Out of Area Request

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I understand that if/when this out of area request is approved, my student's records will be transferred to the requested school.

Please select the enrollment period*

2019-20

Today's Date*

Does the student currently attend a school in the Alpine School District?*

Yes
No

Is your student requesting an out of area transfer to an Elementary school or a Jr. High/High school?*

If your student is transferring from an elementary school to a Jr. High/Middle school, please select Jr. High/High School.

Elementary
Jr. High/High School

Do you have a preference for which track your student is on? (If applicable)

Track A (early)
Track B (late)

Student Name*

First Last

Student Number*

The student number will be 6-8 digits long

Current Grade*

Grade Entering Next School Year*

Birth Date*

Student Address*

Street Address City State ZIP Code

Parent Phone Number*

School District the student is transferring from.*

School the student is transferring from.*

Current School*

Boundary Jr. High/Middle School*

Requested School*

Does the student currently have a sibling attending the requested school?*

Yes
No

You've selected a school that is currently closed to out of area students. Please use the field below to explain the reason for your request or select a different school.

Reason For Request*

Does your student currently have an IEP?*

Yes
No

Is your student currently in the Special Education Life Skills/Special Class program?*

A student in the Life Skills program will be reviewed by Special Education in order to determine if the requested school can meet your student's needs.

Yes
No

Has the student ever been suspended or expelled from a public school?*

A student may be denied an open enrollment opportunity if the student has been suspended or expelled from a public school consistent with 53A-2-208(3)(b)

Yes
No

Reason for suspension or expulsion*

Current Principal

Requested Principal

Current Registrar

Boundary Registrar

Requested Registrar

*

I understand that all transfer requests are contingent on early enrollment school capacity ("maximum capacity") or late enrollment school capacity ("adjusted capacity"), special program limitations, staff availability, and/or circumstances under 53A-2-207(4)(c). If this request is granted, I agree to leave my child at the requested school through the end of the requested school year.

*

I understand that a request may be denied in cases where the student has a history of excessive behavior problems, been suspended or expelled, or where the school/grade level has been declared closed to out of area requests.

*

I understand that students admitted to an out of area school may remain enrolled without a renewed application for attendance in subsequent years at the school unless any of the following occurs: The student graduates; Is no longer a Utah resident; or the district determines that enrollment will exceed the open enrollment threshold.

*

I understand that I, as parent or guardian, am responsible for transportation of my student to and from school.

*

I understand that my student may not be eligible to participate in Utah High School Activities Association (UHSAA) activities based on the UHSAA school transfer rules and policies. For more information please contact the UHSAA.

*

I understand that any falsification of information on this form will result in cancellation of out of area transfer.

Signature

Name*

First Last

Email*

Signed: 11/14/2019
From: 172.69.63.65
Form: Out of Area Request

Resident School Principal Email

Request for Out-of-Area Transfer

You've selected a school that is currently closed to out of area students. Please use the field below to explain the reason for your request or select a different school.

Signature