Student Application For Enrollment In A Choice District
ADVERTISEMENT
1
2FOR OFFICE USE ONLY
LOTTERY INFORMATION
Tier 1 ____ Tier 2____
Grade: __________ Wait List # ______
Choice Year:_______
Grade:______
Accepted into Program: Yes ____ No____
Resident District Confirmation Attached: Yes ____ No_____
Notified ______
Accepted _____
Enrollment Preference: Yes ____ No_____
Distr. Code__________ Sch.Code_________
___ Siblings in Choice (Sibling Grade: _____)
___From send-receive or limited purpose regional districts
___Resident student who moved during the school year (Date moved:______)
(TEMPLATE)
[School Name &Address]
INTERDISTRICT PUBLIC SCHOOL CHOICE APPLICATION
FOR ENROLLMENT IN A CHOICE DISTRICT
2013-2014 SCHOOL YEAR
To avoid a delay in processing your application, ALL sections of the application must be completed.
To be completed by the parent or legal guardian:
Name of Student Applicant:
Student Address:
City:
County:
Zip:
Home Phone Number:
Parent’s Work Phone:
District of Residence:
•
School the student is currently enrolled in for the 2012-2013 school year:
•
Student’s grade level for 2012-2013 school year:
•
Does the student have a current IEP (Special Education Plan)?
…………..If yes, attach a copy.
•
Does the student have a 504 Plan (Accommodation Plan)?
…………..… If yes, attach a copy.
•
Grade level in which the student is applying for admission in the 2013-2014 school year:
•
If the student has a sibling enrolled in this Choice district, enter sibling’s name:
and grade:
•
[Note to Choice District: If a Choice district has been granted approval of the use of enrollment criteria for a special
program, then the application may include a request that applicants address the criteria (for example in an essay,
explanation or interview.)]
If you have received a Confirmation of Student Enrollment/Eligibility from your Resident
District please attach it to this application.
Please check the appropriate box(es):
My student is eligible for the School Choice Program as a Tier 1 student because we meet one of the following
requirements:
•
I received the Confirmation of Student Enrollment/Eligibility from my Resident district who confirmed my
student was enrolled as of Oct. 15, 2012 and I confirm that my student will be enrolled in a NJ public
school for the entirety of the 2012-2013 school year.
•
We moved to our current district after Oct. 15, 2012, and I confirm that my student will be enrolled in
his/her resident district for the entirety of the 2012-2013 school year.
•
My student is applying for kindergarten and is attending his/her district preschool, or if no district
preschool exists, he/she has a sibling currently attending the Choice district.
My student is applying to the School Choice Program as a Tier 2 student because he/she meets one of the following
characteristics:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business