APPLICATION FOR SCHOOL CHOICE TRANSFER

APPLICATION FOR SCHOOL CHOICE TRANSFER
(Deadline for submission is May 1, unless the student is eligible for School Choice for Military Families)
TYPE OF SCHOOL CHOICE TRANSFER REQUESTED

Public School Choice Act of 2015 Opportunity School Choice Act
NOTE: Applications for the Public School Choice Act of 2015 must be sent to the resident and nonresident districts. Applications for the Opportunity School Choice Act must be sent to the resident district, the nonresident district, and the Division of Elementary and Secondary Education.

If you are unsure which type of school choice best applies, please review the FAQ following this form for information about the different types of school choice that may be available to your student.

If applying for a transfer under the Public School Choice Act, does the applicant have a sibling or step-sibling already attending the nonresident district listed in this application pursuant to the Public School Choice Act? If so, please list:
APPLICANT INFORMATION
Student Name
Grade

Gender: Male Female Yes No
Grade
Student Date of Birth

Month Day Year
Date
Is the applicant currently expelled?
Does the applicant have a parent or guardian who is an active-duty member of the military who has been transferred to and resides on a military base? If so, please state the date of the parent's or guardian's arrival on the military base:

NOTE: In order to take advantage of school choice options available to military families who have recently transferred to a military base, you must submit military transfer orders and proof of residency on the military base to the resident and nonresident school districts.
RACE OR ETHNIC ORIGIN (CHECK ONE)

White
Pacific Islander

2 or More Races This information is collected for data reporting purposes only, pursuant to Ark. Code Ann. §6-18-227(f2B) African-American Hispanic Native American Native Hawaiian
RESIDENT SCHOOL AND SCHOOL DISTRICT OF APPLICANT
District and School Name
County Name
Address
Phone
NONRESIDENT SCHOOL/SCHOOL DISTRICT APPLICANT WISHES TO ATTEND
PARENT OR GUARDIAN INFORMATION
DISTRICT USE ONLY
Date and Time Received by Nonresident District

Month Day Year
Date
Date and Time Received by Resident District:
Nonresident District LEA#
Student's State Identification #:
Application

Rejected Accepted
Reason for Rejection (If Applicable)
Date Notification Sent to Resident District and Parent/Guardian of Applicant

Month Day Year
Date
Should be Empty:

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APPLICATION FOR SCHOOL CHOICE TRANSFER

APPLICANT INFORMATION

RESIDENT SCHOOL AND SCHOOL DISTRICT OF APPLICANT

NONRESIDENT SCHOOL/SCHOOL DISTRICT APPLICANT WISHES TO ATTEND

PARENT OR GUARDIAN INFORMATION

DISTRICT USE ONLY