Request for Re-Assignment of Designated
School Attendance Area Due To Change in Residence
Directions: Please fill in all fields of this form and then click on Submit. The form will be routed to the Principal of the Elementary School for the area that you currently reside in. You will receive an email from the district informing you of approval or denial within 5 business days of this request. All requests for the following year must be turned in by
May 1st.
Re-assignment requests are only approved for one (1) school year.
Student Name:
Parent(s)/Guardian(s):
Parent Email:
Address:
Phone:
The grade of your student for the requested year:
What Elementary School does your child currently attend:
None
Halmstad
Hillcrest
Jim Falls
Parkview
Southview
Stillson
Appeal
None
What Elementary School currently serves the area that you live:
Halmstad
Hillcrest
Jim Falls
Parkview
Southview
Stillson
Appeal
None
What Elementary School are you requesting to attend:
Halmstad
Hillcrest
Jim Falls
Parkview
Southview
Stillson
Appeal
None
When are you requesting to start attending this school:
School Year:
Please provide the justification for this request:
Are you able to provide transportation to and from the requested school?
Yes
No
I understand that by checking this box and typing my full name, it constitutes a legal signature confirming that the information submitted is accurate.
Parent Signature:
Date Submitted: