Fillable Printable Syudent Transfer Form - Illinois

Syudent Transfer Form - Illinois

ILLINOIS STATE BOARD OF EDUCATION

Public School and Recognition Division

100 West Randolph Street, Suite 14-300

Chicago, Illinois 60601

STUDENT TRANSFER FORM

STUDENT IDENTIFICATION NUMBER

(9-digits)

In accordance with Section 2-3.13a of the School Code, all public school districts are to provide this form to any student who is moving

out of the school district to verify whether or not the student is “in good standing” and, whether or not their medical records are up-to-

date and complete as dened in Section 2-3.13a. “In good standing” means that the student is not being disciplined by an out-of-school

suspension or expulsion, and is entitled to attend classes, as of the date of this form. No public school district is required to admit a new

student unless they can produce this form from the student’s previous Illinois public school district. This form is not to be returned to

the Illinois State Board of Education. It is to be sent directly to the student’s new school they will be attending.

NAME OF STUDENT (Last, First, Middle) BIRTHDATE (Month, Day, Year) GENDER GRADE LEVEL

Male

Female

ADDRESS OF STUDENT (Street, City, State, Zip Code)

NAME OF PARENT OR GUARDIAN PARENT/GUARDIAN TELEPHONE (Include Area Code)

Home Work

ADDRESS OF PARENT OR GUARDIAN (Street, City, State, Zip Code)

DISTRICT NAME AND NUMBER TRANSFERRING TO NEW DISTRICT ADDRESS (Street, City, State, Zip Code)

NAME OF SCHOOL STUDENT WILL BE TRANSFERRING TO NAME OF PRINCIPAL AT NEW SCHOOL

Please check () the appropriate box.

I hereby attest that the above student is “in good standing” and that all medical records for the above student are up-to-date

and complete as of the date of this form.

The above student’s medical records are not up-to-date and complete as documented in the student’s permanent

records.

I hereby attest that the above student is not “in good standing” due to a current suspension and/or expulsion

from _______________________________________ until _______________________________________; but is entitled

to transfer in accordance with Section 2-3.13a (105 ILCS 5/2-3.13a), unless the receiving district has, pursuant to Section

2-3.13a, adopted a policy providing that if a student is suspended or expelled for any reason from any public or private school

in this or any other state, the student must complete the entire term of the suspension or expulsion before being admitted into

the school district. This policy may allow placement of the student in an alternative school program established under Article

13A of this Code, if available, for the remainder of the suspension or expulsion.

I hereby attest that the above student is not “in good standing” due to a current suspension and/or expulsion

from _______________________________________ until _______________________________________ and is not eligible

for transfer for knowingly possessing in a school building or on school grounds a weapon as dened in the Gun Free Schools Act

(20 U.S.C. 8921 et seq.); for knowingly possessing, selling, or delivering in a school building or on school grounds a controlled

substance or cannabis; or for battering a staff member of the school.

NAME OF PRINCIPAL SCHOOL PHONE (Include Area Code) COUNTY

DISTRICT NAME AND NUMBER DISTRICT ADDRESS (Street, City, State, Zip Code)

_________________________ _____________________________________

Date Signature of Principal

ISBE 33-78 (3/1

5) THIS FORM IS TO BE SENT DIRECTLY TO THE STUDENT’S NEW SCHOOL THEY WILL BE ATTENDING.