INTER/INTRA DISTRICT TRANSFER AGREEMENTInter/Intra District Transfer Agreement • July 9th, 2024
Transfer requested for: □ Current school year 20 ‐ 20 Grade □ Next school year 20 ‐ 20 Grade Date of Request Student Name (Last, First) Birth Date Gender□ M □ F Current or Last School of Attendance Current or Last District of Attendance School of Residence District of ResidenceLJSD School Requested District Requested Parent/Guardian Name Contact Number Email Address Alternate Number Address City/Zip 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 □ None If student is receiving Special Education services, what is their current placement? (Please attach IEP) □ None□ Special Day (SDC) □ Resource (RSP) □ Speech or Vision □ Pending Assessment □ Other What is the reason for the request? Please provide supporting documentation.□ Moved to LJSD durin
