Revised 12/10/2200
FREDERICK COUNTY PUBLIC SCHOOLS
OUT OF DISTRICT (ATTENDANCE) AREA APPLICATION
IN ACCORDANCE WITH REGULATION 400-15
If you have any questions please call: 240-236-2493 or email: outofdistrict@fcps.org
Student’s Legal Name (No nicknames)
Request is for the school year
Grade child will be in during the school year requested above:
(For PRE-K contact Early Education Office 301-696-6864)
Contact Information (whom the child resides with):
Name of most recent school attended:
Name of school the student should attend (from your address):
Name of school requested to attend:
The Out of District request must meet one of the established reasons listed in FCPS Regulation 400-15 to be considered for
approval. If there is willful misrepresentation of information, the request will be denied or the approval will be revoked, and the
child will be assigned to his/her home district school. (Check appropriate reason below.)
Acceptance in Academy or Signature Program: Name of Program:
Childcare - K thru 8
th
ONLY
Childcare Provider’s Name:
Childcare Provider’s Address:
Street Address City Zip Code
Childcare Provider’s Phone Number:
Psychological/Health – Must provide written recommendation to support request from medical professional (must have an established therapeutic
relationship with student for psychological requests). Send documentation with application to outofdistrict@fcps.org in PDF format.
Relocation into the requested school district – Must provide verification of bona fide plans to move into requested school district (copy of
signed lease, copy of signed contract etc). Send documentation with application to outofdistrict@fcps.org in PDF format.
Child of Benefitted Employee –Name of Benefitted Employee:
Provide School/Office of Employment of Benefitted Employee:
Remainder of Current School Year – Student has completed the first two quarters of the school year, has moved, but desires to complete the school
year in his/her current school.
Other -Give specific reasons for this request (see FCPS Reg. No. 400-15):
(Continue on another sheet and send with application to outofdistrict@fcps.org in PDF format.)
FOR OFFICE USE ONLY: Approved Denied PPW: Date: Comments: .
Note: If request is granted to attend a different school, applicant must complete enrollment in the approved school and provide a current proof
of residency. FOR ALL OUT OF DISTRICT APPROVALS TRANSPORTATION FOR THE STUDENT MUST ALSO BE PROVIDED BY THE
APPLICANT.
EXCEPTION for transportation: Transportation will only be provided to/from daycare providers within the school district.
Otherwise, it is the responsibility of the parent/guardian to provide transportation for the student(s) to the approved out-of-district school.
I have read and understand these conditions and Regulation 400-15:
APPLICATIONS WITHOUT A SIGNATURE WILL NOT BE PROCESSED. Parent/Guardian Signature Date
by typing your name here, you accept the terms of the application.
