Jefferson County Public Schools

Student Assignment Application

Student and Household Information

This section is pre-populated from our records.
Student's Name: Sex: Date of Birth:
Last First Middle Suffix
Student's Address:
Street Apt. No. City State Zip Code
Category: Resides School: Choice Zone:
Name Relationship Home Phone No. Work Phone No. Cell Phone No. E-mail
Other Children in the Home:
Name:  Grade: School:

Application Information

Please complete this section.
The primary e-mail address is where we will send information about this application's status.
 Grade Level: Primary E-mail Address:

Last School Attended

Complete this section if your child most recently attended a non-JCPS school. Otherwise, the information will be pre-populated.
Enter the name, city, and state of the school that the child most recently attended. This may be the school that the child is currently attending.
School Name:
City, State:

Magnet Programs and Magnet Schools

Only complete this section if you wish to apply for an Magnet program. If you are accepted to an Magnet program, and you confirm that assignment, your Zone School Choices will not be considered.
This section cannot be completed until you have selected an address and a grade.

School Choices

Please complete this section.
This section cannot be completed until you have selected an address.

Transportation Information

This section will help us plan our bus routes.
Student will be transported by:
Bus Pickup Address: Drop Off Address:

Not Saved
Grade level not valid
Grade level not selected
Primary e-mail not entered
Enter last school attended
name, city, and state
Last school attended entered
Optional/magnet program(s)
required if waiving cluster
Cluster choices not complete Or Magnet Choice not complete
Answer either Bus, Car, Walk, CEP, or Unknown under transportation information
Transportation information entered
Application not submitted