School District No. 71 (Comox Valley)
Cross Boundary Transfer Request

As per Board Policy 6000MR1, this form is to be used to request attendance at a school outside the student’s catchment area.A copy of the policy is available from a school, the school board office, or from the school district website (http://sd71.bc.ca).

When you have completed this form, the district office will contact the principals of the schools involved for their recommendation.The superintendent or designate will make a determination and you will be notified of the decision.

Typically, cross boundary requests are considered for the beginning of a school year (September). This request is for:
September
Other, please specify date:   Reason:

Student Information

Legal Last Name as on Birth Certificate:*
Legal First Name:*
Legal Middle Name:
Preferred Last Name:
Preferred First Name:
Street Address:*
City:*
Postal Code:*
P.O. Box:
Home Telephone #:

Parent/Legal Guardian Information

Salutation:* Ms. Mrs. Mr. Miss
Last Name:*
First Name:*
Home Phone #:*
Work Phone #:
Cell #:
E-mail Address:

Parents/guardians – please read and then check each of these conditions:*

For students whose request for transfer has been approved, transportation to and from school is a parent/guardian responsibility I Agree
Because this policy is subject to annual review, parents/guardians need to inquire about the specific deadline for submission of this request I Agree
All cross-boundary placements are governed by SD #71 Board Policy 6000MR1 Regulations I Agree
Once school capacity and availability of space has been determined, the district will declare the school to be:
  1. open with a defined number of spaces, or
  2. closed for cross-boundary and out-of-district applicants
 I Agree
Applications submitted within the established timelines will be grouped by priority category as outlined below.This priority order does not apply to district programs such as French Immersion or to students who have been administratively transferred to schools by the Superintendent of Schools or designate:
  1. Siblings of continuing students in the school whose residence falls outside the school’s catchment area
  2. Students who will attend an academy or specialized program in their non-catchment school
  3. Students whose residence falls within the attendance areas of other SD #71 schools
  4. Students whose residence falls outside the SD #71 School District (out-of-district)
 I Agree

School Information

Name of School Student Currently Attends:* Grade Level:*
Name of School Student is Requesting to Attend:* Grade Level:*

The Principal from the student’s Current school and the Principal of the student’s Requested school will be contacted by School District personnel on your behalf.The status of this request will be made known to you once a decision has been made.

Reason for Transfer

Please indicate the reason(s) why this student is requesting to attend this school: i.e. sports academies, extenuating circumstances ( social, emotional)*

Learning Needs

Does your child receive any additional learning support at your school?* Yes No

If Yes, please describe:

Medical Information

Does your child have any special medical needs that require support or any medical alerts or allergies, etc.?* Yes No

If Yes, please describe:

Sibling Information

Please note the name(s) and grade(s) of any sibling(s) currently attending your requested school:

     

* - Required field