Out of Area Request

*This form is currently only for Out of Area Requests between secondary schools. Elementary schools are not listed on this form. If your student is currently attending an elementary school, please fill out the paper form.

Please select the enrollment period*

2018-19
2019-20

*Open enrollment for the next school year does not open until December 1st. If you are filling out this form for the 2019-2020 school year, you will not be able to submit the form until then.

Today's Date*

This application is currently past the open enrollment deadline. Your request may be delayed.

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

Yes
No

Student Name*

First Last

Student Number*

The student number will be 6-8 digits longs

Grade*

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*

Requested School*

Boundary 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*

*

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 this form is currently only available for Out of Area requests between secondary schools. I understand that submitting this form for a student currently attending an elementary school may cause a delay or other inconveniences in the process.

*

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: 11/13/2018
From: 162.158.79.217
Form: Out of Area Request

Resident School Principal Email

Request for Out-of-Area Transfer

*This form is currently only for Out of Area Requests between secondary schools. Elementary schools are not listed on this form. If your student is currently attending an elementary school, please fill out the paper form.

*Open enrollment for the next school year does not open until December 1st. If you are filling out this form for the 2019-2020 school year, you will not be able to submit the form until then.

This application is currently past the open enrollment deadline. Your request may be delayed.

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.