2017-2018 Lamphere Schools  Schools of Choice Application
SECTION 105 SCHOOL OF CHOICE APPLICATION for the 2017-2018 SCHOOL YEAR

This application should be completed by persons seeking admission to The Lamphere Schools for the 2017-2018 school year, who reside in any Oakland County School District other than The Lamphere Schools.

The Lamphere Schools will accept students living in Oakland County districts, free of charge, on a space availability basis.

Applications must be received by September 5, 2017

ONE STUDENT PER APPLICATION
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Student Information
Grade Student Completed in 2016-2017 *
Grade of Child in Fall 2017
Preferred School (Elementary only)
Student Name (First, Middle, Last) *
Student Date of Birth (Month, Date, Year) *
MM
/
DD
/
YYYY
Gender *
Parent(s)/Guardian *
Street Address *
City and Zip Code *
Home Phone (if none, type none) *
Cell Phone (if none, type none) *
Mother's Work Phone (if none, type none) *
Father's Work Phone (if none, type none) *
School District of Residence *
District Attended in 2016-2017 *
Name of School Attended *
Do you already have a child attending Lamphere Schools? *
If yes, which School and Grade *
ADDITIONAL INFORMATION
1. Section 105 Choice is a once per year event.

2. For grades K-8, student’s most recent report card and behavior record must accompany application. For grades 9-12,
student’s most recent report card, transcript and official behavior record must be submitted to complete application.

Additional documents may be emailed to sandersd@lamphereschools.org or mailed to Lamphere Schools, attn: Denise Sanders, 31201 Dorchester, Madison Heights, MI 48071  ***PLEASE NOTE*** Your application will be reviewed and processed when all required documentation has been received.

Applications and additional documentation must be received by Friday, April 28, 2017.

3. It is not responsibility of The Lamphere Schools to provide transportation for Section 105 School of
Choice Students.

4. The Lamphere Schools will comply with all requirements of 1996 Public Act 30, Section 105,
(School of Choice).
Does your child require special services *
If yes, please explain
Has this student ever had school discipline referrals *
If yes, how many referrals in the past two years?
Reason for referrals
Has this student ever been expelled from a previous school? *
If yes, please explain
Has this student ever been suspended from a previous school *
If yes, please explain
Dates and total number of suspensions
Reason for making application to The Lamphere Schools *
How did you hear about Lamphere Schools Open Enrollment (check all that apply) *
Required
Signature/Acknowledgement
Clicking the Submit button grants The Lamphere Schools permission to seek student information/records from prior school district.
FALSE INFORMATION WILL RESULT IN DENIAL OF ENROLLMENT OR ATTENDANCE IN THE LAMPHERE SCHOOLS.
Submitted by *
Email address *
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