Eligibility Verification of Transfer Student

Eligibility Verification of Transfer Student
Student & Family Information
Student Information
Student Name*

First NameLast Name
Grade*
Birth Date*

MonthDayYear
Date
Previous Schools

Must list all schools attended upon initially entering 9th grade (in person and virtual).
Select a School from the list. If it is not found, select "Other"*
School Name*
State School Is Located In*
Transfer Scenario
State Reason for Transfer*
Please select one of the following:*

Change of residence by parents/guardians with studentChange of residence by the student onlyPending change of residence by parents/guardians with studentsNo change of residence by parents/guardians or student
Student's Current Address
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Currently lives with:*

MotherFatherOther (Relationship to student)
Is the student's current address within the receiving school's district or territory?*

YesNo
Student's Former Address
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previously lived with:*

MotherFatherOther (Relationship to student)
Date Left

MonthDayYear
Date
Parent/Guardian Information
Previous Residence of Parents/Guardians was:*

OwnedRentedOtherN/A
Previous Residence of Parents/Guardians is still:*

OwnedRentedOtherN/A
New Residence of Parents/Guardians is:*

OwnedRentedOtherN/A
Date of occupancy at new residence:*

MonthDayYear
Date
Parent's Marital Status*
Mother Description
Modify the Parent/Guardian designations as needed by typing a new description into the 'Mother' entry box as needed.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Father Description
Modify the Parent/Guardian designations as needed by typing a new description into the 'Father' entry box as needed.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Sports Participation

Please select all sports and levels the student participated in from grades 9-12

	Var (9)	NV (9)	Club (9)	Var (10)	NV (10)	Club (10)	Var (11)	NV (11)	Club (11)	Var (12)	NV (12)	Club (12)
Baseball
Basketball
Cross Country
Football
Golf
Gymnastics
Hockey
Lacrosse
Softball
Soccer
Swimming & Diving
Tennis
Track & Field
Volleyball
Wrestling

Siblings

List information below for all siblings of the Student
Student's Siblings*
Should be Empty:

Eligibility Verification of Transfer Student

Student & Family Information

Student Information

Previous Schools

Transfer Scenario

Student's Current Address

Student's Former Address

Parent/Guardian Information

Sports Participation

Siblings