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Brookesmith

INDEPENDENT SCHOOL DISTRICT INDEPENDENT SCHOOL DISTRICT

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Brookesmith Independent School District

P.O. Box 706
Brookesmith, Texas 76827-0706
(325) 643-3700

NONRESIDENT STUDENT REQUEST TO TRANSFER INTO THE BROOKESMITH SCHOOL DISTRICT

Transfer Form

School Year Requesting Transfer

Student's Name Copy

Student's Date of Birth

Reaquired field: Current Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

School district in which student resides

Reaquired field: Bangs ISD

Reaquired field: Brownwood ISD

Reaquired field: Early ISD

Reaquired field: Other

Parent's Name

Reaquired field: Parent's Address

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Work Phone

Home Phone

School district in which student attends

Reaquired field: Bangs ISD

Reaquired field: Brownwood ISD

Reaquired field: Early ISD

Reaquired field: Other

Is either parent employed by the Brookesmith School District?

Reaquired field: Yes

Reaquired field: No

Has the student ever been enrolled in Brookesmith School District?

Reaquired field: Yes

Reaquired field: No

If Yes, What grade or school year?

Student's grade level for year of requested transfer

Reason for transfer request

How many days was the student absent in the school year prior to the year for which a transfer is requested?

If this request is for a transfer during a school year, how many days has the student missed in the current school year?

If the student missed more than ten percent of the days in the school year, please provide an explanation:

Has the student been expelled or removed to a disciplinary alternative education program (DAEP) for one or more days in the most recent school year?

Reaquired field: Yes

Reaquired field: No

Has the student been expelled or removed to a disciplinary alternative education program (DAEP) for one or more days during the preceding year?

Reaquired field: Yes

Reaquired field: No

If yes to either question, for what offense(s)?

Please include the most recent report card.

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By typing my name below. I acknowledge the information provided in this form is true and factual to the best of my knowledge, and I understand that if any of this information is ever found to be incorrect, this application may be denied or revoked.

Date

School Use Only Min: 1

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