INTERDISTRICT TRANSFER AGREEMENTInterdistrict Transfer Agreement • December 17th, 2022
Contract Type FiledDecember 17th, 2022STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year20 — 20 Grade Requested Date of Request Student Name (Last, First) Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non-‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all that apply. S
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • January 4th, 2021
Contract Type FiledJanuary 4th, 2021STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year2024-2025 School Year Future year 20 - 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • January 4th, 2021
Contract Type FiledJanuary 4th, 2021STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year2023-2024 School Year Future year 20 - 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of ResidenceSimi Valley Unified School District School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • January 4th, 2021
Contract Type FiledJanuary 4th, 2021STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year2023-2024 School Year Future year 20 - 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • January 4th, 2021
Contract Type FiledJanuary 4th, 2021STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year2023-2024 School Year Future year 20 - 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of ResidenceSimi Valley Unified School District School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • January 4th, 2021
Contract Type FiledJanuary 4th, 2021STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year2024-2025 School Year Future year 20 - 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of ResidenceSimi Valley Unified School District School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all th
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all th
INTERDISTRICT TRANSFER AGREEMENTInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of ResidenceMoorpark Unified School District School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all th
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all th
INTERDISTRICT TRANSFER AGREEMENTInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all th
INTERDISTRICT TRANSFER AGREEMENTInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all th
INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • September 27th, 2011
Contract Type FiledSeptember 27th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) † Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all th
INTERDISTRICT TRANSFER AGREEMENTInterdistrict Transfer Agreement • July 8th, 2011
Contract Type FiledJuly 8th, 2011STEP 1: To be completed by parent/guardian (Please print) New Application Renewal School Year: Current year Future year 20 — 20 Grade Requested Date of Request Student Name (Last, First) Birth Date GenderMale Female Current or Last School of Attendance Current or Last District of Attendance School of Residence District of Residence School Requested District Requested Parent/Guardian Name Contact Numbers: Home: Address Work: Cell: City/Zip Email Address: Is the student currently pending disciplinary action or under an expulsion order? Yes No What special services has the student received? (Check all that apply and attach proof of enrollment in the special program.) Gifted (GATE) Section 504 Special Education English Language Learner If the student is receiving Special Education services, what is their current placement? (Please attach IEP.) Special Day (SDC) Resource (RSP) Non‐Public School (NPS) Pending Assessment What is/are the reason(s) for the request? (Check all that