Out of District Enrollment Form

Out of District Enrollment

Out-of-District Student Enrollment Form
Continuing Students: Please complete and return this form by May 15th. I am an out-of-district student that is applying to attend Stevensville School District. I understand that I must provide the following information and agree to the attendance, conduct, and academic procedures outlined below. A separate application form must be completed for each student seeking admission.
Academic Year * Required
I hereby request that attendance in the Stevensville School District be approved for the following named child for the ________ school year.
Student Name * Required
Grade Level Requested * Required
Prior School Name/Address
School Name Address City State / Province / Region ZIP / Postal Code Country
Custodial Parent Mailing Address 1
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Custodial Parent Mailing Address 2
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Physical address of residence where child is actually living. Box or route number is not sufficient. Students not residing with custodial parent, legal guardian or other person with documented legal custody will not be admitted except by court order, unless custodial parent, legal guardian or other person with documented legal custody also resides in the district.
Address of Parent/Guardian where child resides
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Are you continuing enrollment in Stevensville School District? * Required
Will transportation services be requested? * Required
Out-of-District students must board the school bus at a designated Stevensville School District approved pick-up/drop-off zone. Exception- Lone Rock residents, grades K-8 are eligible if a sibling attends Stevensville High School or the K-8 student rode the bus under this provision but the High School sibling has graduated.
Will special education services be requested? * Required
My school record is free of truancies or attendance issues: * Required
I have all passing grades in the school that I previously attended: * Required
I have been expelled, suspended or have a criminal record: * Required
I have pending issues that could cause me to be expelled, suspended, or have criminal charges brought: * Required
Signature of Student * Required
Date - must be mm/dd/yyyy format * Required
Signature of Parent * Required
Date - must be mm/dd/yyyy format * Required

**Completion of this document does not insure that the applicant will be admitted to Stevensville School District. Please make any appropriate arrangements on the event that the applicant is not ultimately admitted.

Out of District Enrollment

Out-of-District Student Enrollment Form