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This application should be completed by the full-time LCSC employee. Please submit a separate application for each student. Please note that previously approved resident transfer students (2021-22 or earlier) do not need to re-apply.

Please select the school year for which you are applying:*
Student's Legal Name:*
Student's Street Address: (Complete only if this address is different from primary parent/guardian AND student sleeps there more than 50% of time during school months)
Student's Current School:*
How many years has the student attended his/her current school?*
Student's current grade level:*
Does this student currently qualify for special education and/or English language learner services?*

Transfer Request

Only one application is necessary for those requesting consideration at more than one school.

Student's assigned school:*
Please call Transportation at 765-482-1499 if you are not sure of the assigned elementary school for your address.
Please select the school at which you are applying for a Resident Student Transfer:*
If you request consideration at more than one school, please indicate your second choice:
Does the student have a sibling attending the school for which the Resident Student Transfer application is being made?*
If yes, what is the sibling's grade level?
Are you submitting a Resident Student Transfer request for another child in your family?*
Please submit separate applications for each student.
If yes, are you willing to have only one student accepted for Resident Student Transfer if space is not available for all family members?

Employee Information

Proof of residency and custody documents, if applicable, are required for student registration.

Employee Name:*
Notification of decision will be sent to this email address.
Employee Address:*

Acknowledgements

Please carefully read each statement and check yes to indicate your acknowledgement.

A) I understand that if accepted, Resident Student Transfer placement can be removed due to excessive absences or tardiness, behavior issues, or other concerns.*
B) I understand the district has the right to change my child's Resident Student Transfer placement based on district needs such as staffing and services.*
C) I understand that I will not be able to change my child's elementary school placement if accepted for Resident Student Transfer.*
D) I understand that if accepted, no transportation is provided, which may include after school and late buses. I plan to provide drop-off and pick-up transportation daily for my child.*
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