OUT-OF-DISTRICT (TUITION) TRANSFER APPLICATION

For Families Living OUTSIDE EACS Boundaries

School Year 2022-2023

Application must be submitted online or received in the Office of Student Services (800 Homestead Drive, New Haven, IN 46774) by May 31, 2022 for priority consideration. (Or by December 5, 2022 for January 2023 enrollment) Students may not proceed with enrollment at their desired school unless the EACS Director of Student Services approves their application.

Student Information

Applying to Attend (School):

Grade for 2022-2023 school Year:

Last Name:

First Name:

Middle Name:

Suffix (Jr, II, etc):

Date of Birth:

Gender on legal documentation: Female Male

School Student is Currently Attending:

Name of public high school that corresponds to the student's home address, regardless of student's current grade level:

Does the student have a current/active Individualized Education Plan (IEP, special education) or 504 Plan?

YES (Must submit copy of document if not from EACS.)
NO

Is the student a dependent of a current EACS employee?

YES/Name:
NO

Did the student have 7 or more UNEXCUSED absences during the past 12 months?

YES NO

Was the student LATE to school and/or first period (unexcused) 7 or more times during the past 12 months?

YES NO

Was the student suspended, expelled, denied attendance, or otherwise separated from school in the past 12 months?

YES NO

Student's Parents/LEGAL Guardians Please do NOT list step-parents and other caregivers in this space. List ONLY the adults named on the birth certificate or related court documentation.

Parent/Legal Guardian #1:

Last Name:

First Name:

Gender: Female Male

Phone:

E-mail:

Street:

City: State: Zip:

Is the address listed also the student's primary address?

YES NO

Parent/Legal Guardian #2:

Last Name:

First Name:

Gender: Female Male

Phone:

E-mail:

Street:

City: State: Zip:

Is the address listed also the student's primary address?

YES NO