Mannington Township School
495 Route 45
Mannington, NJ 08079
phone 856-935-1078
fax 856-935-3747
Ms. Kristin Williams Mrs. Karen Mathews
Chief School Administrator Business Administrator
Non-Resident Tuition Student Request Form
Student Information
Name: ____________________________________________________
First Middle Last
Address: ______________________________________________________________
Street Town State Zip Code
Birth Date: ____________________________
Month Day Year
School Information
District & School Name: __________________________________________________
School Address: ________________________________________________________
Street Town State Zip Code
School Contact Name: _________________________________
School Phone Number: ________________________
Grade Level: ______________________________
Parent/Guardian Information
Name: ____________________________________________________
First Middle Last
Address: ______________________________________________________________
Street Town State Zip Code
Phone Number: __________________________
Relationship to Student: ____________________________________________
Signature: ________________________________________ Date: _____________________
Mannington Township School District does not discriminate on the basis of race, color, creed or sex in the
administration of its educational policies, admissions policies or any school administered program.
Please Note : The non-resident tuition program pricing is for regular education students.
Additional charges will apply for special education and/or related services.
Non-Resident Tuition Student Request Form - Page 2
____________________________________________________________________________________
For School Use Only:
Appointment Date: ___________________________ Appointment Time: _______________
Staff Members Attending: ___________________________________________________________
Comments:
Recommend Acceptance of Student: Yes or No or Wait List
Start Date: __________________________ Grade Level: _______________
Signature: __________________________________________
Chief School Administrator
BOE Approval Date: ____________________