Etiwanda School District   "Excellence in Education"
   6061 East Avenue, Etiwanda, CA 91739
   (909) 899-2451  Fax (909) 899-1235
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Request for Intradistrict Transfer

****NOTE****
If you are currently on an approved interdistrict transfer to the Etiwanda School District and want to request another site within
 our district, you must complete a hardcopy at the Etiwanda Educational Center located at 6061 East Avenue, Etiwanda, CA 91739.

 

 

PLEASE PRINT ALL INFORMATION

     

    (Fill out one form for each student)

ETIWANDA SCHOOL DISTRICT

6061 East Avenue, Etiwanda, CA 91739

"REQUEST FOR INTRADISTRICT TRANSFER"

Please check if this is a New transfer   or a Renewal (if applicable)  

School Year Requested:

Name of Student:   Male    Female

Grade for year requested:   Age:  Birthdate:                                 Home Phone:

Parent/Guardian:                   Work Phone:

Address:   City:   ZIP:

Email Address:

My resident school is:

I am currently attending:

I am requesting attendance at:

Reason for transfer: Please be specific (I.E. employee, including location and position...): Max 1000 Characters

THE FOLLOWING MUST BE COMPLETED

Is student in Special Education Classes?  Yes    No              If yes, which program? RSP   SDC  

Is student receiving speech services? Yes    No        

Is student identified as Section 504?  Yes    No                                                       

Intradistrict transfers are granted upon space availability, review of the students conduct and discipline, punctuality, attendance and parental support of the school’s educational program. The Intradistrict transfer is valid while conditions stated are maintained. I understand that this transfer can be revoked at anytime if district standards of student conduct and discipline, punctuality, attendance, and parental support of the school’s educational program are not maintained or falsification of information is given, or for any other reasons as determined by district policy. I also understand that I must provide transportation to attend the school requested.

Signature (Please type your full name)                              Date:


Etiwanda School District