McAlester Public Schools

Please Fill Out The MPS Transfer Application Form Below

Full name of student as it appears on the student's birth certificate:

Date of student's birth:

Reaquired field:

Address

City

State / Province / Region

Zipcode Min: 1 Max: 5

Country

Full names of parent(s), guardian(s), or custodian(s) of the student:

Educational History

School district in which student currently resides:

School in which the student is currently enrolled, if different from above.

If the student has not exclusively attended the school district in which the student is currently enrolled, list the name of EACH school district and addressed, if known, in which the student has ever been enrolled:

School:

Dates of Attendance:

Grade Completed Upon Leaving District:

School:

Dates of Attendance:

Grade Completed Upon Leaving District:

School:

Dates of Attendance:

Grade Completed Upon Leaving District:

Current or last completed grade of student:

Grade in which the student desires to enroll:

Courses in which the student desires to enroll in each semester in the coming school year:

Does the student have a disciplinary record for violating school regulations?

Reaquired field: Yes

Reaquired field: No

If Yes, state school(s) in which each violation occurred and approximate date(s) of violation(s):

Has the student ever been suspended from school or placed in an alternative education program or setting for disciplinary reasons?

Reaquired field: Yes

Reaquired field: No

If Yes: For each suspension and alternative program or setting, state the school which suspended or placed the student; the nature of the offense; and approximate date of the suspension or placement, if different from the above:

Has the student been adjudicated as a delinquent for either a violent or nonviolent offense under relevant Oklahoma law?

Reaquired field: Yes

Reaquired field: No

If Yes: State the name of the court making the adjudication; the time of such adjudication; the nature of offense; whether the student is still under any court supervision; and, if so, the name of the person overseeing such supervision :

Has the student been convicted as an adult for either a violent or nonviolent offense as defined in relevant Oklahoma law?

Reaquired field: Yes

Reaquired field: No

If Yes: State the name of the court in which the conviction was entered; the time of the conviction; the nature of the offense; the sentence imposed; whether the student is still under any court supervision; and, if so, the name of the parole officer or other supervisor:

Has the student committed on school property, in school transportation, or at a school event, a violent act or an act showing deliberate or reckless disregard for the health or safety of faculty or others?

Reaquired field: Yes

Reaquired field: No

If Yes: State the school district attended when the act occurred; the approximate date of the act; and describe what occurred:

Has the student possessed on school property, in school transportation, or at a school event, an alcoholic beverage; low-point beer, as defined by relevant Oklahoma law; or been involved with missing or stolen property found to have been taken from a student, school employee, or the school during school activities?

Reaquired field: Yes

Reaquired field: No

If Yes: State, for EACH separate act, the school district attended when the act occurred; the approximate date of the act; and describe what occurred:

Has the student possessed on school property, while in school transportation, or at a school event, a dangerous weapon or a controlled dangerous substance, as defined by relevant Oklahoma law, or a prescription or non-prescription mood-altering substance?

Reaquired field: Yes

Reaquired field: No

If Yes: State, for EACH separate act, the school district attended when the act occurred; the approximate date of the act; and describe what occurred:

Has the student ever been removed from any school for making an electronic communication with the intent to terrify, intimidate, harass, or threaten injury or harm to faculty or other students?

Reaquired field: Yes

Reaquired field: No

If Yes: State, for EACH separate act, the school district attended when the act occurred; the approximate date of the act; and describe what occurred:

If the student has been identified as a child with a disability, this district will need to review all such records to make a reasonable determination of whether the district has the facilities, programs, sta ff, and space to implement the student's current or anticipated Individualized Education Program (IEP) or Section 504 Accommodation Plan, and , if preliminary approval of a transfer is made, to conduct the statutorily-required joint IEP or Section 504 conference with the resident school district. Is the student currently, or has the student been, a child with a disability who received an IEP or Section 504 Accommodation Plan?

Reaquired field: Yes

Reaquired field: No

If Yes: Brief describe the nature of the disability; the approximate time period in which the student has been, or was, under an IEP or Section 504 Accommodation Plan; and the names of the school districts which implemented the student's plan:

OKSDE Transfer Form

It is the policy of the McAlester Board of Education to provide equal opportunity in all its operations and to assure that there shall be no discrimination against any student or applicant on the grounds of age, race, religion, sex, color, national origin, ancestry, or handicapping conditions. This form will serve as your request to be considered for an open transfer into McAlester Public Schools. The submission of this form is not a promise of approval. By signing your name below, you do hereby certify that to the best of your knowledge all of the facts and statements contained in this form are correct and true. You understand that if you are considered for an Open Transfer, falsified statements on this form shall be considered sufficient grounds for denial.

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McAlester Public Schools

MPS Transfer Application Form

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