2025-26 Intra-District Transfer Application

Student Name

First NameLast Name
What is the student's grade for the 2025-2026 school year?
What is the student's gender?
What is the student's race?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Home Phone
Cell Phone
Parent/Guardian Name
Parent Email
example@example.com
Does this student receive Special Education?

YesNo
Does this student receive 504 Services?

YesNo
What is your zoned school?
What NLRSD school is your first choice?
What NLRSD school is your second choice?
What NLRSD school is your third choice?
Explain briefly your reason for requesting this transfer (attach an additional sheet if necessary)
Upon approval, your child will be allowed to remain until they have completed the highest grade level at that school. TRANSPORTATION IS NOT PROVIDED.

Please provide the school with the following information:

* Birth Certificate Immunization

* Special Education Papers Transcript

NOTE: During the first two weeks of school, all elementary school assignments are tentative. This permission may be revoked due to excessive unexcused tardiness or abscences.
Signature

Clear
Date

MonthDayYear
Date
Should be Empty: