Creswell School District                                                                                   IGBHA-AR3

998 A Street

Creswell  OR  97426-9633

541-895-6000 phone /fax 541-895-6019





                 Student’s Name




504 Plan

ELL Services

TAG Services


IEP Services




Yes    No



Yes    No


Yes    No



Yes      No



Yes    No


Requesting a Transfer from Resident School, _________________________ , in the Resident School District, _________________________ , where the student or parent currently reside.  The student currently attends/last attended                                                           school.  If last attended, when                


Requesting a Transfer to Receiving School, _________________________ , in the Creswell School District for the 200___ -- 200___ school year.


Parent /Guardian Name(s): _______________________________________________________________


Legal Resident Address: _________________________________________________________________

                                Street                                                      City                                        Zip


Mailing Address (if different): ____________________________________________________________

                                    P.O. Box                                                City                                        Zip


Home Phone: ________________   Work Phone: ________________   Msg Phone:_____________


Reason for Request?  Be as specific as possible, attach a letter if needed:  ____________________________




I understand and agree to the conditions listed on the attached guidelines. I attest that the information provided on this form is truthful and accurate. I understand that if this information found to not be accurate I will be held liable for payment of student tuition.


________________________________________                _____________________________

Parent/Guardian Signature                                                                                Date

signature indicates you have read the attached guidelines



I agree to accept the above named student pending the Superintendent’s or Designee’s approval:



Signature Receiving School Principal or Designee



#1: Resident District

r Approved                                                             r Denied


Superintendent’s or Designee’s Signature                     Date




#2: Receiving or Host District

r      Approved                                                              r Denied


Superintendent’s or Designee’s Signature                    Date


Reason/ Conditions:                                                                   



     _____/_____/_____   Date Received by District       Student ID # _______________       DB                LTR                     eSis                                    (OVER)



Declaration Under Penalty of Tuition Payment



I,                                                                                                                             , am the parent/legal guardian/person in parental


relationship of                                                                                      .



I declare that this student is not living temporarily in this school district for the primary purpose of attending a district school.  I declare that he/she resides with me within district boundaries at:



(physical, street address)



This is a true statement and I understand the district relies upon this statement to establish residency for this child to attend a district school.


Knowingly submitting a false declaration may subject me to responsibility to pay tuition for the dates of attendance in which my child did not legally reside within the District and ineligibility of the child to attend the District school.




Signature of parent/guardian/person in parental relationship                                                                    Date










District Acknowledgement:


The District has reviewed the Notice and accepts the representations in this Notice as true.







Admissions Representative                                                                                                                               Date




I understand that the Resident District, by Oregon Law and/or District Policy, may refuse a transfer request.  I understand that the Host or Receiving District reserves the right to deny or revoke permission for an Inter-District Transfer student to attend the Host School.  The approval of an Inter-District Transfer does not create any right to attend the Host School, even for the remainder of a current school year.  The Superintendent or designee may revoke permission to attend the Host School for a student whose conduct, attendance, or academic efforts are not satisfactory:

Ř                   Inter-District Transfer Requests must be made annually;

Ř                   Host District may require an interview with the student and legal guardian prior to making a determination,

Ř                   Student must maintain regular school attendance of at least _____ % or better;

Ř                   Student must continue to develop in the school program(s), submit schoolwork on time, honor the Student Code of Conduct, and submit to any host school criteria.

Ř                   Parent and/or Legal Guardian is responsible for transportation to and from school;

Ř                   If the above named student is eligible for Special Education Services, the Resident and Host Districts will convene an IEP meeting to determine placement and funding responsibility for said student;

Ř                   The Resident District will release State Basic Funds to the Host District for the time the student is enrolled at the Host School.


High School students, please note:  Inter-District transfer can affect interscholastic eligibility for those activities governed by OSAA (Oregon State Activities Association).  Student and legal guardian should investigate OSAA regulations prior to transferring.




Students are expected to pre-register and complete final registration for the school in their attendance area even though a request for transfer has been submitted.  Also, these students may not sign up for or practice with athletic teams or other activity groups in the school where they want to attend until the transfer is approved and eligibility is determined. 




1.                   Transfer applications from students who do not reside in the Creswell School District will be accepted beginning the first school day of January for the upcoming school year.


2.                   A lottery drawing will occur after the last school day in January.  Applications are placed on a three-tier waiting list and assigned a number by lottery draw.  Returning seniors will receive top priority (tier one).  Students who attended Creswell Schools during the previous school year and are requesting to return to a Creswell school for the next school year will be given priority (tier two) over new applicants (tier three).


3.                   Applications received after the last school day in January will be assigned to the waiting list in the order they are received.




              The school district is committed to transferring students to a school requested by their parents.  Inter-District transfers are permitted on a one-for-one student exchange ONLY between the transferring student’s resident district and the Creswell School District.


              Students who live or whose parent/legal guardian live outside the Creswell School District attendance boundaries are required to apply each year. 


              Parents will be notified in writing when a transfer is approved or denied.  The review of transfer requests and notification is a continuous process through the second week of school.


              Parents are reminded that this transfer application, if approved, will allow the student to complete an academic transfer, but does NOT guarantee eligibility to participate in competitive interscholastic activities at the receiving school.  Competitive eligibility is determined by Oregon School Activities Association (OSAA) rules.  If you have questions about OSAA eligibility, contact the activities or athletic director at the receiving school prior to completing the transfer.


              An approved transfer does not establish a priority for younger students wishing to attend the same school as an older sibling.  Each request is considered on a case by case basis regardless of the number of children in the family.


              During the school year, applications are reviewed two weeks prior to the end of each quarter.  However, applications may be processed immediately if:


                a.             an exchange is available and both districts agree to allow immediate transfer.


                b.             a previously approved student is dropped from the exchange list.


              Transfers will not be considered if the reason for the request is to participate in extra curricular activities.


              Only one transfer per student is considered during the school year.


              Students remain on the waiting list for the school year of the transfer request.  If a transfer is not available during the school year, parents may reapply for the next school year.


              A transfer may be revoked at any time for poor student behavior, poor grades, tardiness, absenteeism or for any other violation of the terms of the transfer.


              The parent/guardian must provide transportation for approved student transfers to and from school and for all athletics, extra curricular activities and after school activities.




Students shall, at no extra cost be enrolled in the district which their parent/legal guardian reside.  Students whose legal residence is outside the school district boundaries may be admitted through a inter-district transfer approval at no cost or by paying tuition.  An inter-district transfer requires approval from both the resident and host districts.


Guardians may be required to furnish copies of court orders appointing them as guardians.  Persons in a parental relationship will be required to sign an affidavit that the student has no living parent and/or legal guardian, or that there are special circumstances that disqualify the parent from serving the role of parent.


Parents/guardians may be required to submit proof of residency (i.e., copy of rental or escrow papers, current utility bill, and driver’s license) prior to the student being enrolled.


Parents, guardians or persons in a parental role who knowingly submit a false declaration may be held responsible for paying tuition for dates of attendance in which the student was not a legal resident of the district.  Students that reside temporarily with the attendance boundary for the primary purpose of attending a school are not considered legal residents of the district and therefore shall pay tuition.




              A student at any grade level who moves out of the Creswell School District on or after February 1 may finish the school year without paying tuition if the parent requests the continuation in writing, the resident district agrees and if private transportation can be arranged.


              A senior whose family moves from the school district after school begins in the fall may finish the school year at the school where enrolled without paying tuition if the parent requests the continuation in writing, the resident district agrees and if private transportation can be arranged.



The Creswell School District does not discriminate on transfers because of race, religion, ethnicity, gender, national origin or marital status, handicap or age.


*  Please return page 1 of this packet to the Creswell District Office, 998 ‘A’ Street, Creswell*