LAUREL SPRINGS SCHOOL DISTRICT

INTERDISTRICT PUBLIC SCHOOL CHOICE

NOTICE OF INTENT TO ENROLL STUDENT

IN CHOICE DISTRICT

TO: Dr. Albert K. Brown, Chief School Administrator

Laurel Springs School District

623 Grand Avenue

Laurel Springs, NJ 08021

The undersigned, as parent(s) or legal guardian(s) of

(Name of student) ____________________________________________________

certify our intention to enroll

(Name of student) ____________________________________________________

in grade ___________(enter grade level) in Laurel Springs School District for the school year beginning in September 2012. We understand that this Notice of Intent to Enroll is

binding upon (Name of student) ____________________________________________

and that (Name of student) ________________________________________________

must remain enrolled in Laurel Springs School District for at least the full 2012-2013 school year.

______________________________________________ Date:________

Signature

_______________________________________________

Print name

______________________________________________ Date:________

Signature

_______________________________________________

Print name

Due to choice district and district of residence no later than December 1, 2011. Admission for the 2011-2012 school year will depend on the continuation of funding for the program.