Augusta Public Schools - USD 402 - Out of District Form

Out of District Student Form

School Information

Parent/Guardian Email:

Which school are you requesting to attend?

What school year are you requesting to attend USD 402?

Student Information

Student Name (First & Last Name):

What grade will your student be entering?

Parent/Guardian Information

Name of Parent/Guardian:

Reaquired field: Street Address:

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Phone Number:

Which school district do you reside in?

Previous School Information

Last School Attended:

City & State:

1. Briefly explain why you are requesting out-of-district status:

a. Did you attend USD 402 the previous year?

2. Are you currently suspended/expelled from your home school?

3. During my last year at (present school), my records indicate the following:

Days Absent:

Days Excused:

Days Unexcused:

Times Tardy:

GPA:

Were you suspended/expelled from school last year?

If yes, please explain:

Agreements

4. We have discussed this application for out of district student status with the enrollment clerk at USD 402 and at present home school. We understand that all paperwork and other procedures must be completed prior to enrolling to be elgible for admission to USD 402.

Please check this box if this has been completed.

5. We realize that, as a result of this transfer, student may lose eligibility with KSHSAA for a period of time. (Middle/High School Only)

Reaquired field: I understand this

By electronically signing this form, I am verifying that I am indeed the parent/legal guardian of this student, and I authorize Augusta Public Schools USD 402 to process this request as outlined within the form itself.

Reaquired field: I agree

Parent Signature:

Date:

Email a copy to

optional

Required Fields

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