Open Enrollment Form

Student Information

First Name*

Answer required for "First Name"

Middle Name

Answer required for "Middle Name"

Last Name*

Answer required for "Last Name"

Date of Birth*

Answer required for "Date of Birth"

School Year for Request*

Answer required for "School Year for Request"

Grade Requesting*

Answer required for "Grade Requesting"

Parent/Legal Guardian Information

Name (first, last)*

Answer required for "Name (first, last)"

Cell Phone*

Number Required

Home Phone

Number Required

Email*

Answer required for "Email"

Address

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Reason for student transfer:*

Answer required for "Reason for student transfer:"

Is your student on an IEP?*

Answer required for "Is your student on an IEP?"

Yes

Is your student on a 504 plan?*

Answer required for "Is your student on a 504 plan?"

Yes

Has your student had a history of attendance infractions within the past three years?*

Answer required for "Has your student had a history of attendance infractions within the past three years?"

Yes

If yes, why?

Answer required for "If yes, why?"

Has your student had a history of disciplinary infractions within the past three years?*

Answer required for "Has your student had a history of disciplinary infractions within the past three years?"

Yes

If yes, why?

Answer required for "If yes, why?"

Will your student participate in IHSAA sanctioned activities?*

Answer required for "Will your student participate in IHSAA sanctioned activities?"

Yes

If yes, which activities or sports?

Answer required for "If yes, which activities or sports? "

Considerations:

If the student participates in any athletic program governed by IHSAA, he/she may not be eligible to participate at the new school. The parent or guardian should check IHSAA rules before submitting an application.
The transfer request is not complete until the resident school has released the student, submitted the request to the requested school, and it has been accepted. The student should remain enrolled in the resident school until there is an effective start date at the requested school.
The district will notify parents of acceptance and the effective start date or denial.
Transportation of open-enrolled students is the responsibility of the parent/guardian.

Decision-Making Criteria, Revocation, and Appeals:

Space Availability:

All applications will be considered on a stringent space-available basis. In the event there is no space available in the grade level, class, or program requested, the student will be placed on a waiting list in the order of the date and time of the request.

Attendance and Disciplinary Infractions:

Open-enrolled students are expected to follow all discipline and attendance policies and regulations applicable to all Preston Joint School District students. Failure to meet these conditions may result in revocation of this Open Enrollment transfer and return to his/her resident school.

Appeals:

Appeals of an administrator’s denial or revocation of open enrollment for students residing within the Preston Joint School District boundary will be directed to the principal of the school, except for denials based on space availability, in which case the administrator’s decision is final.

Acknowledgements:

I certify that the information provided is accurate and complete.
I understand that approval of this request shall be dependent upon the acceptance and rejection standards stated in the district’s policy, and revocation of this transfer may occur in accordance to the conditions listed in the district’s policy.
I understand that my student must continue to attend the resident school until the effective start date of the transfer and that nonattendance is subject to truancy procedures.
I understand that I am responsible for providing transportation to and from school for my student.
I understand that requests are approved for one school year only, and it is my responsibility to complete an Open Enrollment Continuation Form each year until my student moves to the next school level.
I understand that the transfer can be revoked at any time if there are attendance or discipline issues or if there is no longer space within the grade level, class or program.

I have read the school district policies and procedures on Open enrollment and hereby request that my son/daughter be permitted to attend the requested schools.

Parent/Legal Guardian Signature*

Signature Required

For students grades 6th-12th: By typing my name below, I agree to the terms above and acknowledge that my typed name serves as my electronic signature.

Answer required for "For students grades 6th-12th: By typing my name below, I agree to the terms above and acknowledge that my typed name serves as my electronic signature."

Please fix the highlighted areas below before submitting.

Open Enrollment Form