• Transfer PUSH Request

  •  
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Corporation Student is Entering*
  • GJCS School*
  • SWD School*
  • NED School*
  • SED School*
  • NS School*
  • SS School*
  • CA School*
  • TC School*
  • PERRY Central School*
  • PIKE County School*
  • Grade Range*
  • Was this student most recently _____?*
  • Prior to being homeschooled, did this student attend or receive services from an Indiana school corp?*
  • Prior to attending Gibault/Holy Cross, did this student attend or receive services from an Indiana school corp?*
  • Prior to the period of PK non-attendance, did this student attend or receive services from an Indiana school corp?*
  • Start Date of Most Recent IEP*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Out of State Eligibility Areas

    Enter this data based on the most recent 'OUT OF STATE' IEP

  • Out of Country Eligibility Areas

    Enter this data based on the most recent 'OUT OF COUNTRY' IEP
  • Has this student ever attended an Indiana School before?*
  • Should be Empty: