502.4P - Intradistrict Student Transfer Application

Adopted: November 1987
Revised:  December 2022

 

Download 502.4P - Intradistrict Student Transfer Application

 

If you are the parent or guardian of a child (or an adult student age 18 or older), who lives in Independent School District 196, and if you would like that child to attend a school other than the child's attendance area school, complete the application form below and return it by the appropriate deadline to:  Student Information Supervisor, Independent School District 196, 3455 153^rd St. West, Rosemount, MN  55068.

 

Grade Level     Reason for Transfer                     Deadline

K-5            Intent to establish residency        Any time (but not before four years of age)

K-5            Parent/guardian request             December 15 (but not before four years of age)

6-8             Intent to establish residency        Any time (but not before 5^th grade)

6-8             Parent/guardian request             December 15(but not before 5^th grade)

9-12           Intent to establish residency        Any time (but not before 8^th grade)

9-12           Parent/guardian/                        December 15(but not before 8^th grade)

                  adult student request

9-12           11^th or 12 grade student to          Any time (but not before 11^th grade)

                     remain at current school

6-12           Attendance area adjustment        December 15

 

You will receive an official notice from the Student Information Department regarding the status of your application after the review process is complete.  Applications received after the specified deadline will be considered on a case-by-case basis.

 

Transportation will not be provided for intradistrict transfer students except as noted in section 3.6.1 of Policy 502, Student Transfers.

                                                                                                                                           

Please print.  Complete a separate form for each student.

 

                                                                                                                                                                                                                                

Student's name                                                 Grade level next school year                                                                                    ID number

 

                                                                                                                                           

Parent or guardian name (last, first, middle)

 

                                                                                                                                           

Parent or guardian address (street, city, zip code)

 

                                                                                                                                           

Parent or guardian telephone number(s) with area code     (home)             (work)       (cell/pager)

 

                                                                                                                                           

School of residence                                                  School requested for next school year

 

Requested date for transfer to begin:                                       (NOTE:  Except for transfers based on intent to establish residency, the ending date of the transfer will be no later than the end of an elementary student’s 5^th grade year, a middle school student's 8^th grade year or a high school student's 12^th grade year. For transfers based on intent to establish residency, the ending date will be the end of the school year.)

 

Reason for Request:         Intent to establish residency (please specify new address if not listed

above, and attach a copy of the purchase or lease agreement, or other

legal document that shows intent to change residence):                        

                                                                                                                   

 

   Parent/guardian/adult student request

 

   11th or 12th grade student to remain at current school (please specify):         

                                                                                                                       

                                                                                                                                   

 

   Attendance area adjustment options as authorized by the School Board

 

The above information is true and correct to the best of my belief and knowledge. 

X

 

 

 

                                                                                                                                           

Parent, guardian or adult student signature                                   Date

 

(NOTE:  Notification of final approval will come only from
the District 196 Student Information Department.)

 

DISTRICT USE ONLY

 

 

                                                 

Date application received

 

Transfer based on intent to establish residency, 11^th or 12^th grade student to remain at current school, parent/guardian/adult student request or attendance area adjustment:

 

_____Approved   _____Denied

 

The student will be enrolled in:

 

                                                                                                                                           

School                                                            Grade level              Beginning (date)

X

 

 

 

                                                                                                                                           

Signature of student information supervisor                                   Date

 

 

 

Distribution:

Parent, guardian or adult student	Principal of school of residence
Student's cumulative folder	Principal of requested school