Non-Resident Transfer Request

Request to transfer your student from another district to Peninsula School District.

OFFICE OF THE CHIEF OF SCHOOLS

School Year

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Student Last Name

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Student First Name

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Student Date of Birth

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Student Grade (transfer year)

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Type of Transfer

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Student Residence Address, City, Zip

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Currently Attending School

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Requested PSD School

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Parent/Guardian Full Name

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Parent/Guardian Email

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Parent/Guardian Phone

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Receiving Special Education Services?

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If yes, describe Special Education services

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Reason for Transfer Request

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Attendance, grades, or disciplinary matters at current school?

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If yes, describe

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Acknowledgements

I understand that providing false or misleading information may result in refusing or terminating admission.
Approval depends on the acceptance and rejection standards of the nonresident district.
My student must continue attending the resident school until the effective start date of transfer.
I am responsible for providing transportation unless required under Section 504/IDEA.
Requests are approved for one school year only; I must submit a new form each year.

I acknowledge the above

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Form Submitted