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:    
Gender:         Student ID #:    
City/State/Zip:         Subdivision:    


Grade/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:      
Requested start date:


Type of Request:      


Parent / Guardian Name:       

Email Address:      

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

I agree that I am the parent/guardian of the child listed above on this confirmation of Out of District and that I have legal educational decision-making authority for the named student. I consent to provide an electronic signature for my student's Out of District request. I have provided my student's name and birthdate and confirm the accuracy of the information listed on the Out of District request form. I further agree, under penalty of law and per the Electronic Signature Act, that I am the person who is signing my name inside the electronic signature box and understand this electronic signature is considered equivalent to a signed or faxed signature.

     Type Full Name: 

Send Validation Code:    (standard data rates may apply)   

NOTE: If you do not receive a text, please check your email for the verification code.

If you have any issues with this form, please email:

Validation Code: