STUDENT INFORMATION:                                                                                  ood instructions

[please enter information as it appears on your child's birth certificate.]

In order to submit this request you must have access to an email:

Student Name:      *
Birth Date:    
v
*
Gender: * Student ID #:    
Address:    *      
City/State/Zip:   * Subdivision: 

SCHOOL INFORMATION: 


School student is currently enrolled at:  
 *
Grade:   *
School in which student is zoned to attend:  * Grade: *
School in which student is requesting to attend:   * Grade:   *
This request is for the following school year:   *

REASON FOR REQUEST:

Type of Request:      

PARENT INFORMATION:

Parent / Guardian Name:    *     *

Email Address:      * This will be used for confirmation of Out of District Request.

Home/Cell Phone:     (###-###-####) *             Work Phone:     (###-###-####)

* REQUIRED FIELDS