TRANSFER REQUEST APPLICATION FOR NON-RESIDENT STUDENT

TRANSFER REQUEST APPLICATION FOR NON-RESIDENT STUDENT
Student's Name

First NameLast Name
- Parent Name
  
  First NameLast Name
- Parent Email
  example@example.com
- Parent Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Mailing Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- Physical Address
  
  Street Address
  
  Street Address Line 2
  
  CityState
  
  Zip Code
- School Name
- Last Semester Enrolled
- Mailing Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- School's Phone Number
  Format: (000) 000-0000.
- School Corporation Name
- Student's Age
- Current Grade Level
- Last Grade Completed
- Has the Student Been Suspended or Expelled for More than Ten (10) School days In the Twelve (12) Months Preceding the Request for Transfer?
- Has the Student Been Suspended or Expelled for Possessing a Firearm, Deadly Weapon, Or Destructive Device in the Preceding Twelve (12) Months?
- Has the Student Been Suspended or Expelled for Causing Physical Injury To a Student, School Employee, or Visitor to the School?
- Has the Student Been Suspended or Expelled for Violating a Drug or Alcohol rule?
- Does the Student Have a History of Unexcused Absences, and Based Upon the Location Of the Student's Residence, Would Attendance of the Student be a Problem if Enrolled in the School Corporation?
- Please indicate why you answered yes to any of the above questions. Also, please explain the circumstances.
- Please sign below to authorize Rossville School Officials to contact your school for further information about your child.
- Student's Signature
- Parent's Signature
Administrator Notification
example@example.com
Should be Empty: