2022-2023 13.96 First Time Hardship Out of Zone Transfer Application

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VALID FOR 2022-2023 SCHOOL YEAR ONLY

Student's Last Name *

Student's First Name *

Student's Middle Name

Student ID Number *

Grade in 2022-2023 School Year *

Residence Street Address *

City *

Zip Code *

Current School (2021-2022) *

2022-2023 Zoned School *

2022-2023 Requested School *

Parent/Guardian First & Last Name *

Parent/Legal Guardian Email Address *

Home Phone Number

Work Phone Number *

Cell Phone Number *

Is your child currently staffed in a Exceptional Education Program? *

Yes

If YES, what program?

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