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Application for Admission of Non-Resident Student

Click on the Tiger to View Policy "JFBB-R" on Inter-District Choice/Open Enrollment

Thank you for your interest in Bennett School District 29J!

Please complete the following Student and School information on the form below. Required fields are marked with an asterisk *. If you have any questions please contact:

Sharron Coover

303-644-3234 Ext 7216

[email protected]

STUDENT INFORMATION

First Name*

Answer Required

Middle Name If your student has no middle name please use NMN *

Answer Required

Last Name*

Answer Required

Birth Date*

Answer Required

Current Grade Level*

Answer Required

Mailing Address

P.O. Box*

Answer Required

City*

Answer Required

Zip/Postal*

Answer Required

Physical Address (if different from Mailing Address)

Street Address*

Answer Required

City*

Answer Required

Zip/Postal

Answer Required

Parent/Gaurdian Contact Information

First Name*

Answer Required

Last Name*

Answer Required

Email 1*

Answer Required

Primary Phone*

Number Required

Secondary Phone

Number Required

CURRENT SCHOOL INFORMATION

Current School Name*

Answer Required

Dates From/To (Month & Year)*

Answer Required

Mailing Address of School

Street Address

Answer Required

City*

Answer Required

Zip/Postal

Answer Required

Phone Number*

Number Required

Name of Principal*

Answer Required

PREVIOUS SCHOOL INFORMATION

Name of Previous School (if applicable)

Answer Required

Dates From/To (Month & Year)

Answer Required

Address of Previous School

Mailing Address of School

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Phone Number

Number Required

Name of Principal

Answer Required

ATTENDANCE/DISCIPLINE INFORMATION

The following questions pertain to the student listed above.

Is this student currently suspended or expelled from any public or private school?*

Answer Required

Yes

How many school days has this student missed in the past 12 months?*

Answer Required

How many were excused absences?*

Answer Required

How many were unexcused absences?*

Answer Required

EXTRA-CURRICULAR ACTIVITIES

Please list any extra-curricular activities in which this student participates in.

Answer Required

Is there any additional information or explanations that you would like to supply?

Answer Required

Please explain why you wish to have your student attend Bennett School District 29J?*

Answer Required

FOR OFFICE USE ONLY

Notes from Adminstrator:

Approval of non-resident student enrollment

Answer Required

Yes

Signature of Administrator____________________________________________ Date_____________________

Confirmation Email

Email Required