2023-24 Student Transfer Request Form
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Parent's Last Name *
Parent's First Name *
PO Box Number (if applicable)
Street or Road Number & Name *
City *
Zip *
Home Phone Number
Cell Phone Number *
Email address *
Check the appropriate box that applied: *
Required
Name of your current assigned school district: *
USD # *
Current school building phone # *
Name of Principal *
Check the school you wish to attend in USD 252: *
Student's Last Name *
Student's First Name *
Grade Student Will Enter
Did the student meet or exceed standards in the most recent Math State Assessment Test? *
Did the student meet or exceed standards in the most recent Reading State Assessment Test? *
Is the student currently under suspension *
Has the students ever been suspended from school  (ISS or OSS)? *
If you answered yes to the previous question, please list each suspension by date and why the student was suspended.
Reason for transfer request: *
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