2022 Out of Area Request Form

The deadline for submission of new requests is June 1, 2022.

Student must be enrolled in required TCPS attendance zone school prior to submitting application if this is an initial request. Applications submitted after June 1st will not be accepted unless the student is new to TCPS or there is a bona fide emergency or event that could not have been foreseen prior to June 1st. Childcare information/verification must be complete if that is the reason for the request. Applications must be submitted and renewed yearly for continued attendance out of area. Continued approval is not guaranteed from year to year. A separate form must be filled out for each child.

*** Transportation to and from school will be your responsibility. ***

Type of request *

Type of request This would be a new school for my child My child already attends requested school
Student Name Student Name * First Last
Student Date of Birth Student Date of Birth * / MM / DD YYYY
Grade entering for requested year *
Student's Street Address *
City *
Zip Code *
Does your student receive Special Education services? *

Does your student receive Special Education services? Yes No
Does your student have a 504 plan? *

Does your student have a 504 plan? Yes No
Mother/Guardian Name Mother/Guardian Name * First Last
Mother/Guardian Street Address *
City *
Zip Code *
Mother/Guardian's Phone Number Mother/Guardian's Phone Number * - ### - ### ####
Mother/Guardian's Email Address *
Father/Guardian's Name Father/Guardian's Name * First Last
Father/Guardian Street Address *
City *
Zip Code *
Father/Guardian's Phone Number Father/Guardian's Phone Number * - ### - ### ####
Father/Guardian's Email Address *
Reason for Request:
School child should attend based on address: *
Out of Area School you would like your child to attend: *
I am a TCPS Employee *

I am a TCPS Employee Yes No
CHILDCARE VERIFICATION

This section must be completed if childcare is the reason for request.
Name of person providing care:
Phone number of person providing care: Phone number of person providing care: - ### - ### ####
Address of person providing care: Address of person providing care:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Upload a letter or other information related to your request.

Attach Files
PLEASE READ BEFORE SIGNING

It is the intention of the Board of Education to further study enrollment trends. If it is necessary to change policy for next year, an early decision will be made to allow adequate planning. Please review Policy 10.10 and 10.10 AR for additional information.

TRANSPORTATION TO AND FROM SCHOOL WILL BE YOUR RESPONSIBILITY.

I hereby declare and affirm under penalties of perjury that the information provided above is true and correct to the best of my information, knowledge, and belief. I understand and agree that if false information of provided, the out-of-zone placement will be denied or revoked.
Draw your signature into the box below.

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.
Today's Date Today's Date / MM / DD YYYY

2022 Out of Area Request Form

2022 Out of Area Request Form

CHILDCARE VERIFICATION

PLEASE READ BEFORE SIGNING