INTERDISTRICT TRANSFER AGREEMENT FOR SCHOOL DISTRICTS IN VENTURA COUNTYInterdistrict Transfer Agreement • April 1st, 2019
Contract Type FiledApril 1st, 2019STEP 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