This form is to be completed whenever a St. John or Endicott School District resident student requests release to a non-resident district. A student desiring to transfer into St. John-Endicott School Districts must initiate the transfer process at his/her resident district.

SECTION I: (To be completed by parent/guardian of student requesting release to another district. One form per student, please.)

Student Name: Date of Request:

Birthdate: Age: Grade:

School to Which Student is Requesting Transfer:

Parent / Guardian Name: Phone:

Address:

Are you also requesting transfers for other students? Yes No

Please indicate at least one reason and additional detail for requesting this transfer:

1. A financial, educational, safety or health condition affecting the above-named student would be reasonably improved as a result of this transfer. Please describe:

2. The non-resident district provides better accessibility to parent's place of work or location of child care. Please describe:

3. A special hardship or detrimental condition affecting the student and/or family would be improved by the transfer. Please describe the condition:

Signature of Parent/Guardian

Return this form to the St. John-Endicott School Districts Superintendent's Office for further processing. Applicant will be notified of transfer decision. Following approval of this request, this form must be presented to the receiving district for permission to enroll. (see reverse)

 

 

SECTION II: DISPOSITION OF REQUEST (To be completed by the Superintendent of St. John-Endicott School Districts)

Date application received in St. John-Endicott School Districts office:

1. Student temporarily released to School District contingent on final approval of the St. John-Endicott School Board.

2. Request to transfer out of St. John-Endicott School District does not meet criteria; permission denied.

Signature of Superintendent Date:

 

SECTION III: NOTIFICATION TO RECEIVING SCHOOL DISTRICT (To be completed by resident school district)

The parent/guardian of the student identified in Section I of this application has requested and been granted temporary permission under the provisions of WAC 392-137 to be released from the St. John-Endicott Cooperative School Districts in order to enroll in the School District. Official board approval will be sought at the next regular school board meeting. Should the board deny the temporary release, both the parent/guardian and the receiving district will be notified immediately.

The parent/guardian of the student has identified the reason(s) for the transfer request in Section I of this application.

There is / is not another child in the family for whom transfer is being requested.

 

SECTION IV: (To be completed by the receiving school official)

Requested transfer meets district criteria and is granted for the school year. It shall be the responsibility of the parent to provide transportation to and from school. If at any time during the period of the transfer, the object of the transfer is either substantially achieved or is determined to be unobtainable, this transfer agreement may be terminated. Transfer requests must be renewed each year.

Signature:

Date:

Requested transfer does not meet district criteria. Admission denied.

Signature:

Date:

Parent / guardian notified of application results. Date:

Original application sent to St. John-Endicott School Districts. Date: