2021/2022 Open Enrollment Application

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

Full day or half day?
Full

Note: Full day is the only option at this time.

Please indicate your first choice of schoolapplying to attend:
Tanque Verde Elementary School
Agua Caliente Elementary School

High School Requrement

All high school applications must include the student’s transcript (grades 10-12) OR a copy of the student’s most recent report card (grade 9).

You did not choose a valid file type. Please try again.

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:

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

To help us determine our capacity to serve your child, please provide the following information:

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

The following questions help us to determine our capacity to serve your child.

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

If you answered YES, a copy of the most current IEP or 504 must be submitted with the application. TVUSD views all applications as INVALID if the complete document is not received with the application.

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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

If you answered YES, a copy of the evaluation must be submitted with the application. TVUSD views all applications as INVALID if the evaluation is not received with the application.

You did not choose a valid file type. Please try again.

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

TVUSD may refuse to admit any pupil who has been expelled from another educational institution or who is in the process of being expelled from another educational institution.

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:

2021/2022 Open Enrollment Application

Creating Pathways to Success!

2021/2022 Open Enrollment Application

Tanque Verde Unified School District Open Enrollment Application

Student Information

High School Requrement

Sibling Information

Parent/Guardian Information

Parent/Guardian Employee

Educational Needs

Special Education Service Needs

Other Service Needs

Student Background Information

Attestation