SUTTER UNION HIGH SCHOOL DISTRICT
2665 Acacia Avenue | PO Box 498 Sutter, CA 95982 | (530) 822-5161 Fax (530) 822-4905 | Registrar Email khelzer@sutterhigh.k12.ca.us
INTER-DISTRICT AGREEMENT
Education Code 46600 and 46601
School Year Requested
Please Select
2022-2023
2023-2024
Date
/
Month
/
Day
Year
Student First Name
Student Last Name
Date of Birth
/
Month
/
Day
Year
Parent First Name
Parent Last Name
Physical Address (no PO Box allowed)
Number, Street and Apartment Number (if applicable
City
Zip
Primary Phone Number
Secondary Phone Number
Grade Level for School Year Requested
Please Select
9th Grade
10th Grade
11th Grade
12th Grade
School Presently Attending
School District of Residence
Requested School District of Attendance
Did your child previously attend school in requested school?
Yes
No
If yes how many years?
Leave Blank if not applicable
Was it on an inter district agreement?
Yes
No
N/A
Is student currently under an expulsion or discipline contract?
Please Select
Yes
No
List any special programs your child is enrolled in
Special Ed./IEP, 504, Gate, etc.
Reason for request
By signing below I understand that an Inter-District Attendance Agreement is conditional upon: 1) the student obeying school rules and maintaining good attendance, good citizenship and passing all courses. 2) Class size not exceeding maximum allowed by statute or contract. The student is subject to change to another school or termination of the agreement if any of these conditions occur. Transportation is the responsibility of the parent/student.
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