Two Rivers Supervisory Union Limited School Transfer Program Application This application may be completed at any time prior to April 14, 2017 by the end of the business day and submitted to the Supervisory Union. The application will be forwarded to the requested receiving school. If an opening is available, the school will then contact you directly within five business days. Each school involved will accept students on the basis of space available, taking into consideration such factors as class size and class profiles. Under this program, six students may transfer from a school to other schools. If more students apply then there are slots available, a lottery will be conducted. If you are not selected in the lottery and an opening does not come available during the school year, you must complete a separate application for any other academic year for which you would like to be considered to participate in the limited school choice program. School Year applied for: _____________________________________________________ School Requested: _____________________________________________________ Student’s full name: _____________________________________________________ Student’s Date of Birth: _____________________________________________________ Current grade in School _____________________________________________________ Current School _____________________________________________________ Anticipated number of years that you expect to participate _____________________________ Parents’/Guardians’ Name: _____________________________________________________ Parents’/Guardians’ Address: _____________________________________________________ _____________________________________________________ _____________________________________________________ __________________________________________________ Today’s date ________________ Signature of Parent or Guardian The deadline for submitting this application to the Two Rivers Supervisory Union Office is April 14, 2017. Our address is: Two Rivers Supervisory Union Attn: Superintendent, Admin. Assistant 609 Route 103 South Ludlow, Vermont 05149