Wachusett Regional School District

Wachusett Regional School District
Holden, Paxton, Princeton, Rutland, Sterling
January 2011
Dear Parent/Guardian:
Although available seating has not yet been finalized, the Wachusett Regional School District may have openings in the
following schools and grades for the 2011-2012 school year:
Town School Grades
Holden Davis Hill Elementary School K-4
Dawson Elementary School K-4
Mayo Elementary School K-4
Wachusett Regional High School 9-11 NO GRADE 12
Paxton Paxton Center School K-4
Princeton Thomas Prince School K-4
Rutland Glenwood Elementary School 3 ONLY
Naquag Elementary School K-2
Sterling Houghton School K-4
**PLEASE NOTE: The District is not accepting applications for grades 5, 6, 7 or 8 for the 2011-12 school year.**
Please use a separate application for each child. Applications received by Friday, April 22, 2011 will be included in
the school choice lottery. Applications received after April 22, 2011 will be considered on a space-available basis.
Siblings of current school choice and newly selected students will have priority when applications are received by April
22, 2011 however, acceptance is not guaranteed. The Superintendent of Schools has the final determination regarding
school choice acceptances and placement.
Please send only the completed School Choice Application; please do not send letters of recommendation, MCAS
scores, transcripts, etc., as this information is not considered in the school choice selection process.
All students will be notified in a timely manner as to whether or not they have been selected to attend school in the
Wachusett Regional School District.
Please return completed form to:
WRSD School Choice Program
Attn.: Nancy Houle, Ph.D.
1745 Main Street
Jefferson, MA 01522
Please do not hesitate to contact me (508.829.1673 x 237 or by email at nancy_houle@wrsd.net) with any questions or
concerns you may have.
Sincerely,
Nancy Houle, Ph.D.
Supervisor of Pupil Personnel Services
“The Wachusett Regional School District does not discriminate on the basis of race, color, sex, religion, age, national origin, sexual
orientation or disability in the operation of the educational programs, activities or employment policies, and no person will be
excluded from or discriminated against in admission to its public schools or in obtaining the advantages, privileges and courses of
study of such public schools on account of race, color, sex, religion, age, national origin, sexual orientation or disability.”

School Choice Application
“The Wachusett Regional School District does not discriminate on the basis of race, color, sex, religion, age, national origin, sexual
orientation or disability in the operation of the educational programs, activities or employment policies, and no person will be
excluded from or discriminated against in admission to its public schools or in obtaining the advantages, privileges and courses of
study of such public schools on account of race, color, sex, religion, age, national origin, sexual orientation or disability.”
Student’s Name: Grade in 2011-12:
Date of Birth: Male: Female:
Parent(s)/Guardian(s):
Home Address:
Mailing Address:
Home Phone: Work Phone: Cell Phone:
Current School:
Current Grade:
Is the student currently under suspension from his/her present school Yes No
Circle “#1” to signify your first choice; “#2” to signify your second choice, etc. Choose only the schools your child
would attend if selected.
Town School Grades Preference
please circle
Holden Davis Hill Elementary School K-4 1 2 3
Dawson Elementary School K-4 1 2 3
Mayo Elementary School K-4 1 2 3
Wachusett Regional High School 9-11
Paxton Paxton Center School K-4 1 2 3
Princeton Thomas Prince School K-4 1 2 3
Rutland Glenwood Elementary School 3 1 2 3
Naquag Elementary School K-2 1 2 3
Sterling Houghton School K-4 1 2 3
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If more than one child from your family is applying, please provide the name(s) and grade(s) below AND complete a
separate application for each child applying for school choice:
Name and Grade:
Name and Grade:
Name and Grade
Name and Grade
The following documents will be requested prior to enrollment, should a vacancy become available for your
child: Student Record (including transcript and temporary record); Health Record, including immunization
record; Individual Education Plan (IEP) or 504 Accommodation Plan, (previous and current); School Discipline
Record, and original and/or notarized Birth Certificate (kindergarteners only).
Parent/Guardian Signature:
Date
Office Use Only:
Date received:
Jefferson School
1745 Main Street, Jefferson, MA 01522
Telephone: (508) 829-1670 Facsimile: (508) 829-1680
www.wrsd.net