SONOMA COUNTY INTERDISTRICT TRANSFER AGREEMENTInterdistrict Transfer Agreement • February 3rd, 2012
Contract Type FiledFebruary 3rd, 2012Transfer requested for : New student Current school year Current grade: Continuing student Next school year Next grade: 20 - 20 Date of Request Student Name (Last, First) Birth Date 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 Number: Home Work Cell Email Address Contact Number: Home Work Cell Address City/Zip Is the student currently pending disciplinary action or under an expulsion order? Yes No Does this student currently receive special education or other special services, such as section 504? (Attach current IEP or 504 plan) Yes, Section 504 Yes, Special Education Yes, Speech/RSP No, Does Not Apply Other: What is/are the reason(s) for the request? Requests will be considered based on local board policies. Please provide written(Check all that apply)Bullying (priority given) Complete Final Year at Current School Health & SafetyContinuing Enrollme
SONOMA COUNTY INTERDISTRICT TRANSFER AGREEMENTInterdistrict Transfer Agreement • February 3rd, 2012
Contract Type FiledFebruary 3rd, 2012Transfer requested for : New student Current school year Current grade: Continuing student Next school year Next grade: 20 - 20 Date of Request Student Name (Last, First) Birth Date 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 Number: Home Work Cell Email Address Contact Number: Home Work Cell Address City/Zip Is the student currently pending disciplinary action or under an expulsion order? Yes No Does this student currently receive special education or other special services, such as section 504? (Attach current IEP or 504 plan) Yes, Section 504 Yes, Special Education Yes, Speech/RSP No, Does Not Apply Other: What is/are the reason(s) for the request? Please provide written documentation/evidence. (Check all that appBullying (priority given) Complete Final Year at Current School Health & SafetyContinuing Enrollment Recommended by SARB Proposed Chang