REQUEST FOR OUT-OF-ATTENDANCE ZONE PLACEMENT 2020-2021 SCHOOL YEAR
Out of Attendance Zone applications must be renewed every year.  In addition to completing this form, please remember that all requests MUST have the required documentation in order to be considered for Out of Attendance Zone placement.

A committee will be reviewing Out of Attendance Zone applications beginning in June. Parents/ guardians will be informed via email of the outcome reached by OOAZ Committee as reviews are completed.

This request may not be used for Magnet Schools

If you have questions, please contact Dena Booker at dbooker1@stamfordct.gov 

Sign in to Google to save your progress. Learn more
Email *
Name of Student (Last, First) Please complete 1 form per student. *
Today's Date *
Name of Parent/Guardian (Last, First) *
Address (Include # and Street) *
Town *
Zip Code *
Home Phone # *
Cell Phone # *
Work/Other #
Email Address *
District School *
District School Grade *
Current School *
Current School Grade *
Requested School *
Requested School Grade *
Reason for Request: (Please note, once reason is selected only fill out the section that corresponds to your selected reason) *
Required
By checking the boxes below, you understand and will abide by the following conditions for out-of-attendance zone placement for your child. *
Required
Is this application is a renewal request? (Child is currently attending school through Out of Attendance Zone Placement) *
If you are requesting Out-of-Attendance Zone placement for medical/psychological reasons, please explain your request for  below.  
If you are requesting Out-of-Attendance Zone placement for child care issues, please explain your request for Out-of-Attendance Zone placement for child care reasons below.
If you are requesting Out-of-Attendance Zone placement for child care reasons, please email a letter from the employer stating the hours and location of employment.  Please also upload a letter from the child care provider documents his/her residence and schedule of child care.
If you are requesting Out-of-Attendance Zone placement for safety issues, please explain your request for Out-of-Attendance Zone placement for safety issues reasons below.
If you are requesting Out-of-Attendance Zone placement for safety issues, please email any evidence that the student's safety at the school is at risk.
If you are requesting Out-of-Attendance Zone placement for special program reasons, please explain your request for Out-of-Attendance Zone placement for special program reasons below.
If you are requesting Out-of-Attendance Zone placement for special program reasons, please email any evidence that the special program reasons, please upload other evidence that the student is qualified to enroll in a special program.
If you are requesting Out-of-Attendance Zone placement for special program reasons, please email any evidence that school administration has signed off endorsement of this request.
If you are requesting Out-of-Attendance Zone placement for other reasons, please explain your request for Out-of-Attendance Zone placement below.
If you are requesting Out-of-Attendance Zone placement for other reasons, please email any evidence to support your request below.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Stamford Public Schools. Report Abuse
Google Forms