2024-2025 NEW Intra-District (Elementary) Open Enrollment Application

The transfer of a student in the Kent City Schools out if his/her official elementary school of residence shall be in accordance with the district's intradistrict open enrollment policy and regulations.

Requested School

Requested School Davey Elementary Holden Elementary Longcoy Elementary Walls Elementary
Official School of Residence

Official School of Residence Davey Elementary Holden Elementary Longcoy Elementary Walls Elementary
Full Legal Name of Student Full Legal Name of Student First Middle Last
Date of Birth Date of Birth / MM / DD YYYY
Grade Level for the 2024-2025 School Year
Do you have another student applying for Intra-District Open Enrollment?

Do you have another student applying for Intra-District Open Enrollment? No Yes
Full Legal Name of Student Full Legal Name of Student First Middle Last
Date of Birth Date of Birth / MM / DD YYYY
Grade Level for the 2024-2025 School Year
Do you have another student applying for Intra-District Open Enrollment?

Do you have another student applying for Intra-District Open Enrollment? No Yes
Full Legal Name of Student Full Legal Name of Student First Middle Last
Date of Birth Date of Birth / MM / DD YYYY
Grade Level for the 2024-2025 School Year
Do you have another student applying for Intra-District Open Enrollment?

Do you have another student applying for Intra-District Open Enrollment? No Yes
Full Legal Name of Student Full Legal Name of Student First Middle Last
Date of Birth Date of Birth / MM / DD YYYY
Grade Level for the 2024-2025 School Year
Parent/Guardian's Name Parent/Guardian's Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Zip
Primary Phone number Primary Phone number - ### - ### ####
Work Phone Work Phone - ### - ### ####
Alternate Number Alternate Number - ### - ### ####
Email address
Please summarize the specific reasons why you are requesting this transfer.
Name of the person completing this form
Transportation for students accepted in the intradistrict open enrollment plan will be the sole responsibility of the parent/guardian. However, with the approval of the Transportation Supervisor, existing bus stops may be utilized on a space-avilable basis when convenient to assist in this process. If the regularly established stops are unavailable to transport your child to the requested school, are you willing and able to provide transportation?

Transportation for students accepted in the intradistrict open enrollment plan will be the sole responsibility of the parent/guardian. However, with the approval of the Transportation Supervisor, existing bus stops may be utilized on a space-avilable basis when convenient to assist in this process. If the regularly established stops are unavailable to transport your child to the requested school, are you willing and able to provide transportation? Yes No (This would jeopardize the approval of your application).
Policies and procedures for this one year application.

Policies and procedures for this one year application. I have read the stipulations of the itradistrict open enrollment plan and agree to abide by the procedures and policies that have been established. I understand that approval of this request is for one shcool year only.
Parent/Guardian

Parent/Guardian I confirm that I am the custodial parent/guardian of the student listed on this form
Please click the word "Type" to the right, and type your full name into the box for your signature.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.