SCHOOLS OF CHOICE APPLICATION

OLIVET SCHOOLS 2017 – 2018

New students (not currently enrolled in Olivet Community Schools) must provide an original birth certificate, up-to-date immunization records and emergency contact information. Transcripts are requested for high school applicants. A copy of  a student’s IEP must be provided for the application to be evaluated for placement. Completed applications do not infer acceptance. Parents will be notified of acceptance status.  Students must complete all enrollment requirements to hold a  SOC slot. 

Applicant Information

Applicant's/Student’s Full-Name_________________________________________  Female         Male

Grade Last Completed:______ Grade/Slot Requested: _____ Date of Birth:____/_____/____

Parent/Guardian Names:__________________________________________________________________

If not custodial parent/guardian, describe relationship:___________________________________________

Home Address:__________________________________________________________________________

City/State/Zip         __________________________________________________________________________

Telephone #:        (_____)_______________Cell #: ________________Work #____________________

Name and Address of last school attended:__________________________________________

________________________________________________________________________________

City/State/Zip                                

Resident School District:        __________________________________________________

Any other Previous Schools:        __________________________________________________

Please check each of the following that apply to the applicant:

_____ Student is not currently enrolled at Olivet Community Schools in grades K-12th grade.

_____ Student is currently enrolled at Olivet Community Schools and has become a non-resident.

_____ The students’ parent(s) are a “non-resident employee” of Olivet Community Schools.

_____ Student receives Special Education Services (A copy of student’s IEP is required).

        Please check services student has received:         

        _____ Special Education Self Contained classroom _____ Resource Room  _____Section 504

        _____ Speech & Language Services         _____Other placement (Please explain below):

_______________________________________________________________________________________

_______________________________________________________________________________________

Any other information you want us to know, special needs or requests:

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

Sibling Information

Does the applicant currently have a sibling(s) attending Olivet Community Schools under the Schools of Choice program?   ____YES  ____NO     If Yes, please list names and present grade and/or Date of Birth:

Name________________________________Grade_____________Date of Birth__________________

Name________________________________Grade_____________Date of Birth__________________

Name________________________________Grade_____________Date of Birth__________________

Does the applicant have a sibling(s) that may be eligible for Schools of Choice "preference" in future years?

____YES    ____NO     If Yes, please list names and present grade and/or Date of Birth:

Name________________________________Grade_____________Date of Birth__________________

Name________________________________Grade_____________Date of Birth__________________

Name________________________________Grade_____________Date of Birth__________________

Student Discipline Information

The law provides districts the opportunity to deny attendance to a student who has been suspended, expelled or convicted of a felony. If the district receives your child’s school records that indicate a suspension or expulsion and it is not identified on this application, the district reserves the right to deny your child’s acceptance through Schools of Choice and notify authorities.

DIRECTIONS:  Parents please check the applicable statement below:

1. _____ The undersigned affirms that the applicant/student  ______________________________ has NOT been suspended or expelled from any public or private school in Michigan or any other state in the past two years.

2. _____ The undersigned affirms that the applicant/student _______________________________  has been suspended or expelled from a public or private school in Michigan or any other state in the past two years.  Please explain the circumstances in detail.  Include the school name, dates of suspension or expulsion, and a description of the incident that resulted in a suspension or expulsion.  You may attach a separate sheet if desired.

3._____  The undersigned affirms that the applicant/student _______________________________  has been suspended or expelled from a public or private school in Michigan or any other state for one or more offenses involving weapons, alcohol or drugs, or for the willful infliction of injury to another person or for any act of violence against persons and/or property committed on school premises, or any school sponsored activity, or on a public or private conveyance providing transportation to and from a school or school sponsored activity. Please explain below.

4._____The undersigned affirms that the applicant/student ____________________________ has been convicted of a felony. Explain suspensions, expulsions or convictions in space below. Include the school name, city, dates as applicable:

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Athletic Eligibility

Students who transfer by choice from one school district to another and do not otherwise satisfy the transfer regulations are ineligible for interscholastic athletics for one semester. Exception: A student entering the 9th grade for the first time is immediately eligible.

Transportation

Transportation will be the responsibility of the student's family to and from school.

By signing below I certify that the information provided on this application is accurate. I also agree that I have read and understand the information regarding Olivet Community Schools’ School of Choice Guidelines. Falsification of any part of this application may result in disqualification of participation in Schools of Choice and enrollment. My signature below gives permission for any and all records, pertaining to the "applicant/student"  to be released and/or discussed with a representative of Olivet Community Schools. I understand that I will be notified by U.S. mail, if my child has been accepted to attend Olivet Community Schools for the 2017-2018 school year.

_____________________        _______________________________________________Rec’d___________

Date                                Signature of Student (if 18 years old)

_____________________        _______________________________________________________________

Date                                Signature of Parent/Guardian

Return Application and any attached documentation to: Olivet Community Schools, Attention: Teresa Montague,  Administrative Assistant to the Superintendent, 255 First Street, Olivet, MI  49076. Questions may also be directed to Teresa by calling (269) 749-9129, Ext #: 2704.

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* * * BUSINESS OFFICE USE * * *

___ Birth Certificate   ______Immunization    _____IEP (if applicable): Notes:_______________________________

Building Principal Recommendation: _____ Accept  _____Deny ______________________________________

(Please attach original Confirmation of Prior Discipline)_______ All Enrollment documents completed by deadline.

Building Principal Signature:__________________________________________________Date:_______________

I _____Accept _____Deny this applicant/student.____________________________________________

Signature of Superintendent of Schools                Date