Renewal New Change of Address
PLEASE NOTE: Alpac, Arthur Jacobsen, Dick Scobee, Evergreen Heights, Hazelwood, Ilalko, Lakeland Hills, Lea Hill, Washington, Mount
Baker, and Rainier have been closed to new out of area transfer requests by the Auburn School Board for the 2020-21 school year.
Name of Student (Last, First, Middle):
Resident Address (Street, City, State, Zipcode):
Mailing Address: Email Address:
Contact Phone: Grade in 2020-21: Date of Birth:
School Requested: Resident School:
Last School Attended: Phone:
(If last school was not in the Auburn School District, attach copy of current year discipline and attendance record)
REASON FOR REQUEST:
HEALTH CONDITION – Describe briefly:
EDUCATIONAL PROGRAM – Course(s) name:
EMPLOYMENT (parent or student works in the area):
DAYCARE – Childcare/Daycare address:
HARDSHIP – Describe briefly:
OTHER – Describe briefly:
Is your student currently receiving special education services? Yes___No___ 504 Plan? Yes___No___
If yes, approval is required by the Executive Director of Student Special Services at the Administrative Annex Bldg. You must attach a copy of
your student’s current IEP and evaluation report or 504 plan.
Has your student been expelled, emergency expelled, or long-term suspended? Yes____No____ If yes, you must submit documentation of
discipline, attendance and academic histories to the school requested for review prior to the further processing of this application. Student
behavior that results in out-of-school suspensions or expulsion; ongoing truancy, or excessive absences, may result in the cancellation of the
waiver agreement. This application may be denied if the non-resident student has a history of convictions, violent or disruptive behavior, gang
membership, OR has been expelled or suspended from school for more than ten consecutive days.
The following conditions will apply:
• A Release of Attendance from resident school district MUST be provided and submitted with this waiver application.
• It is the responsibility of the parent/guardian to provide transportation for their student.
• High school students who are granted a non-resident waiver are not eligible to participate in varsity athletics for one year
after being enrolled in their new school.
• Waiver transfers may only take place at the beginning of a grading period and must be renewed annually.
• NOTE: Waiver requests shall be considered upon availability of space at the requested school. Requests received
at the start of the school year may be held for up to 2 weeks after the first day of school to monitor enrollment
capacity.
Parent/Guardian Signature____________________________Print Name____________________________Date_________________
FOR OFFICE USE ONLY
Principal Recommendation: Yes No
Comments______________________________________ Principal Signature Date
_______________________________________________________________________ _____________
Signature of Assistant Superintendent or Director of Student Special Services Date
Approved Denied
If you believe that the school board policy has not been followed, you have the right to appeal. Please call 253-931-4712. For
students receiving special education or 504 services, contact Student Special Services, at 253-931-4927.
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ATTENDANCE AREA TRANSFER APPLICATION
ASD Board Policy No. 3141
(for students who live out-of-district and wish to
attend a school in the Auburn School District)
click to sign
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