CHINO VALLEY UNIFIED SCHOOL DISTRICT NO by xL11v3Q5

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									                                  CHINO VALLEY UNIFIED SCHOOL DISTRICT NO.51
                                         OPEN ENROLLMENT APPLICATION




 Students Name                                                                                    Grade
 Date of Birth                                      Home Phone                             Work Phone
 Parent/ Guardians Name
 Home Address                                                         City                                     Zip
 Present School of Attendance                                            District of Residence
                                     Resides outside the School District; or
 The above-named student:            Resides within the School District
                                     In-District School:

 Is the above named child currently expelled, suspended, being considered for expulsion/suspension, or being withdrawn to avoid
 expulsion/suspension from any school or district?
     No          Yes (please explain circumstances on reverse)
Is the above-named child currently on probation or under conditions imposed by a juvenile court?

     No          Yes (please explain circumstances on reverse)

                 The signatory affirms that open enrollment in Chino Valley Unified School District is
                 conditional on the following:

                               Enrollment is subject to capacity limits established for the school and/or grade
                                level.
                               An attendance application must be completed and submitted on or before May
                                15.
                               Transportation to and from school may be the responsibility of the
                                parent/guardian (except as provided by statute).
                               On or before August 1, the parent or legal guardian will be notified in writing
                                whether the application has been accepted, rejected, or placed on a waiting list.
                               Providing false information on this form may result in the application being
                                denied or open enrollment being revoked.
                               The signatory affirms that the student will abide by the rules, standards, and
                                policies of the school and the District if enrolled.
 Signature of Parent/Guardian                                                                           Date

                                                    For District Use Only

    Accepted___ Waiting List___ Rejected___ Reason for rejection___________________________________

    Site Principal Signature______________________________________________

    Determination copy sent by school to applicant (Date)_________________

   Date copy sent District Superintendent’s Office ___________________

								
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