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Appendix I - Request for Resident Student to Attend a Non-Designated School


SECTION A                                                      NAME OF STUDENT: _______________________________________


Principal of School in Attendance Area:


Name of school:_____________________                       Name of Principal: ____________________________________


1.   Discussion with parents/legal guardians:                                                            __________________________


2.   Educational rationale identified by parents/legal guardians:         _____________________________________________


3.   If necessary, prior to finalizing a decision, consultation may occur with the

      Director of Learning Services or, if applicable, the Coordinator of Student

      Services:                                                                                                         ___________________________


4.   A program which addresses the needs of the student/child is available at

      the current, designated school:                                                                           __ Yes     __ No

  • If no, the Principal contacts the Principal of the non-designated school

        to initiate a discussion regarding the request.  Refer to clause 3.4,

        Administrative Procedure 305.


  • If the parents/legal guardians agree to accept responsibility for daily

         transportation to the non-designated school, the Principal contacts the

         Principal of the non-designated school to initiate a discussion regarding

         this request.  (Proceed to Section B)                                                                       ____________________________

                                                                                                                                    Signature of Principal




1.   Discussion with Principal of non-designated school:                                         __________________________


2.   Information from the parents’/legal guardians’ request, as identified

      above, was shared with the Principal of the non-designated school.                    __ Yes     __ No


3.   Both Principals agree that:

  • the non-designated school could meet and deliver the educational

          programming for the student/child                                                              __ Yes     __ No


  • space is available at the non-designated school                                               __ Yes     __ No


  • the request will move forward to the Principal of the non-designated

          school.  (Proceed to Section C)                                                                   __ Yes     __ No


4.   Decision to move forward with supporting this request:                                      __________________________





SECTION C                                                                                          NAME OF STUDENT: ________________________________


Principal of Non-Designated School:


Name of school:_____________________                                   Name of Principal: ___________________________________


1.   Discussion with parents/legal guardians:                                                                    __________________________


2.   Educational rationale identified by parents/legal guardians:  ________________________________________________


3.   The school can provide educational programming that meets the needs

       of the child:                                                                                                      __ Yes     __ No


4.   A.  The principal contacts the Director of Transportation to ascertain

            transportation services for the student to attend a non-designated school.           __ Yes     __ No                                   

      B.  Identify the response from the NGPS Director of Transportation:  ________________________________________


5.   Parents/legal guardians are committed to provide daily transportation if bussing is not available.

      ________________________________                                                                              _________________________

        Signature of parents/legal guardians                                                                               Date


6.   Principal recommendations:

  • educational programming requirements:  _________________________________________________________


  • required resources: _____________________________________________________________________________
  • parental responsibilities:  _______________________________________________________________________


7.   Start date of student at the non-designated school:  _________________________________________________

8.   Principal comments:  ______________________________________________________________________________

        ________________________________                                                                 _________________________

        Signature of Principal                                                                                      Date


9.   Forward a copy of completed Appendix 305-I to the NGPS Director of Transportation:




Annual Reviews:          _______________                      _______________                      _______________

                                    Date                                         Date                                         Date


Revised July 2010