A separate application must be completed for each child for whom enrollment is requested.

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2015-16 OPEN ENROLLMENT APPLICATION (for students residing outside the Goddard School District) Goddard Public Schools USD 265 P.O. Box 249, 201 S. Main St., Goddard, KS 67052 316-794-4000 A separate application must be completed for each child for whom enrollment is requested. Open enrollment in Goddard School District, USD 265, is available from May 5 - July 30, 2015, for the 2015-16 school year on a space-available basis. Schools will be assigned by the superintendent, and may not be selected by the applicant. No transportation to/from school is provided for out-of-district students. Submit completed application with all requested documents to the USD 265 Administration Center, PO Box 249, 201 S. Main, Goddard, KS 67052. FOR OFFICE USE ONLY COMPLETE COMPLETED APPLICATION RECEIVED: DATE: TIME: INCOMPLETE APPROVED ASSIGNED TO: SCHOOL DISAPPROVED Superintendent/Designee Signature Grade (2015-16) If Kdg- All Day 1/2Day Sex F / M Student s Legal Name (Last, First, Middle) Home Address of Birth: City / State Mailing Address (if different from above) City / State Social Security # Nickname: Zip Code Zip Code Parent/Guardian Name (Last, First, Middle) Home Phone Work Phone Cell Phone School district student attended in 2014-15: Name of School Address of School City State Zip Code Special and/or unique instructional programs currently provided for applicant student. (For example: reading or math assistance, special education, gifted/talented, assistance with learning English, etc.) I attest that my signature below confirms the accuracy and truthfulness of all requested information. I have read the Goddard School District Open Enrollment Procedures, and hereby request that my son/daughter be permitted to attend Goddard School District. I also understand that my child and I will be required to sign a contract upon enrolling, if this application is approved. I further understand that the Goddard School District reserves the right to remove a non-resident student at any time because of unacceptable behavior, false or misleading information on the open enrollment application, lack of academic progress, or poor attendance. Parent/Guardian Signature

GODDARD SCHOOL DISTRICT OPEN ENROLLMENT PROCEDURES 2015-16 OPEN ENROLLMENT Goddard School District, USD 265, recognizes the desire of some parents/guardians to enroll their children in a school other than their neighborhood schools. Limited enrollment of non-resident students is available on a space available basis from May 5 through July 30, 2015. Non-resident students accepted for enrollment in Goddard USD 265 will be assigned to a Goddard School District school by the superintendent/designee and may not be selected by applicant. To apply for admission to Goddard School District, please follow these Open Enrollment application procedures. 1. Request an Open Enrollment Application form from the Goddard USD 265 Administration Center, 316.794.4000. 2. Complete an Open Enrollment application form for each child you are requesting to enroll in Goddard School District. 3. Return the completed form to the USD 265 Administration Center, P. O. Box 249, 201 S. Main Street, Goddard, KS 67052. Completed applications must include the records from the student s previous school that are listed on the Pupil Records Request form. 4. Application form will be reviewed by the superintendent or designee, and a decision to approve or deny the application will be made. 5. COMPLETED open enrollment applications will be accepted from May 5 - July 30, 2015, on a space-available basis. Applicants will be notified of acceptance or rejection by August 13, 2015. 6. A USD 265 enrollment packet for 2015-16 will be mailed to, or may be picked up by, the parent/guardian of non-resident students upon receiving approval for enrollment in Goddard School District. All enrollment packet forms must subsequently be completed and returned to the assigned school before enrollment is considered complete. 7. Students who reside in Goddard School District and move out of their school attendance zone during the school year must inform the school office of that status and their intent to continue or discontinue enrollment. 8. A non-resident student accepted through open enrollment is not required to reapply on an annual basis providing the student has continuous enrollment and has not withdrawn from Goddard School District and enrollment has not been revoked by Goddard School District officials. 9. Goddard School District is a member of a special education interlocal cooperative. IEP s will be reviewed and written to align with district services, instruction and assessments. TRANSPORTATION Parent/guardians are responsible for transporting non-resident students accepted under open enrollment.

KSHSAA VARSITY SPORTS/ACTIVITIES A student who plans to participate in a varsity sport and/or activity governed by the Kansas High School Activities Association (KSHSAA) should review KSHSAA rules prior to submitting an open enrollment application form. Certain school transfers will lead to a student being ineligible to participate at the varsity level for 18 weeks. APPLICATION/APPROVAL PROCESS Open enrollment applications for non-resident students will be available from May 5 through July 30, 2015, for the 2015-16 school year. Applications will be considered on a space available basis. Applicants will be notified by August 13, 2015, of approval/non-approval status. The superintendent or designee may deny an open enrollment request when such enrollment would have a negative impact on the efficient use of district resources. The superintendent or designee may set numerical limits for schools, grade levels, or programs to provide for appropriate and efficient use of facilities and staff. Resident students (school district residents of Goddard School District, USD 265) shall have priority to all classes, buildings and grade levels over non-resident open enrollment applicants. Goddard School District is a member of a special education interlocal cooperative. IEP s will be reviewed and written to align with district services, instruction and assessments. REVOCATION OF ACCEPTANCE Goddard School District reserves the right to revoke enrollment of a non-resident student at any time because of unacceptable behavior, false or misleading information on the open enrollment application, lack of academic progress, or poor attendance. STUDENT RIGHTS AND RESPONSIBILITIES Due process for all students remains the same regardless of what school they attend within the Goddard School District and regardless of where the student resides once accepted under the open enrollment policy. PREVENTING OR RECRUITING POTENTIAL OPEN ENROLLMENT STUDENTS Goddard School District employees will take no action to prohibit or prevent application by its students to attend school in another school district. In no case is an employee of Goddard School District to recruit students outside of their attendance area. RESTRICTIONS Factors which may cause an Open Enrollment Application to be denied include: 1. School, grade, or program(s) lack available space and/or staff; 2. The student has been suspended or expelled from school; 3. The student is not in good standing in the current school; 4. Information on the Open Enrollment Application has been misrepresented or was incomplete. Goddard USD 265 does not discriminate on the basis of race, color, national origin, sex, religion, handicap/disability, or age as to treatment of students in programs and as to employment. Persons having inquiries concerning the District s compliance with Title VI, Title IX, Section 504, the Americans with Disabilities Act, the Americans with Disabilities Act Amendments Act and the Age Discrimination Act may contact the school district's ADA and Section 504 coordinator, the District s Assistant Superintendent of Human Resources, 201 South Main, Goddard, KS, 67052, Telephone: 316-7944000. Those wishing to make a federal inquire may do so at the U.S. Department of Education through the Office for Civil Rights. Contact may be made at OCR.KansasCity@ed.gov or (816)268-0550

NOTICE OF EXPULSION/LONG-TERM SUSPENSION It is the policy of the Goddard School District, USD 265, to deny admittance to any student if the student has been expelled long-term suspended from a school in another school district and the period of the expulsion/long-term suspension has not expired. Student of Birth Grade in 2015-16 TO BE COMPLETED BY PARENT/GUARDIAN The student listed above is: NOT EXPELLED OR LONG-TERM SUSPENDED from another school district at this time. EXPELLED OR LONG-TERM SUSPENDED from the School District at this time. This period of expulsion/long-term suspension expires on Parent/Guardian Signature TO BE COMPLETED BY SCHOOL DISTRICT IN WHICH STUDENT WAS ENROLLED IN 2014-15 (Goddard School District will request this information from the previous school district.) The student listed above is: NOT EXPELLED/LONG-TERM SUSPENDED from School District at this time. EXPELLED/LONG-TERM SUSPENDED from the School District at this time. This period of expulsion/long-term suspension expires on The student listed above: IS in good standing IS NOT in good standing School Official Signature Title of School Official School District

PUPIL RECORDS REQUEST Present this form to student s current school to request the records shown below. Student's Last Name First Name Middle Name Birth The following records must be submitted with the Open Enrollment application: Transcript of Grades/Credits Health Records Discipline and Attendance Records Test Records Withdrawal Grades State Assessment Scores Immunization Records ESOL Records (if applicable) Special Education Records 504 Plans Other Signature of Parent/Guardian Current Address City State Zip Previous School School Address City State Zip

OPEN ENROLLMENT CONTRACT This Open Enrollment Contract documents an agreement between, Student and Goddard Public Schools USD 265 Parent/Guardian is based on the following expectations: 1. Student must follow attendance and discipline policies as outlined in the school student handbook. 2. Student shall receive no major disciplinary violations as outlined in the school student handbook. 3. Student shall make progress toward positive academic achievement. Any violations of these expectations will require specific documentation from the school principal or designee. As an open enrolled student, I understand if I do not fulfill this contract, I may be disenrolled from Goddard USD 265 and required to return to my home school district. This Open Enrollment Contract is in effect for the duration of my enrollment in Goddard School District, USD 265. Student Signature Parent Signature FOR OFFICE USE ONLY Assigned School Building Administrator Signature