NONRESIDENT AGREEMENTNonresident Agreement • September 29th, 2014
Contract Type FiledSeptember 29th, 2014Student’s Last Name First Name Middle Name School Year Grade Student’s Address Apt. No. City Zip Code Student Racial/Ethnicity (Check one only)American Indian Asian oror Alaskan Native Pacific Islander Hispanic Black, not of White, not of Hispanic Origin Hispanic Origin Student’s Birthdate Gender M F Mo. Day Year Parent or Guardian Last Name(s) First Name(s) Middle Initial H:W: Phone(s) Parents Address (if dirrerent from Student’s) Apt. No. City Zip Code: Reason this transfer is requested: New Address SERVING School District Name Delano District Number879 School Student Would Attend Date Student Moved Has student been receiving Special Education Services?Yes No Mo Day Year RESIDENT School District Name DistrictNumber School Most RecentlyAttended Signature of Parent/Guardian The above information is true and correct to the best of my belief and knowledge. Date Signed