Ingleside Independent School District 2452 First Street Ingleside, Texas 78362 Ph. # (361) 776-7631 Fax # (361) 776-0267

NONRESIDENT STUDENT REQUEST TO TRANSFER INTO THE DISTRICT 2017-2018

To allow staff adequat e ti me to meet TEA reporting requirements and to prepare for and administer state assessments, enroll ment applications will not be accepted during the following ti me periods for some or all grade levels: • Two weeks prior to t he TEA fall snapshot date. This applies to all students and covers the period October 17 to October 28, 2017 . • Transfer applications will not be accepted after the end of the fourth six weeks.

1.

Student’s name: _______________________________________________________________

2.

Current address: _______________________________________________________________ _____________________________________________________________________________

3.

School district where your address is located: ________________________________________

4.

Parent’s name: ________________________________________________________________

5.

Parent’s address: _______________________________________________________________ _____________________________________________________________________________ Home phone:

6.

Work phone: __________________________

Reason for transfer request: ______________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

7.

Is either parent /grandparent employed by INGLESIDE ISD:  Yes  No

8.

Has the student ever been enrolled in INGLESIDE ISD?  Yes  No

9.

Student’s grade level for year of requested transfer: ____________________

10.

Please complete the Texas Education Agency’s Application for Transfer found on the back of this page.

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TRANSFER AGREEMENT This Transfer Agreement establishes the terms and conditions for _____________________ (“student”) to attend the INGLESIDE ISD public schools (“District”) as a transfer student for the 2016-2017 school year, although the student is a resident of the __________________________________________ SD. The student’s parent or other person having lawful control of the student, __________________________________________ (“parent”), requests that the student be permitted to attend District schools in the INGLESIDE ISD school year and agrees to the following terms and conditions for that transfer: 01. This transfer is effective for the current school year only. District approval of this transfer creates no right or expectation that the student will be admitted as a transfer for any subsequent school year. 02. This transfer is approved for the named student only. District approval of this transfer creates no right or expectation that another student from the same family will be admitted as a transfer. 03. The student must maintain acceptable levels of attendance and compliance with District rules and regulations, including the Student Code of Conduct, throughout the entire school year. Acceptable levels are defined as: a.

Attendance that does not place the student at risk of losing credit under Education Code 25.092 or require the District to warn the parent or the student of truancy proceedings under Education Code 25.095;

b.

Compliance with the District’s rules and regulations, including the Student Code of Conduct, such that no offenses result in removal to a disciplinary alternative education program or expulsion, and no more than 7 (seven) referrals are made within any semester for other misconduct. Discipline shall be correlated to the seriousness of the offense, the student’s age and grade level, the frequency of misbehavior, the effect of the misconduct on the school environment, and statutory requirements.

04. In accordance with Board policy FDA (LOCAL), the Superintendent may revoke the transfer of a student who fails to maintain an acceptable level of attendance or compliance with District rules and regulations, including the Student Code of Conduct. Notice of revocation will be sent to the district of residence. 05. If this agreement is revoked, revocation ordinarily will be effective at the end of a semester; however, the Superintendent has discretion to revoke the transfer immediately if the student’s continued attendance threatens the safety of other students or teachers or will be detrimental to the educational process. 06. The parent or the student will be responsible for transportation to and from the District school to which the student is assigned. 07. The student and parent acknowledge that eligibility of transfer students for participation in any UIL activity or other activities governed by UIL rules and regulations will be determined in accordance with UIL rules and regulations. 08. Except as modified by this transfer agreement, the student will be subject to all policies, regulations, rights, privileges, and responsibilities of enrollment in the District as if he or she resided in the District.

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PLEASE CIRCLE THE APPROPRIATE RESPONSE Ye s No

I s E n g li s h sp o ke n i n yo ur ho me mo st o f t h e t i m e? I f no , wh a t la n g ua g e i s s p o ke n? Ye s No Ha ve yo u e ver s u sp e cted t hat yo ur c h ild mi g h t h av e a lea r ni n g d is ab i li t y ? Ye s No I f ye s , ha s yo ur c hi ld e v er b ee n r e ferr ed fo r a co mp r e he n si ve a s se ss me nt ? If ye s , p l ea se g i ve r e fer r al d a te a nd wh o d id t he ev al u at io n. Dat e / E va l uato r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Plea se id en t if y t he e du ca t io na l se rv ic e s y o u r chi l d ma y n ee d. Ye s Ye s Ye s Ye s Ye s Ye s

No No No No No No

Ye s No

Mo d i f ica tio n s i n t h e re g ul ar c la s sro o m Gi f ted & ta le n ted i ns tr u ctio n Sp ec ia l ed uc at io n i n s tr u ctio n D ys le x ia ser v ice s Sec tio n 5 0 4 s er vi ce s o r mo d i fi cat io n s Re la ted ser v ice s : ( p l ea s e cir cl e) O cc up a tio n al t her ap y, p h ys i cal t he rap y , sp e ec h th er ap y, p s yc h o lo g ica l t her ap y, ad ap t i ve p h ys . e d uc ., a s si st i ve te c h no lo g y o r sp ec ia li zed eq u ip m e n t. Ha s t h i s s t ud e n t b e e n re tai n ed ? If ye s , l i st gr ad e le ve l( s)

Ye s No

Ha s t h i s s t ud e n t e v er b e en s u sp e nd ed , e xp el led and /o r a tt e nd ed a n a lter na ti v e ed u cat io n p r o gr a m fo r d is cip li nar y rea so n s? If ye s , e xp lai n _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Ye s No

Ha s t h i s s t ud e n t e v er b e en ci ted fo r fa il ure to at te nd sc ho o l o r t r ua nc y ?

Do c u me nt a t io n R eq u ir ed All d o c u me n t s mu s t b e c o mp let ed a nd rec ei ved i n o rd er fo r ap p l ica tio n t o b e co n sid ered . It i s th e p a ren t s’ re sp o n sib il it y to in c lu d e req u i red d o cu men t s wi th a p p l ica t io n 1 . Att e nd a nc e r e co r d s fro m p rio r a nd c urre n t sc ho o l year . 2 . Rep o r t c ar d s fr o m la st y ear a nd c urre n t ye ar. 3 . Co p y o f S tat e As se s s me nt s s co re s fro m la st t wo ye ar s 4 . Di sc ip l i ne r e co r d s fro m p rio r sc ho o l d i str ic t. 5 . Sp ec ia l p r o gr a ms f ro m p rio r sc ho o l d i s tric t ( i f a p p lic ab le )  All c he c kl is t ite ms mu s t b e co mp let ed a nd t ur ne d i nto t he S up er i nt e nd e n t ’s o ffi ce.  A co m mi t tee wi l l t h e n c o n sid er t h e ap p lic at io n fo r p o s sib le p lac e me n t i f t here i s a v ai lab i li t y o n th e c a mp u s b e i n g r eq ue s ted .

D ue to D i f fer e nt C a mp u s P o p ula tio n s a nd Sp ac e / I n str u ct io nal S ta ff Av ail ab i li t y, All T ran s fe r s W il l B e D eter mi n ed O n An I nd i v i d ua l B a si s No t B y F a mi l y.

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NOTES TO PARENTS AND STUDENTS

District policies can be accessed on line at www.inglesideisd.org. As a p ar e nt o r p er so n st and i n g i n t he p o s it io n o f le ga l re sp o n sib il it y fo r th e c h ild n a med i n t hi s r eq u es t, I ac k no wl ed g e t h at t he T r ans f er Ag r ee me nt t ha t mu s t b e e xec u ted b e fo r e t he c hi ld i s e nro l led i n t he Di str ic t. T h e i n fo r ma tio n p r o v id ed i n t h i s fo r m i s t r ue a nd fac t ua l t o t he b es t o f m y k no wl ed ge, a nd I u nd er s ta nd t hat i f a n y o f t hi s i n fo r ma tio n i s e ve r fo u nd to b e i nco rrec t, t hi s ap p l ica tio n ma y b e d en ied o r revo k ed . If gr a nt ed , e ac h tr a n s fer is val id fo r a p er io d o f o ne s c ho o l ye ar o n l y, a n d is s ub j e ct to re vo cat io n d u r i n g th e sc ho o l year ad o u tl i ned i n Di st r ic t p o l ic y F D A ( lo ca l) a nd t he No n - Re s id e nt S t ud e nt T ran s fer Ag ree me n t. Ap p ro val o f a tr a n s fe r r eq u es t fo r t he c urre n t ye ar d o e s no t i mp l y o r g ua ran te e t h at a tr a ns fer re q ue s t wi l l b e ap p ro ved t he fo l lo wi n g year . P ar e nt/ g u ard ia n mu s t re - ap p l y fo r a tr a ns fer e ac h sc ho o l y ear. T h e st ud e nt mu s t ma i nt ai n al l p er fo r ma n ce s ta nd a rd s eac h se me s ter p er P o l ic y FD A ( lo ca l). In g le sid e IS D d o e s no t p r o v id e tr a n sp o rt at io n t o o r fro m sc ho o l fo r tra n s fer s t ud e n ts. B y si g n i n g b e lo w, I a u t h o r ize I n g le s id e I SD to a na l yze ed uc at io n re co rd s o f m y c hi ld ( s) a tt e nd a nc e, grad e s, sta te as s es s me n t s a nd co nd uc t fo r t he sc ho o l d i st ric t l i st ed ab o v e. I n re t ur n fo r t he d i str ict p er mi tt i n g m y st ud e nt to tr a n s fer i nto a d is tri ct s cho o l, I e xp re s sl y wa i ve an d re lea se a n y c la i m t ha t I ma y h a ve t ha t t h e d i s tr i ct c a n no t r e vo ke a tr a ns fer , a nd /o r t h at t he tra n s fer o f m y s t ud e nt mu s t b e fo r a p erio d o f o n e yea r . B y m y s i g na t ur e b e lo w, I e xp r e s sl y co n fir m t ha t I a gree wi t h a nd ac cep t all o f t h e rea so n s fo r a t ran s fer agr ee me n t, a nd f ur t her a gr e e t h at t hi s a gree me nt ca n b e re vo ked fo r a n y o f t ho se re a so ns b e fo re t he e nd o f t he sc ho o l ye ar fo r whi c h t h e t r a n s fer i s ap p r o ved .   

P aren t s nee d to co mp l et e ap p l ica tio n , re t ur n a ll req u ired i n fo r ma t io n to th e S up er i nte nd e nt ’s o ffice. Ap p l ica tio n s wi ll b e p r o ces s ed a nd d eter mi na tio n wi ll b e mad e i f ap p l ic an t me et s lo ca l d is tri ct p o lic y F D A lo c al. I f s t ud e nt d o e s no t mee t cri teri a, p a re nt wi l l b e no t i fied .

Parent’s signature ___________________________________________________

Printed Name_______________________________________________________

Date __________________________________

Texas Education Agency Division of Equal Education Opportunity

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Application for Transfer 2017-2018 Authority for Data Collection! Texas Education Code 21.061: Civil Action 5281, Section A Planned use of Data: To complete the report required by Federal Court Order Civil Action 5281. Instructions: This form must be used for all student transfers, within the State of Texas, including hardship. Column instructions can be found on the reverse side of this form. The Superintendent of the receiving district must circle, approved or disapproved, and sign the transfer form. For further Information, contact the Division of Equal Education Opportunity at (512) 463-9671. Student's

Last

First

Ml

Gender (M/F)

Student’s SS or ID Number

Student’s DOB (mm/dd/yy)

Student’s In Ethnic District Code Last Year Y

Sending Co. District Number

Exempt Hardship Code

N

Please Note *** Any attendance or discipline problems will be reason for this transfer to be revoked. This section must be completed by a parent or guardian. I have been informed of the receiving district's policy concerning tuition charges, if any, for a transferred student whose grade is taught in the student's district of residence; and I accept responsibility for the payment of tuition.

Signed _____________________________________________________, Date _____________ Parent / Guardian Signature Street Address: _______________________________________________________________________________ City, ________________________________________State, _________Zip:_________________ Home Phone ( ) ___________________________________________ Work Phone ( ____________________________

)

This section must be completed by the receiving District Superintendent The above transfer was approved/disapproved on this _______ day of ____________, 201___.

Typed Name of Receiving

Telephone

Superintendent's Signature

District’s Superintendent

Troy Mircovich

361-776-7631

One copy should be retained at both districts for audit purposes.

DO NOT MAIL TO THE TEXAS EDUCATION AGENC

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Grade Level

Receiving Campus Number