Ne
w 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, Zip Code):
Mailing Address: Email Address:
Contact Phone Number: 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.
Note: If your child is in an Auburn School District ECE, Adaptive Behavior, Structured Learning program or enrolled in the
STEP Program at Terminal Park, a transfer request may not be necessary.
• Student will follow rules and regulations applicable to all students. Student behavior that results in out-of-school suspensions or
expulsion; ongoing truancy, or excessive absences, may result in the revocation of the Attendance Area Transfer.
• When a student has been accepted on an Attendance Area Transfer to the requested school, the resident student may
continue there without reapplying, as long as attendance, grades, and behavior are satisfactory. Students must reappl
y
w
hen moving from elementary to middle school, or middle school to high school.
• It is the responsibility of the parent/guardian to provide transportation for their student, and student will be held to hig
h
s
tandards of academic progress, behavior, and attendance in order to maintain this transfer.
• The student will not need to apply again as long as he/she attends this building, however, parent may rescind the transfer at
their own discretion.
• NOTE: Transfer requests shall be considered upon availability of space at the requested school. Requests received at th
e
s
tart 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
915 4
th
St NE; Auburn, WA
RESIDENT STUDENTS
ATTENDANCE AREA TRANSFER APPLICATION
ASD Board Policy No. 3131
(for ASD students who wish to attend a school
other than neighborhood school)
2020-2021 SCHOOL YEAR
click to sign
signature
click to edit
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click to sign
signature
click to edit
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click to sign
signature
click to edit
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