Student Transfer Application
Madison-Grant United School Corporation - Open Enrollment Form

Thank you for your interest in Madison-Grant United School Corporation!  Please fill out this form in its entirety before submitting.  One student per form.  Please fill out multiple forms if you are applying for multiple students.

Please contact the school office with any questions.

Thank you, and Go Argylls!
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Last Name of Student *
First Name of Student *
Student's Date of Birth *
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Grade Level of Student for the 25-26 School Year *
Permanent Street Address *
City *
Zip Code *
Last Name of Parent/Guardian #1 *
First Name of Parent/Guardian #1 *
Last Name of Parent/Guardian #2 *
First Name of Parent/Guardian #2 *
Email Address of Parent/Guardian *
Phone Number of Parent/Guardian *
Name of Previous School Attended *
Address of Previous School Attended *
Public School District in Which You Reside *
Has your student had ten (10) or more days of suspension or expulsion over the last 12 months? *
Has your student been suspended for causing physical injury, drug / alcohol violations, or weapons? *
Has your student had ten (10) or more days of unexcused absences per semester in the last 12 months? *
Do you currently have or anticipate needing academic accommodations?   *
Does the child who is applying for enrollment have a family member already attending Madison-Grant United School Corporation?  If YES, please type their name(s).  If NO, please leave this blank.
I HEREBY CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND AUTHORIZE THE RELEASE OF ALL PAST STUDENT RECORDS TO MADISON-GRANT UNITED SCHOOL CORPORATION. I AM AWARE THAT  MADISON-GRANT UNITED SCHOOL CORPORATION MAY LEGALLY DENY THE REQUEST UNDER INDIANA CODE 20-26-11-32. I CERTIFY THAT THE STATEMENTS GIVEN ABOVE ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND UNDERSTANDING UPON MY SIGNATURE BELOW. *
Electronic Signature of Parent / Guardian (please type your full name)
 *
***If you are submitting additional Google Forms for other children, please type their name(s) here. *
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