Out of District Transfer Application

Student Last First Middle Name
DOB (MM/DD/YYYY)
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
School Requested - 1st Choice
School Requested - 2nd Choice
School Requested - 3rd Choice
*Please choose another school since the first or second school choice may have reached its capacity
Current Grade
Regular Education

Regular Education Yes No
Special Education

Special Education Yes No
School District of Residency
Name of Previous School
Previous School Address Previous School Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Has your child been expelled or suspended in the past school year
Name of Principal - Previous
Name of School Counselor - Previous
School Phone # School Phone # - ### - ### ####
Parent/Guardian #1 REQUIRED
Name Name First Last
Relationship to Student

Relationship to Student Mother Father Legal Guardian Other
Does the student live with this parent / guardian

Does the student live with this parent / guardian Yes No
Primary Phone # Primary Phone # - ### - ### ####
Cell Phone # Cell Phone # - ### - ### ####
Work Phone # Work Phone # - ### - ### ####
Employer
Email
Parent/Guardian #2 REQUIRED
Name Name First Last
Relationship to Student

Relationship to Student Mother Father Legal Guardian Other
Does the student live with this parent / guardian:

Does the student live with this parent / guardian: Yes No
Primary Phone # Primary Phone # - ### - ### ####
Cell Phone # Cell Phone # - ### - ### ####
Work Phone # Work Phone # - ### - ### ####
Employer
Email
Reason for requesting this transfer:
Sibling(s) attending SCH - Name of sibling(s) and school
Paqrent or Guardian is an employee of SCH - Name of Employee
(Check all that may apply and/or explain your reason below)

(Check all that may apply and/or explain your reason below) The student’s previous legal settlement was in the School City of Hammond and relocated outside of the school corporation and is requesting to remain as a student. Campagna Academy students – Students residing in School City of Hammond, as currently or formerly enrolled students will be re-enrolled while attending Campagna Academy (DRP). Curriculum/honors courses that are being offered at the School City of Hammond are necessary for the student’s established academic or vocational aspiration and the same or a substantially similar curriculum offering is unavailable at the transferor’s school. The transferor school is overcrowded and School City of Hammond schools are not. The overcrowded conditions of the transferor school materially affect the student’s opportunity to learn, while the conditions for School City of Hammond would be significantly less crowded. The student has a medical condition that could be better accommodated by attending the School City of Hammond schools rather than the transferor school. Attendance at the transferor school poses a risk of physical illness, while attendance at School City of Hammond would substantially reduce this risk. (This would have to be supported by written documentation of two (2) persons holding unlimited licenses to practice medicine in Indiana who have personally examined the student). The transferor school is not fully accredited by the State Board of Education, and the student’s request is related to the reason that the transferor school has probationary accreditation status.
Please indicate below the reason this transfer is being requested on behalf of the above-named student(s) and describe in detail why the transfer is necessary to better accommodate the student(s).
The following applies to High School students ONLY:
Do you plan to participate in extra-curricular activities?

Do you plan to participate in extra-curricular activities? Yes No
The family is responsible for providing transportation for the student who has been granted a transfer.
I understand that transferring schools may affect my child’s eligibility to participate in athletics. School City of Hammond Schools follows the Indiana High School Athletic Association (IHSAA) eligibility rules in regard to transfers between schools. Information regarding the rules may be obtained from the Athletic Director in your high school or at www.IHSAA.org.

This is the description of your section break.
Do you participate in athletics at your current school?

Do you participate in athletics at your current school? Yes No
Sport(s):
Do you plan to participate in athletics if transferred?

Do you plan to participate in athletics if transferred? Yes No
Sport(s):
Parent Statement: Please sign below to authorize School City of Hammond officials to contact your current school of legal settlement or prior school attended for further information for the child listed in this Out of District Transfer Request Agreement. Also, it is understood that we, as parents, must assume responsibility for adequate transportation and supervision to and from school. We certify that we have read and agree to the above terms of the School City of Hammond.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY
FOR USE BY STUDENT SERVICES
Transcripts Discipline Record
This transfer was approved / denied therefore student must enroll at
Date parent was contacted (Decision): Date parent was contacted (Decision): / MM / DD YYYY
Residency Documents:

Residency Documents: NIPSCO / water/sanitation bill Matriculate Card State Issued Letters IN DL / State ID Verification letters Public Assistance/Social Security Employee check or stub Vehicle registration Lease Agreement/ Mortgage papers Tax Returns from past year / W-2’s Other ID Other ID
Administrator for Student Services
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Frequently Asked Questions

Q. Do you have to provide the students requested documentation (attendance, discipline and transcripts or
report cards)?
A. Yes, you must have documentation of attendance, discipline and grades for consideration of approval.
For grades 1-5, Student(s) report card and attendance reports are needed;
For grades 6-12, Student(s) unofficial transcript, attendance and discipline reports are needed
All documents must come from the previously attended school when submitting application.
(See footnote1 listed below)
Q. Do you have to provide proof of your current residence?
A. Yes, you must have two (2) proof of residency, e.g. (NIPSCO, water, driver’s license, employer check stub;
car registration; mortgage or lease contract)
All proof of residency must have the current address (within at least thirty days of enrollment)
Q. Of the students applying for approval were any suspended for more than 9 days?
A. Unfortunately, the school district will not accept any student that has been suspended for more than nine
(9) days consecutively. It is at the discretion of the school district to withdraw any student if the student is
facing disciplinary charges of expulsion per Indiana Code.1
Q. Are any of the students requesting an Out of District Transfer on suspension pending an expulsion at this
time?
A. Unfortunately, the school district will not accept any student that previously has been or is currently
expelled or is pending an expulsion. (see footnote1 listed below)
Q. How long will the approval process take?
A. All transfers are individually deciding upon and carefully considered. Parents will be notified by mail and/
or phone before the start of the beginning of the school year or as soon as a decision is made.
Board policy 5111:
Transfer Students
In addition to students with legal settlement in the Corporation, students without legal settlement in the
Corporation (hereafter referred to as "transfer students") will be enrolled in compliance with I.C.
20-26-11-32 and the following procedure:
1. By August 1, the Board will establish the number of transfer students that can be accepted in each
building and grade level.
2. The Board will establish a date by which requests to enroll a transfer student must be submitted to
the Superintendent. This date shall be submitted to the Indiana Department of Education and
published on the Corporation Internet website.
3. Requests to enroll a student without legal settlement in the Corporation shall not be denied if the
student to be transferred:
a. has been enrolled in the Corporation in the prior school year;
b. is a member of a household in which any other member of the household is a student in
the transferee school; or
c. has a parent who is an employee of the Corporation who currently resides in Indiana and
has a salary of at least $8,000 or $3,000 earned due to being included an employee in the
extracurricular portion of the Corporation's collective bargaining agreement and the
Corporation has the capacity to accept the student.
4. If the number of requests to enroll in each building and grade level exceeds the number
established by the Board reduced by the number of transfers that may not be denied as described
in paragraph (C) above, the students to be enrolled in each building and grade level shall be
determined by random selection in which each application submitted on or before the date
established by the Board pursuant to paragraph (A) above has an equal chance of being selected.
Pursuant to State law, the Board may deny a student’s application to transfer to the Corporation,
discontinue enrollment of a transfer student currently attending, rescind approval of a student approved to
attend in a subsequent year, or establish terms or conditions for enrollment or for continued enrollment in a
subsequent school year, if:
1. During the preceding twelve (12) months, the student has been suspended or expelled for:
a. ten (10) or more school days;
b. possession of a firearm, deadly weapon, or a destructive device;
c. causing physical injury to a student, school employee, or visitor to the school; or
d. a violation of the Corporation's drug or alcohol rules.
2. the student has had a history of unexcused absences, and the Board believes that, based upon the
location of the student's residence, attendance would be a problem for the student if the student is
enrolled in the Corporation.
For purposes of computing the number of days of suspension of the student requesting enrollment, student
discipline received from a teacher pursuant to I.C. 20-33-8-25(b)(7) and I.C. 20-26-11-32(j) shall be
included in the calculation of the number of school days that a student has been suspended.
The Board delegates authority to the Superintendent to deny a student's application to transfer to the
Corporation, discontinue enrollment of a transfer student currently attending, rescind approval of a student
approved to attend in a subsequent year, or establish terms or conditions for enrollment or for continued
enrollment in a subsequent school year if the student meets the criteria listed above.
Transportation will not be provided by the School Corporation for transfer students accepted for enrollment
unless the transfer student has an Individualized Education Program (IEP) in which transportation is
required to be provided as a related service.
No transfer student shall be accepted for enrollment for athletic reasons.
Transfer students will not be charged unless otherwise required by law.
I have read the Board Policy 5111 parent signature. Draw your signature into the box below.

Draw or Type

I have read the Board Policy 5111 parent signature Clear

Full Name

I have read the Board Policy 5111 parent signature

Out of District Transfer Application

Out of District Transfer Application

Parent/Guardian #1 REQUIRED

Parent/Guardian #2 REQUIRED

Reason for requesting this transfer:

The following applies to High School students ONLY:

FOR USE BY STUDENT SERVICES

Frequently Asked Questions