2026-2027 RCS Change in Enrollment Request Form

Change in Enrollment Request Form

This form is used to request a change to a student’s current enrollment at Roseville Community School (RCS). Changes may include increasing or reducing program days and adding or removing enrichment.Please complete all sections below. All changes are subject to availability, staffing, and administrative approval.
Student Name

First NameLast Name
Guardian's Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Guardian's Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Which program is your student currently enrolled in?

Financial & Charter Acknowledgment

I understand that changes to enrollment may result in a tuition adjustment, prorated charges, or credits based on the effective date of the change. I understand that a change fee may apply. I know that changes may impact charter funds already submitted or issued to RCS, and that families may be responsible for any amounts not covered by charter funding. I understand that enrollment changes are not finalized until RCS administration confirms them in writing.
Parent Participation Acknowledgment

I acknowledge that parent participation requirements may be adjusted based on the new enrollment option selected and agree to meet the updated participation expectations associated with this change.
Signature

By signing below, I confirm that the information provided is accurate and that I agree to all RCS policies. All terms of the original Participation Agreement continue to apply unless they are specifically changed in this Addendum.
Once this form is submitted:

RCS will review the request and confirm availability
A confirmation email will be sent to the family
An updated invoice or quote reflecting the enrollment change will be issued
The form will be signed by the administration and placed in the student’s file
Signature
Should be Empty:

Requested Change