Student Name* First Last What grade is your student applying to attend in the 2022-23 school year?*6th7th8thThis is the grade your student is applying to attend at Churchill for the 2022-2023 school year.Student # Leave blank if unknown.Legal Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Birth Date*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Boundary School*OtherAcademy ParkArcadiaBacchusBeehiveBennionBridgerCopper HillsCottonwoodCrestviewDiamond RidgeDriggsEastwoodElk RunFarnsworthFox HillsFremontFrostGourleyGrangerHillsdaleHillsideHunterJacklingLake RidgeLincolnMagnaMill CreekMonroeMorningsideMossOakridgeOakwoodOquirrh HillsOrchardPennPioneerPleasant GreenPlymouthRedwoodRolling MeadowsRooseveltRosecrestSandburgSilver HillsSmith, CalvinSouth KearnsSpring LaneStansburyTaylorsvilleTrumanTwin PeaksUpland TerraceValley CrestVistaWest KearnsWest ValleyWestbrookWestern HillsWhittierWilsonWoodstockWright, GearldIf other, please specify school and district Current School*OtherNone – Not Yet Enrolled In SchoolAcademy ParkArcadiaBacchusBeehiveBennionBridgerCopper HillsCottonwoodCrestviewDiamond RidgeDriggsEastwoodElk RunFarnsworthFox HillsFremontFrostGourleyGrangerHillsdaleHillsideHunterJacklingLake RidgeLincolnMagnaMill CreekMonroeMorningsideMossOakridgeOakwoodOquirrh HillsOrchardPennPioneerPleasant GreenPlymouthRedwoodRolling MeadowsRooseveltRosecrestSandburgSilver HillsSmith, CalvinSouth KearnsSpring LaneStansburyTaylorsvilleTrumanTwin PeaksUpland TerraceValley CrestVistaWest KearnsWest ValleyWestbrookWestern HillsWhittierWilsonWoodstockWright, GearldIf other, please specify school and district Requested School*Churchill Jr. HighReason for Request* Has the student ever been suspended or expelled from a public school?*NoYesIf yes, please explain.Does your student require services or programs other than what is offered in the regular school classroom?*NoYesIf yes, please explain.Does your student have a sibling already attending Churchill Jr?NoYesSibling Name: First Last I understand that all transfer requests are contingent on early enrollment school capacity ("maximum capacity") or late enrollment school capacity ("adjusted capacity"), special program limitations, staff availability, and/or circumstances under 53A-2-207(4)(c). If this request is granted, I agree that my child must remain at the requested school through the end of the requested school year. I understand that I, as parent or guardian, am responsible for transportation of my student to and from school. I understand that a students' acceptance into a school or school district does not establish UHSAA eligibility. Type your name to signify you agree.* Home Phone*Work PhoneEmail* Please ensure that you verify the accuracy of this email, as all notifications will be sent to this address.