3010F: Open Enrollment Application

Gooding Joint School District No. 231

STUDENTS 3010F

OPEN ENROLLMENT APPLICATION DATE/TIME RECEIVED:

For School Year 20 – 20 Grade

This application form was prepared pursuant to Section 33-1402, Idaho Code, and may be used by any school district. Any other form must be approved the State Superintendent of Public Instruction.

NOTE: For out-of-district applicants, a copy of the applicant student’s cumulative record must be attached to this application. The cumulative record may be obtained from the student’s current school.

( ) Out-of-District Application Name of District ( ) In-District Transfer Application



Name of Proposed Receiving School (Some specialized programs are only offered in a limited number of schools, e.g. special education, English Language Learner, etc. Contact Gooding District Offices at 208-934-4321 for further information.)

  1. Applicant Student’s Name

Date of Birth

  1. School student is presently attending, or would attend if student were in a public school.

Name of School

Address of School

Present Grade Level of Student

  1. Has the student ever been suspended or expelled from school or has the student committed a disciplinary violation for which he/she could be suspended or expelled? Yes No

  1. Has the student had a history of disciplinary infractions? Yes No

If YES, describe the circumstances (including dates and duration)

  1. Reason(s) for requesting attendance in this school (optional).

  1. Special and/or unique instructional programs in which the applicant student is currently enrolled. (For example: vocational, foreign language, remedial, special education, gifted/talented, etc.)

  1. Special and/or unique instructional programs in which the applicant student expects to

enroll in at the new school.

  1. Extra-curricular activities in which the applicant wishes to participate

  1. Transportation arrangements that will be made by the parent/guardian.

  1. Parent/Guardian’s Name

Parent/Guardian’s Address

Home Phone Work Phone

I have read the school district procedure on open enrollment, and hereby request that my son/daughter be permitted to attend

(Name of Proposed Receiving School) Parent/guardian’s Signature:

Misrepresentation of information on this application may result in revocation of the applicant’s approval to attend a School District school.

PRINCIPAL SIGNATURES

In-District Transfer: (Home School)

(Receiving School)

Out-of-District Transfer: (Receiving School)

Transcript Request Form

Please initial below to acknowledge that you are the student named above and that you have reviewed the information above and agree that it is accurate. By initialing below you endorse this document as legally binding in accordance with the e-sign bill S.761 and release the below initials in lieu of a signature.
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