. Final approval of all transfer requests are made by the Superintendent.

By typing your name in the below box, you are agreeing that all the information provided is accurate and true. *

Date of Application: * +

___________________________________________________________________

Sending School Principal Area:

If you approve the above school change, an email will be sent to the Receiving School for their review/approval or denial.

You will receive an email upon completion of the form by all parties.

Sending School Principal:

Sending School Date: * +

___________________________________________________________________

Receiving School Principal Area:

If you approve the above school change, an email will be sent to the Superintendent's office for their review/approval or denial.

You will receive an email upon completion of the form by all parties.

Receiving School Principal:

Receiving Principal Date: +

Please hit the Submit button when finished.

Thank you.