NONRESIDENT STUDENT ENROLLMENT APPLICATION

NONRESIDENT STUDENT ENROLLMENT APPLICATION

SOUTH HAVEN USD #509
All nonresident students (students whose parents/legal guardians live outside USD 509 school boundaries) are required to submit a nonresident student enrollment application annually. Nonresident students will be considered for admittance only at the beginning of a semester grading period.
Date of Application

MonthDayYear
Date
Student's Name

First NameLast Name
Student's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Grade Level
Parent's/Legal Guardian Name

First NameLast Name
Parent's Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to student: Please check correct answer.
What is your district of legal residence?
What school did you attend last year?
Have you been suspended or expelled from another school?
If yes, please explain.
Have you been expelled from South Haven Schools?
If yes, please explain.
Did you withdraw from another school due to either poor attendance, disciplinary reasons, or poor academic performance?
If yes, please explain.
Why do you want to attend a South Haven District school? Please be specific.
NOTE: Students who have been suspended, expelled, or who have withdrawn from another school due to poor grades, poor attendance, or disciplimary reasons may not be admitted in USD #509.
Student's Signature and Date
Parent's Signature and Date
NOTE: Violation of school rules and regulations may result in the immediate termination of this enrollment application. Nonresident students (out of district) who become a disciplinary problem, establish poor attendance, or suffer from poor academic performance while attending a South Haven district school will not be allowed to continue their education in USD #509. Class size may be a determining factor for approval.
For School Office use only.
Disposition:
Principal's Signature
Date

MonthDayYear
Date
Superintendent's Signature
Date

MonthDayYear
Date
Should be Empty: