2019-2020 School of Choice Application Form
A separate application form must be completed by the student’s parent or legal guardian for each student desiring to attend the Eau Claire Public Schools under School of Choice State Aid Act of 1996, P.A. 300, Sec.105.
Email address *
SECTION I
STUDENT AND PARENT/GUARDIAN INFORMATION
PARENT/GUARDIAN NAME (FIRST, MIDDLE, LAST) *
Your answer
HOME ADDRESS (STREET, CITY, STATE, ZIP) *
Your answer
PHONE NUMBER *
Your answer
STUDENT'S FULL NAME (FIRST, MIDDLE, LAST) *
Your answer
STUDENT'S D.O.B. *
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DD
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STUDENT'S CURRENT GRADE *
Your answer
STUDENT'S GENDER *
STUDENT'S ADDRESS (IF DIFFERENT THAN ADDRESS LISTED ABOVE).
Your answer
STUDENT'S PHONE NUMBER (IF DIFFERENT THAN PHONE LISTED ABOVE).
Your answer
WHAT SCHOOL IS THE STUDENT CURRENTLY ATTENDING? *
IF YOU SELECTED OTHER, WHAT IS THE NAME OF THE MOST RECENT SCHOOL DISTRICT THE STUDENT ATTENDED.
Your answer
WHAT OTHER SCHOOL(S) HAS THE STUDENT ATTENDED IN PREVIOUS YEARS (CHECK ALL THAT APPLY): *
Required
*IF THE STUDENT HAS ATTENDED EAU CLAIRE PUBLIC SCHOOLS IN PRIOR YEARS, LIST THE YEARS AND GRADE LEVELS.
Your answer
SECTION II: WHY DID YOU CHOOSE EAU CLAIRE PUBLIC SCHOOLS?
Tell us why you want to attend Eau Claire Public Schools
WHAT IS THE REASON YOU WANT YOUR CHILD TO ATTEND EAU CLAIRE PUBLIC SCHOOLS? *
Your answer
DOES THE STUDENT HAVE ANY RELATIVES ALREADY ATTENDING EAU CLAIRE PUBLIC SCHOOLS? *
LIST ALL RELATIVES THAT CURRENTLY ATTEND EAU CLAIRE PUBLIC SCHOOLS (FULL NAME AND GRADE LEVELS). IF YOU DO NOT HAVE RELATIVES THAT ATTEND, TYPE "NONE". *
Your answer
SECTION III: STUDENT SERVICES
WHAT SERVICES AND ACTIVITIES IS THE STUDENT CURRENTLY INVOLVED?
WHAT ACTIVITIES OR CLUBS HAS THE STUDENT PARTICIPATED? CHECK ALL THAT APPLY. *
Required
Has the student been truant or had attendance problems at another school during the preceding two (2) years? *
IF YOU ANSWERED YES ABOVE, PLEASE EXPLAIN.
Your answer
Has the student ever been suspended from school for any reason during the past two (2) years? *
IF YOU ANSWERED YES ABOVE, PLEASE EXPLAIN.
Your answer
Has the student ever been expelled from any school for any reason? *
IF YOU ANSWERED YES ABOVE, PLEASE EXPLAIN.
Your answer
WHAT SERVICES IS THIS STUDENT CURRENTLY RECEIVING? *
Required
WHAT CAN YOU TELL US ABOUT THE SERVICES YOUR CHILD IS CURRENTLY RECEIVING?
Your answer
HAS YOUR CHILD RECEIVED ANY OF THE SERVICES LISTED BELOW IN THE PAST? *
Required
SECTION IV: UNDERSTANDINGS
AS THE PARENT/GUARDIAN OF THE ABOVE LISTED STUDENT, READ EACH STATEMENT BELOW AND CHECK YES THAT YOU UNDERSTAND THESE EXPECTATIONS:
I (we) understand that incomplete applications will not be considered. *
I (we) understand that transportation to and from school is the responsibility of the parent/guardian. However if accepted, the student will be eligible for transportation services at specifically designated bus stops outside the District or the student may receive transportation from any pick up/delivery point within the Eau Claire School District. *
I (we) understand that transportation is a privilege and both the parents and the students are expected to follow the rules and expectations of the transportation department. Failure to comply may result in the termination of transportation privileges provided by the District. *
I (we) understand that transportation services may be available, but not guaranteed, after school for student-athletes or students participating in afterschool programs. *
I (we) understand that if Eau Claire Public Schools finds any information that is incorrect, deficient, or falsified on this application, that Eau Claire Public Schools reserves the right to immediately terminate the enrollment of the student. *
SECTION V: AGREEMENTS
As the parents(s)/legal guardian making application for Eau Claire Public Schools under School of Choice State Aid Act of 1996, P.A. 300, Section 105, my/our signature(s) on this application signifies my/our understanding and agreement to the Schools of Choice language and guidelines and to all rules and regulations of student handbooks. My/Our signature(s) also holds harmless the Eau Claire Public Schools, their employees, and the Board of Education members for any decisions made relative to the Schools of Choice Language and guidelines.
I/we give permission for the student's current school district and any previous school districts to release any requested information to Eau Claire Public Schools *
I/we understand that a copy of the student’s latest report card or transcript should be sent/emailed to the District the completed application. *
SECTION VI: ELECTRONIC SIGNATURE
PLEASE understand that your typed name serves as your electronic signature and is considered binding that all information in this application is correct to the best of your knowledge.
Your full name (FIRST, MIDDLE, LAST NAME) *
Your answer
Today's Date *
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A copy of your responses will be emailed to the address you provided.
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