M i n n e s o t a
D e p a r t m e n t
of E d u c a t i o n / SCHOOL DISTRICT ENROLLMENT OPTIONS PROGRAMREQUIRED FORM FOR ALL MINNESOTA DISTRICTS / ED-01861-22

Parent/Guardian: Use one application per student. Complete Section 1 and sign Section 2. Send the completed application to the non-resident district (Minneapolis). Applications must be sent to the non-resident district by January 15 for enrollment beginning the following school year. If you miss the January 15 deadline, contact the non-resident district to determine if you are eligible for a waiver of that deadline (Minneapolis waves the deadline). You can expect to receive an approval or disapproval from the non-resident district by February 15 or 30 days after applying. After receiving approval, you must notify the non-resident district of your commitment to attend by March 1 or 15 days after applying.

For Open-Enrollment questions call Rich Goodwin at (612) 668-0033 and mail this application to his attention at the following address:

Minneapolis Public Schools 807 NE Broadway Minneapolis MN 55413.

S E C T I O N 1: T O B E C O M P L E T E D B Y T H E S T U D E N T’S P A R E N T O R G U A R D I A N
Parent/Guardian Name (Last, First, M.I.) / Home Phone: ( )
Work Phone: ( )
Parent/Guardian Address / City/State / Zip Code
Resident School District of Student / District of Choice (Non-Resident School District)
MINNEAPOLIS PUBLIC SCHOOLS
Student Last Name First Name Middle Initial / Birthdate:
Mo ______Day ______Yr ______/ Gender:
M □ F □
School Currently Attending or Last Attended / Current
Grade: / Seeking enrollment
for what grade? / Starting when? / Special Needs? (optional)
Reason for request: (This does not affect your acceptance) / School(s) family wishes student to attend in non-resident district:
1.  ______
2.  ______
3.  ______
Is this student currently expelled under Minn.Stat.121A.45 for a reason listed in Minn.Stat.124D.03,Subd.1? No □ Yes □
S E C T I O N 2 : P A R E N T/G U A R D I A N V E R I F I C A T I O N O F I N F O R M A T I O N
I hereby verify that the above information is true and correct to the best of my knowledge and belief.
______
Signature – Parent/Guardian Date

Non-Resident District: Complete Section 3. The non-resident district must notify parents/guardians by February 15 (or 30 days after receiving applications that come later) of approval or disapproval of application. Families must accept or decline the offer by March 1 or 15 days later. After receipt of commitment to attend, the non-resident district must notify the resident district by March 15 (or 60 days after initial receipt if form is filed after January 15) of the student’s intent to enroll. Districts report all rejected applications to MDE by July 15.

S E C T I O N 3 : T O B E C O M P L E T E D B Y T H E N O N - R E S I D E N T D I S T R I C T
Date of Receipt of Application / District Name

MINNEAPOLIS PUBLIC SCHOOLS

/ District Number
S01
Contact Person
RICH GOODWIN / Title

ENROLLMENT OPTIONS ADMINISTRATOR

/ Telephone Number
(612) 668-0033
□ A P P R O V E D 1 □ D I S A P P R O V E D 2
______
Signature of Superintendent / Responsible Authority Date
1.On the basis of information provided in the above application, and with respect to district policies and procedures, the above student will be assigned for enrollment
in ______on______at______
School Building Name Starting Date Grade Level
Please visit the district offices at least ten (10) days prior to the above starting date for completion of all enrollment forms. / 2.The above district is unable to approve your request for enrollment for the following reason(s):
□ January 15th deadline was not met
□ Statute enrollment has been reached
□ Grade is closed by board action
□ Student is currently under expulsion