2016-2017 Lamphere Schools Schools of Choice Application - Semester 2
SECTION 105 SCHOOL OF CHOICE APPLICATION for the 2016-2017 SCHOOL YEAR
This application should be completed by persons seeking admission to The Lamphere Schools for the second semester of the 2016-2017 school year, who reside in any Oakland County School District other than The Lamphere Schools.

The Lamphere Schools will accept students living in Oakland County districts, free of charge, on a space availability basis.

Applications must be received by Wednesday - February 1, 2017.

ONE STUDENT PER APPLICATION

Student Information
Grade Student Completed in 2015-2016 *
Your answer
Grade of Child in Fall 2016 *
Your answer
Preferred School (Elementary only)
Student Name (First, Middle, Last) *
Your answer
Student Date of Birth (Month, Date, Year) *
MM
/
DD
/
YYYY
Gender *
Parent(s)/Guardian *
Your answer
Street Address *
Your answer
City and Zip Code *
Your answer
Home Phone (if none, type none) *
Your answer
Cell Phone (if none, type none) *
Your answer
Mother's Work Phone (if none, type none) *
Your answer
Father's Work Phone (if none, type none) *
Your answer
School District of Residence *
Your answer
District Attended in 2015-2016 *
Your answer
Name of School Attended *
Your answer
Do you already have a child attending Lamphere Schools? *
If yes, which School and Grade *
Your answer
ADDITIONAL INFORMATION
1. Section 105 Choice is a once per year event.

2. For grades K-8, student’s most recent report card must accompany application. For grades 9-12,
student’s most recent report card, transcript and official behavior record must accompany application
Applications must be received by Wednesday, September 7, 2016

3. It is not responsibility of The Lamphere Schools to provide transportation for Section 105 School of
Choice Students.

4. The Lamphere Schools will comply with all requirements of 1996 Public Act 30, Section 105,
(School of Choice).

Does your child require special services *
If yes, please explain
Your answer
Has this student ever had school discipline referrals *
If yes, how many referrals in the past two years?
Your answer
Reason for referrals
Your answer
Has this student ever been expelled from a previous school? *
If yes, please explain
Your answer
Has this student ever been suspended from a previous school *
If yes, please explain
Your answer
Dates and total number of suspensions
Your answer
Reason for making application to The Lamphere Schools *
Your answer
How did you hear about Lamphere Schools Open Enrollment (check all that apply) *
Required
Signature/Acknowledgement
Clicking the Submit button grants The Lamphere Schools permission to seek student information/records from prior school district.
FALSE INFORMATION WILL RESULT IN DENIAL OF ENROLLMENT OR ATTENDANCE IN THE LAMPHERE SCHOOLS.
Submitted by *
Your answer
Email address *
Your answer
Submit
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