School Choice Application 2023

Applicant Name*

First NameLast Name

Date of Birth*

Date

Gender*

MaleFemale

Grade (for 2023 - 2024 School Year)*

Does the applicant require special needs or programs?*

YesNo

Is the applicant currently under expulsion?*

YesNo

Ethnic Origin (Check One):*

District Name*

District County Name*

District Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

District Phone Number*

Please enter a valid phone number.

Parent / Guardian Name*

First NameLast Name

Home Phone Number *

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Work Phone Number*

Please enter a valid phone number.

Parent / Guardian Signature*

Clear

Today's Date*

Date

Pursuant to standards adopted by a non-resident school board a non-resident district may reserve the right to accept and reject applicants based on capacity of programs, class, grade level, or school building. Likewise, a non-resident district’s standards may provide for the rejection of an applicant based upon the submission of false or misleading information to the above listed request for information when that information directly impacts the legal qualifications of an applicant to transfer pursuant to the School Choice Act. However, a non-resident district’s standards shall not include an applicant’s previous academic achievement, athletic or other extra curricular ability, handicapping conditions, English proficiency level, or previous disciplinary proceedings, except that an expulsion from another district may be included pursuant to Ark. Code Ann. §6-18-510. Priority will be given to applicants with siblings attending the district. The non-resident district shall accept credits toward graduation that were awarded by another district and award a diploma to a non-resident applicant if the applicant meets the non-resident district’s graduation requirements. This application must be filed in the non-resident district or postmarked no later than July 1 of the year in which the applicant would begin the fall semester at the non-resident district.

School Choice Application 2023 - 2024

Resident School District of Applicant

Parent or Guardian Information of Applicant