1112 E. Clay Street, New Buffalo, MI 49117 APPLICATION FOR SCHOOLS OF CHOICE OR TUITION DATE:

DATE APPROVED BY NBAS:

CHILD’S NAME:

___________________________________________________

ADDRESS:

____________________________________________________

CITY/ZIP CODE:

____________________________________________________

TELEPHONE NUMBER:

____________________________________________________

PARENTS’ NAME(S):

____________________________________________________

CHILD’S PRESENT SCHOOL:

____________________________________________________

GRADE LEVEL 2017-2018 SCHOOL YEAR:

____________________________________________________

SPECIAL PROGRAMS NEEDED (Special Education, Gifted & Talented – Please attach current IEP.)

____________________________________________________

Do you have any children currently enrolled in our district? ____________________________________________________ Has your child been suspended or expelled from school in the last two years? If yes, please explain: _________________________________________________________________________ Is there anything you would like us to know about your child? ______________________________________ ________________________________________________________________________________________ If interested in transportation, please circle one of the following pick-up points: Union Pier: Galien: Three Oaks:

Mario’s Pizza 122 E. Southeastern Ave (Old School) Oak & Paw Paw Oak & Locust Oakview Estates Lakewood Estates

(continued …….. Three Oaks) Hickory & Sycamore Hickory & Poplar Cherry & Butternut Cherry & Chestnut Hidden Harbor Villas (305 W. Locust)

PLEASE BE ADVISED THAT PROVIDING FALSE INFORMATION ON THIS FORM WILL BE GROUNDS FOR NONACCEPTANCE.

If your high school child is accepted, are there any extra-curricular activities they are interested in joining? There may be some summer activities before school starts.

Is your child’s application for the New Buffalo Area Schools contingent upon the New Buffalo Area Schools providing transportation to and from your resident district?

If yes to question #2, where is a convenient pick-up point?

Are there any other questions you have?

NOTE: THE BISON EDUCATIONAL TRUST CHOICE OR TUITION STUDENTS.

DOES NOT APPLY TO SCHOOLS OF

Tuition Fee: ____________________

____________________________________________ Parent (Guardian) Signature