2014-2015 Enrollment Packet
_______________________________________________________
Please review the information below. Based on your student (s) grade and applicable circumstances, you are required to submit documentation in order to complete this step in the enrollment process. You can fax, scan and email, or mail the required enrollment paperwork.Important Note: Please send copies only, do not mail the original documents.
Fax (preferred): 1.517.798.5012 Scan and email: [email protected] Mail: See address above
Required for? Item Description Provided by?
Proof of Age Official Birth Certificate (not the hospital issued certificate.) Provided by you
Required for all Students
Proof of Residency
Must include guardian name and verify student address. Examples include a utility bill, a current driver’s license or state ID, a mortgage statement, a property deed, or a residential lease agreement.
Provided by you
Immunization Record
Student’s immunization records signed by a physician.
Provided by you
Release of Student Records
By filling out this form, you are giving our school permission to request your student’s official records from their previous school after the approval process. If your child was Homeschooled please indicate it on the form, fill out the top portion and sign it. Please do not submit this form to your student’s previous school, GLOS will submit it after your student has been approved for enrollment.
Provided in this packet
Free and Reduced Meals form
Please complete this form even if you do not think you qualify, and submit along with other enrollment papers.
Provided upon request
Required for all rising 9th graders
Report Card A copy of your student’s current or most recent report card. Provided by you Required for all rising
10th-12th graders Transcript and Report Card A copy of your students current Transcript and most current report card. Provided by you Required for students
with an IEP or other Special Education needs
IEP A copy of your student’s current IEP (Individualized Education Plan). Please submit the most current plan, as these expire yearly.
Provided by you
Evaluation Report
The Evaluation Report is valid for 3 years. If you do not have a copy of your student’s ER, you can request a copy from your student’s current school.
Provided by you
Required for students that have a 504 plan
504
Accommodation Plan
A copy of your student’s current 504 Accommodation Plan. Please submit the most current plan, as these expire yearly.
Enrollment Process for GREAT LAKES ONLINE SCHOOLS.
Step 1: Contact GLOS to obtain the enrollment packet: 989-729-3492 or go online to greatlakesonlineschools.com/enroll to download a copy. Step 2: Once you have receive the enrollment packet please fill it out as completely as possible. If you have any questions please call 989-729-3492 or email [email protected].
Step 3: Turn in the Enrollment Packet and all necessary paperwork by dropping it off at the district administration building, or submit via fax to: 517-798-5012, or scan and email to [email protected].
Be sure to include the following: 1: Records Release Request
2: School of Choice Application and Student Registration Application (3 pages) 3: Non-resident release form (if student resides outside of Ovid-Elsie School District) 4: A copy of the student’s proof of age such as a birth certificate.
5: A copy of the student’s proof of residency such as a recent utility bill. 6: A copy of the student’s immunization records
7: A copy of the student’s most recent report card and/or transcript.
8: A copy of the student’s most recent Individual Educational Plan (IEP), Evaluation report, or 504 plan (if applicable).
Step 4: After turning in your paperwork please wait to be contacted by the Site-Coordinator guaranteeing your enrollment. Please note that there are a limited number of seats available, and NOT ALL STUDENTS ARE GUARANTEED ENTRANCE INTO THE PROGRAM. Please DO NOT remove the student from their current school district until you are told that you have been accepted into GLOS. If the student must be released from their current school district, Great Lakes Online Schools will submit the non-resident release form and records request to the appropriate school.
Step 5: After the Site-Coordinator confirms your enrollment you will be asked to come into the Academic Enrichment Center to review your educational plan, set up your schedule, receive your laptop, get your photo taken for a school ID, and sign additional paperwork.
Step 6: Once you have been placed into your courses with Connections Academy (our online learning partner) you will receive an email and/or a phone call letting you know what your username and password is for Connexus.com (the website that you will log into to complete your courses).
________________________________________________________________________________________
Submit application by fax to 517-798-5012, or by mail to 8989 E. Colony Rd. Elsie MI, 48831. Applications may be submitted in person to the Ovid-Elsie Administration Building between the hours of 8:00 am to 4:00 pm Monday –Thursday. Call 989-834-2271 ext. 1122 to check staff availability during summer months. All school of Choice applications must be received no later than September 2, 2014.
Ovid-Elsie Are Schools will refuse to enroll a nonresident applicant if he/she has been suspended or expelled in the past two (2) years.
Please note that the following applies to Schools of Choice applications for students who reside in an intermediate school district other than Clinton County RESA. If your application for schools of choice enrollment is accepted and if your child is eligible for special education programs and services according to statue or rule, or is a child with disabilities, as defined under the individuals
with disabilities education act, Title VI of Public Law 91-230, actual enrollment cannot occur until Ovid-Elsie Area Schools reaches a written agreement with the district in which you reside. This agreement will address providing your child with a free appropriate
public education and must also include, but is not limited to, and agreement on the responsibility for the payment of the added
costs of special education programs and services for the pupil. If such agreement is not reached, your application will not be accepted.
Office use only:
2014-2015 Records Release Request
Please accept this document as formal approval for the release of all official school records (including the record of transcripts, behavioral reports, testing information, special education, health and immunization records.)
STUDENT INFORMATION Student’s Full name : Student’s Date of Birth Student’s Legal
Address: Home Phone:
Check below if applicable:
Student was always previously homeschooled. If yes, do you have a transcript? _________________________ Student previously attended another online school. If yes, what school? ______________________________
PRIOR SCHOOL INFORMATION
Name of Prior School:
Prior School Address:
Prior School Phone: Fax:
SIGN AND DATE BELOW
Name of Parent or Legal
Guardian:
Parent/Guardian’s
Signature: Date :
FOR SCHOOL OFFICIALS ONLY
Please send records to:
Great Lakes Online Schools
C/O Ovid-Elsie Area Schools
Attention: Jamie Kirby
2014-2015 School of Choice and Student Registration Application
STUDENT INFORMATIONDate of Application : Full Legal Name:
Legal Address: City: Zip: Grade Entering 2014-2015: Last Grade Completed
Last School Attended: School District in which you live:
Date of Birth: Birthplace:
Gender: Male Female
Ethnicity: Is this student Hispanic/Latino? No Yes
Race: (Please check all that apply) White Hispanic/Latino Black/African American
Asian Pacific Islander American Indian/Alaskan Native
Note: Both Ethnicity and Race sections must be completed. We encourage you to select an answer for both parts. If either part is not answered, the US Department of Education requries the school district to supply an asnwer on your behalf.
Does this student receive Special Education services? Yes No If yes, type of service: _________________ Has this student previously attended Ovid-Elsie Area Schools? Yes No If yes, when?: _________________ Has your child ever been suspended from any school? Yes No If yes, why?_________________________ If student has siblings currently attending Ovid-Elsie Area Schools as a Schools of Choice student? If yes, please list names: ___________________________________________________________________________________________ Please list any current legal court documents or restraining orders pertaining to this student. A copy of this information must be provided to the district.
P
ARENT INFORMATIONParent/Guardian’s full name:
Street Address:
City: Zip :
Phone (Home): Alternate (Cell):
P
RIOR SCHOOL INFORMATION(
INCLUDE ALL SCHOOLS IN THE LAST2
YEARS)
List most recent first
Name of Prior School:
Prior School Address:
Prior School Phone: Fax:
Name of Prior School:
Prior School Address:
Prior School Phone: Fax:
Has your child ever been expelled from any school district? Yes No Has your child ever been suspended from any school within the last two years? Yes No
By my signature below, I give permission for the release of discipline information for
______________________________ (Student’s name), to Ovid-Elsie Area Schools, and I certify that all of the information contained in this application form is complete and correct. I understand that any incorrect or
inaccurate statement, including but not limited to the statement on suspensions and expulsions, will result in non-admission and no further consideration of this application or if already admitted, immediate suspension and dismissal as a student.
Parent/Guardian’s name (print):___________________________________
Parent/Guardian’s signature (required) ___________________________________________Date: ____________________
P
RIMARYH
OUSEHOLD INFORMATIONPrimary Household address: Number N/S/E/W Street Name Apt/Lot# PO Box City State Zip State County Primary Household Phone with Area Code
With whom does the student reside (primary residence)? Joint Custody? Yes No
Mother/Father Mother/Stepfather Mother Only Father/Stepmother Father Only Other Parent Guardian Info 1st parent’s info Legal Guardian?
Yes No
2nd parent’s info Legal Guardian? Yes No
Name:
S
ECONDARYH
OUSEHOLD INFORMATIONDoes the student have a parent at the second residence? Yes No Joint Custody? Yes No
Secondary Household address: Number N/S/E/W Street Name Apt/Lot# PO Box City State Zip State County Household Phone with Area Code
With whom does the student reside (primary residence)? Joint Custody? Yes No
Mother/Father Mother/Stepfather Mother Only Father/Stepmother Father Only Other *Biological parents will receive mailings and access to student information unless court documentation supplied indicates otherwise.
Secondary Household Info: 1st parent’s info Legal Guardian? Yes No
2nd parent’s info Legal Guardian? Yes No
Name:
Cell phone (include area code) Work phone (include area code) Email address (for district purposes only)
E
MERGENCYC
ONTACT INFORMATIONHousehold Emergency Contact Information (Parents/Step-parents/Guardians)
Number from 1 to 4 the order they should be contacted (if applicable): Mother _____Father _____ Stepmother ________ Stepfather ________Other: __________________________ Other: ______________________________
Non –Household Emergency Contact Information (if no Parent/ Guardian are available) 1. Name: ________________________________________________Gender: M___ F___
Relationship to student: _________________________Phone #1: ___________________Phone #2____________________ 2. Name: ________________________________________________Gender: M___ F___
Relationship to student: _________________________Phone #1: ___________________Phone #2____________________
H
EALTHH
ISTORYPlease circle any current medical conditions:
Asthma ADD/ADHD Bee Stings Diabetes Drug Allergy EPI-pen Food Allergy Seizure Other: If Drug and/or Food allergy is circled, specify what this student is allergic to:_______________________________________
Please list prescribed medications currently taken by this student: ________________________________________________ *Please note. All medications taken at school must follow Michigan Law, which requires schools to have a written physician’s order and parent/guardian authorization. (Medication Authorization forms available on line or at school)
EMERGENCY CARE PERMISSION
In case of serious illness or injury, I hereby request and give my full consent for authorized school personnel to transport my child directly to the nearest hospital, or send by ambulance if needed, and I will assume all financial obligations. I further authorize any licensed physician or dentist and/or hospital to provide necessary treatment. I understand this health information can be shared when it is educationally relevant for academic progress, necessary for providing health services including emergency care, or essential to ensure the protection of other students and school personnel. I understand this permission will continue to be in effect as long as the student is enrolled in Ovid-Elsie Are Schools District, unless revoked in writing.
GREAT LAKES ONLINE SCHOOLS C/O OVID-ELSIE AREA SCHOOLS
Non Resident Release Form
Important: Completion of this form does not automatically enroll a child in another district. The parent(s) is responsible for contacting the district in which the child/children wishes to attend, completing enrollment papers, supplying immunization records and birth certificate along with any other required forms.
Name of Parent (s)_________________________________________________________Date: ____________________________________ Address: _________________________________________________________________Phone: __________________________________
Name(s) of children to be released Grade Date of Birth
_________________________________________________ ______________ ________________________ _________________________________________________ ______________ ________________________ _________________________________________________ ______________ ________________________
Name of School District of residence: ___________________________________________________________________________________ Name of School District you are currently attending: _______________________________________________________________________ School District you would like your child to attend: _________________________________________________________________________ Does the student (s) receive special education services? ___________________________________________________________________ Has the student (s) been expelled from a school? _________________________________________________________________________ Are charges for expulsion pending against the student (s)? __________________________________________________________________ Please state why you want your child/children released: ____________________________________________________________________
Note: The signature of the parent/guardian/student (if over 18 years of age) found below indicates understanding of, and adherence to, the stipulations, operation aspects of “Open Enrollment” procedures and the “Hold Harmless Clause” found below. This decision to request a school other than our residential school is the best interest of the education of our child/children.
______________________________________________________________________ ________________________ Signature of Parent(s)/Guardian(s) or Student (if over 18 years of age) Date signed:
HOLD HARMLESS CLAUSE: (PLEASE READ CAREFULLY) The parent(s), guardian(s) or student of over 18 years of age making application for participation in the Ovid-Elsie Are Schools “Open Enrollment” Project agree(s) to hold harmless each contiguous public school district, its’ employees, and Board of Education members for any decision in the selection process and/or potential participation or actual participation as an “Open Enrollment” child/student relative to academic achievement, co-curricular participation, student discipline related to behavior, and/or all other aspects of participation as a member of a student body. Please release all information regarding the above named student to the receiving school district. Information should include all documents in the following categories: CA60 and CA39 records, MEAP scores, EDP, portfolios, disciplinary files, psychological evaluations, social worker or Department of Social Services, mental health recommendations, grade reports, transcripts, records of special education placement, evaluation or referrals and any other pertinent information.
By Board Policy and Sec. 105 & 105C of the State School Aid Act, you may not attend any Clinton County Public School or a contiguous district until that school has received up-to-date immunization records.
I hereby RELEASE the above named student (s) to the Ovid-Elsie Are School District. THIS RELEASE WILL REMAIN IN EFFECT AS LONG AS THE STUDENT IS ENROLLED AT OVID-ELSIE AREA SCHOOLS.
Releasing Superintendent: __________________________________________________Effective Date: _________________________ I hereby (ACCEPT/DENY) the above named student (s) to our school district.
