Student Information

Student Last Name:


Student First Name:


Student Middle Name:


Student Date of Birth:


Student Gender:
Male
Female
Non-Binary


Grade Level Applying to Attend:
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th




Does your student have a sibling currently attending TVUSD schools?
Yes
No

Sibling Information

Sibling Name:


Sibling Grade Level:


Sibling School Site:
Tanque Verde High School
Emily Gray Junior High
Agua Caliente Elementary School
Tanque Verde Elementary School

Parent/Guardian Information

Last Name:


First Name:


Street Address:


City:


State:
Please Choose... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code:


Email Address:


Phone Number:


Is either parent or legal guardian an employee of TVUSD?
Yes
No

Parent/Guardian Employee

Employee Work Site:
Tanque Verde High School
Emily Gray Junior High
Agua Caliente Elementary School
Tanque Verde Elementary School
District Office
Transportation

First and last name of Parent or legal guardian employed by TVUSD:

Educational Needs

Has your student been enrolled in or in need of any Gifted services?
Yes
No
Has your student ever been considered for retention?
Yes
No

Special Education Service Needs

Has the student ever had an Individualized Education Program (IEP) or a 504 plan?
Yes
No

Has the student received any special services but does not have an IEP?
Yes
No

Has the student ever been evaluated for special education services?
Yes
No

Other Service Needs

Does the student have any chronic health issues that might require special nursing and or health services?
Yes
No

If you answered YES, please explain:

Student Background Information

Current School and District the student is attending:


Within the past 24 months, has your student been expelled, long-term suspended or placed on a formal behavior plan from any school or school district?
Yes
No

Within the past 24 months, has your student withdrawn from a school or school district because of an imminent or potential expulsion or an imminent or potential suspension?
Yes
No

Within the past 24 months, has your student not been in full compliance with any condition imposed as disciplinary action or imposed in lieu of disciplinary action by a school or school district?
Yes
No

Within the past 24 months, has your student been adjudicated a delinquent or been convicted of a crime?
Yes
No

Within the past 24 months, has your student not been in full compliance with any condition imposed by a juvenile court?
Yes
No

Within the past 24 months, has your student had a record of excessive absences, truancies or tardies (10 or more)?
Yes
No

If you answered YES to any of the above questions, please explain:

Attestation

I attest that this student is in good standing at his/her current and previous schools and is eligible to return to such school.
Yes
No

I further attest to the truthfulness and accuracy of the information provided in this application form. I understand that false or misleading information may result in the denial of this Open Enrollment application form or the revocation of the student's status as an Open Enrollment student.
Yes
No

If my child is accepted, I affirm that my child will abide by the rules, standards, conditions and policies of the school and the District.
Yes
No

If you answered NO to any of the above questions, please explain: