SCH Permanent Transfer Request Application

Home School
Parent/Guardian Name:
Phone Number Phone Number - ### - ### ####
Parent Email:
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
List the names of the children you want to include in this transfer:
Name
Date of Birth Date of Birth / MM / DD YYYY
Grade
Special Education

Special Education Yes No
School Currently Attending
School Requested 1
School Requested 2
School Requested 3
Additional Student

List the names of the children you want to include in this transfer:
Name
Date of Birth Date of Birth / MM / DD YYYY
Grade
Special Education

Special Education Yes No
School Currently Attending
School Requested
Additional Student

List the names of the children you want to include in this transfer:
Name
Date of Birth Date of Birth / MM / DD YYYY
Grade
Special Education

Special Education Yes No
School Currently Attending
School Requested
I am requesting this transfer because:
Please Note:

This transfer is permanent and is only for the student(s) listed above. It does not guarantee that other siblings or wards will be able to transfer to the same school.
Transfers are dependent upon space availability and the students’ academic, attendance, and disciplinary record. This transfer is contingent on the student’s behavior and can only be revoked for disciplinary and/or attendance reasons.  If your transfer is approved please note that the School City of Hammond will not provide transportation, it will be the parent/guardian(s) responsibility to provide transportation.
A permanent transfer is good for the duration of the time the student is attending his/her specific school. When a student has completed his/her education at that school the parent/guardian must complete a new permanent transfer from for the next phase of the educational process.
If a student is withdrawn or if the stipulations of the permanent transfer are violated the withdrawal/violation automatically voids this permanent transfer and the student must register at his/her home school.
If your child has participated in sports at their current school, transferring to a new school could affect their eligibility to play sports. An athletic transfer must be completed at the new school to determine athletic eligibility by the IHSAA.
Signature of Parent/Guardian:

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:
This transfer was approved / denied therefore student must enroll at
Date Parent was contacted (Decision): Date Parent was contacted (Decision): / MM / DD YYYY
Administrator for Student Services

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.
NOTES:

SCH Permanent Transfer Request Application

SCH Permanent Transfer Request Application

List the names of the children you want to include in this transfer:

Additional Student

Additional Student

Please Note:

FOR USE BY STUDENT SERVICES: