District Change Form
To be completed when a family moves from one district to another, within Washtenaw County.
Student name:
*
First Name
Last Name
Parent/Guardian Name:
*
First Name
Last Name
Parent/Guardian Email:
*
example@example.com
What program is the student enrolled in?
*
Early College Alliance at EMA (ECA)
Washtenaw Alliance for Virtual Education (WAVE)
Washtenaw International High School & Middle Academy (WIHI & WIMA)
Current School District:
*
District wanting/needing to transfer to:
*
Reason for transfer:
*
Transfer Date Requested:
*
/
Month
/
Day
Year
Date
Today's Date:
*
/
Month
/
Day
Year
Date
Parent/Guardian Signature:
*
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Submit
Should be Empty: