LOS ANGELES UNIFIED SCHOOL DISTRICT Policy Bulletin

Transcription

1 TITLE: NUMBER: ISSUER: Intra-district (School to School) Permits and Student Transfers in Elementary and Secondary Schools René Gonzalez, Assistant Superintendent Student Health and Human Services Judy Elliott, Chief Academic Officer Office of Curriculum, Instruction and School Support DATE: December 20, 2010 ROUTING Local District: Superintendents Operations Coordinators Administrators of Instruction Principal Leaders All Principals PreK-12 Coordinators School Administrative Assistants POLICY: MAJOR CHANGES: Intra-district permit applications are requests to allow students that reside within the boundaries of one school in the LAUSD to attend another school within the LAUSD. School administrators may not delay or deny authorization of an application that meets the criteria for an intra-district permit, unless that program or opportunity is already offered at the school of residence.. This Bulletin replaces the Intra-district permit section within BUL , Permits and Student Transfers in Elementary and Secondary Schools, dated July 21, There are now separate bulletins related to inter-district permits, intra-district permits, and foreign student admissions. GUIDELINES: I. GENERAL INFORMATION FOR ALL INTRA-DISTRICT PERMITS Intra-district Permits may be granted for students to attend a school in the LAUSD other than the LAUSD school of residence. These permits are not processed through the Office of Permits and Student Transfers (OPST), and the paper application process is handled by the two schools involved. These permits may be issued only to students who reside in the LAUSD. School officials may grant, deny or revoke intra-district permits only. The application information and documents are available at school sites or on-line at: II. GUIDELINES FOR ALL INTRA-DISTRICT PERMITS A. Permit Issuance and Termination 1. All parents requesting an intra-district permit will be provided the opportunity to apply for one. Each permit application will be reviewed on its own individual merit. 2. Permit applications and required documentation must be submitted annually and approved by both schools involved. 3. Permits may be issued at any time for the current school year; however, applications for the upcoming school year will only be accepted after Student Health and Human Services Page 1 of 18 December 20, 2010

2 March 1 st. 4. Incomplete application packets or those without required supplemental documentation will not be processed. 5. A separate permit application packet must be submitted and approved individually for each student. 6. Permits do not carry sibling privileges. 7. Intra-district permits do not carry transportation privileges. Parents/guardians are responsible for transporting the student(s) to and from school and attending school conferences and meetings as requested. 8. Students are expected to be on time and in school for the full school day. 9. The LAUSD must consider integration regulations, available space and cost factors involved prior to granting a permit. 10. Students receiving Special Education may only be transferred as determined by the Individual Education Program. Please refer to the Division of Special Education for additional information. 11. Students with an active Section 504 plan may be required to be re-evaluated prior to any change in placement. Please refer to BUL , Section 504 and Students/Other Individuals with Disabilities. 12. Students designated as homeless do not require a permit to remain at their school of origin. Please refer to BUL Enrollment of Homeless Children and Youth in Schools, dated March 5, 2008 for further information. 13. Students designated as foster youth do not require a permit to remain at their school of origin. Please refer to BUL-787 Guidelines for School Enrollment of Students In And Out Of Home Care, dated July 1, 2004 for further information. 14. In a case involving divorced or separated parents, the student may attend the school in the residence area of either parent. No permit is necessary for the student to remain at one school or to transfer to the other. 15. If the student s school of residence is a charter school conversion, and parents opt out of enrolling in the charter school, the students may utilize the same enrollment options as other resident students including but not limited to: intra-district transfers, magnet, and open enrollment. B. Cancellation, Revocation, or Denial of Permits 1. Permits may be cancelled, revoked, or denied renewal by the school site administrator for the following reasons: a. Falsified information or documentation b. Any change to the criteria required for the permit issued c. Truancy d. Infractions of school rules and regulations e. Failure to make satisfactory academic progress f. The student is dropped off or picked up beyond regular school hours, including before and after school programs 2. If a permit request is cancelled, revoked or denied renewal, parent will be informed of appeal procedures by the school that denied the request. Please refer to Section V. Student Health and Human Services Page 2 of 18 December 20, 2010

3 C. School Responsibility 1. The school administrator shall be responsible for verification of the address of all students for the purposes of enrollment. 2. The school administrator of the school of residence must review all required documentation relevant to the type of permit requested prior to releasing the student to the school requested. 3. School administrators may not delay or deny authorization of an application that meets the criteria for a permit based solely on reduction of student population at the school of residence. 4. When permits are granted, these students are to be treated in every respect as though they were resident students in the resolution or mediation of any problems. 5. Once a semester, each school shall notify parents, in writing, of the parents responsibility to inform the school of any change of address or contact information. 6. Each school shall retain documentation of compliance with the notification requirements. 7. The school shall notify the parents in writing in regard to any change in residence, contact information or criteria related to the type of permit issued that has been discovered. The school administrator is responsible for all cancellations and revocations of permits. 8. Students discovered to be living outside the LAUSD, in the absence of an inter-district permit, must be referred immediately to OPST. 9. The permit application and supporting documents must be retained in the student s cumulative record. 10. The school administrator shall be responsible for entering the correct ISIS/SIS codes for intra-district permit students. School personnel shall indicate the appropriate code in the permit reason field and enter the date the permit was granted. D. Parent Responsibility 1. Parent shall supply all requested documentation relevant to the type of permit requested to the school of residence and the requested school. 2. The parent shall notify the school of attendance immediately of any change of residence, contact information or criteria related to the type of permit issued. 3. Parents are expected to get students to school on time and for the full school day. 4. Permit applications and required documentation must be submitted annually and approved by administrators at both schools involved. E. Athletic Eligibility 1. All permits carry interscholastic athletic privileges, subject to limitations in rules and regulations governing interscholastic athletics. 2. All questions regarding student interscholastic athletic eligibility should be referred to the director of Interscholastic Athletics Section. Student Health and Human Services Page 3 of 18 December 20, 2010

4 III. TYPES OF INTRA-DISTRICT PERMITS AND REQUIREMENTS Intra-district permit applications are requests to allow students that reside within the boundaries of one school in the LAUSD to attend another school within the LAUSD. School administrators may not delay or deny authorization of an application that meets the criteria for an intra-district permit, unless that program or opportunity is already offered at the school of residence. A. Parent Employment 1. When a child lives in one school s attendance area, but at least one parent physically works within the attendance area of the requested LAUSD school, a permit to attend that LAUSD school may be issued. 2. The following proof is required by the qualifying parent: a. A copy of a recent pay stub and a letter on employer s stationary verifying schedule (hours and days) and physical address of employment or b. If self-employed, attach a copy of a current business license and a letter on business stationary verifying schedule (hours and days) and physical address of employment. B. Senior Status 1. Permission may be granted to allow students in the final year of elementary, middle or senior high school to complete the year at the same school they attended the previous year. 2. The parent must provide a transcript or report card verifying current school enrollment in the requested school to the school of residence. C. Child Care 1. Child Care permits are only issued when both parents are employed 28 hours or more, or enrolled in school on a full-time basis. When the student lives in one school s attendance area, but is cared for within the attendance area of another LAUSD school, a permit to attend that LAUSD school may be issued. 2. Both parents must provide the following documentation: a. A copy of a recent pay stub and a letter on employer s stationary verifying schedule (hours and days) and physical address of employment or b. If self-employed, a copy of a valid current business license and a letter on the parent s business stationary verifying schedule (days and hours) and location of employment or c. Copy of documents showing full-time enrollment in a school or training program and d. Child care provider must complete the Child Care Affidavit and the parent must sign the form (Attachment D). 3. The student must be picked up at dismissal if the student is not utilizing an after school program on the school grounds. The Youth Services Program is not an authorized child care provider. Student Health and Human Services Page 4 of 18 December 20, 2010

5 D. Continuing Enrollment 1. Continuing Enrollment permits may be issued when a student moves out of the area of the school of attendance to allow the student to complete the current school year or to continue attendance in the current school (with written approval by both school principals). a. The student must have been enrolled in the requested school for a minimum of 20 consecutive weeks. b. No days of attendance after the student has changed address shall be counted toward eligibility for a Continuing Enrollment Permit. c. If the enrollment period was for less than 20 continuous weeks, the following guidelines may prevail: 1) During the first half of any track/semester, the student may be transferred to the School of Residence. 2) The student may remain at the school of attendance while the parent requests an Intra-District Permit of a different type, or in the event of dispute, during the appeals process. 3) During the second half of any track/semester, the student may be permitted to complete that track/semester by the administrator at the school of attendance. 2. Additional Continuing Enrollment Considerations a. If the move is due to the family being displaced by the District, proof of LAUSD displacement is issued by the LAUSD Facilities Services Division, Real Estate Office. In such cases, the Continuing Enrollment Permit is granted on a permanent basis. b. If a secondary student is already enrolled in a school that undergoes a boundary change due to new school construction, a student may be eligible for a Continuing Enrollment Permit on the basis that athletic or other programs are not available at the new school. The student must show proof of previous participation in that specific athletic or other program. In such cases, the Continuing Enrollment Permit is granted on a permanent basis. c. While the above guidelines must be considered even when students are transferred between schools with differing schedules, the following concerns must also be addressed. 1) The student must be assured the opportunity to have the equivalent of a full year s assignment, irrespective of the school s schedules. 2) The exact date of the transfer shall be determined only after consultation with the parent and between administrators of the schools involved. Educational continuity for the student and the impact of enrollment in the new School of Residence must be of primary consideration. E. Safety and Protection Permit 1. Safety and Protection Permits are issued for the purpose of protection or personal welfare of a student. These are parent-initiated permits and should not be confused with Opportunity Transfers. Please see BUL , Student Health and Human Services Page 5 of 18 December 20, 2010

6 Opportunity Transfers (OTs) Policy, dated January 19, These permits are not granted based solely on parent or student preference. 2. These permits are transfers from one LAUSD school to another LAUSD school. They may be issued across Local District boundaries, but may not be issued between the LAUSD and other school districts. 3. These permits may be issued: a. If the student s school of residence is classified as Persistently Dangerous by the LAUSD Office of the Chief Operating Officer, or b. If the student is the victim of a violent criminal offense that occurred in or on the grounds of the school of attendance, or c. For the protection or personal welfare of the student. 4. Parents Responsibilities a. Parents shall provide specific details regarding the circumstances which make the student s current school assignment unsafe, e.g., discipline records, police reports, known gang affiliations, or any other information which provide a basis for this transfer request. F. Specialized Program 1. These permits may be issued to allow students access to a special program or opportunity that is not available in their school of residence. These programs may include but are not limited to Dual Language Program, International Baccalaureate Program, small learning community specialization, etc. 2. The application may require additional information, authorization and/or documentation. IV. Application Process A. All Intra-District applications must be acknowledged and approved by the administrators from both the school of residence and the requested school. 1. Parents must first obtain a permit or release from school of residence to apply to another LAUSD school. 2. The paper permit application and information will be provided to parents by the school upon request. These documents are also available on-line at 3. Parent must first fill out the application and obtain the signature of the school site administrator from the school of residence. Parent must provide all required documentation relevant to the type of permit requested. (Attachment B) a. School administrator acknowledges the application by signing and dating the application form (Attachment C). b. If acknowledged by the school of residence, the parent submits the application and the required documents relevant to the type of permit to the requested school. c. The requested school administrator approves the application by signing and dating the application form. d. If there is not room for the student at the requested school at the time of Student Health and Human Services Page 6 of 18 December 20, 2010

7 the request, the application will not be approved by the requested school administrator. 4. If the permit is granted, the requested school will enroll the student. The permit application and supporting documents must be kept in the student cumulative record, and the permit type must be documented in SIS/ISIS. 5. If a permit request is cancelled, revoked or denied renewal, parent will be informed of appeal procedures by the school that denied the request. Please refer to Section V. 6. Please see Section V for appeal policy procedures. V. APPEAL PROCEDURES FOR ALL INTRA-DISTRICT PERMITS A. If an intra-district permit application has been denied, cancelled or revoked, parents have the right to appeal if they believe that an exception to district policy is warranted or that their circumstances fall within district guidelines. 1. The denying administrator must provide: a. The reason for the denial in written letter to the parent (Sample, Attachment F) b. The original permit application that had been submitted by the parent c. The Intra-district Permit Appeals Process (Attachment E) d. The Application to Appeal a Permit Request or Cancellation (Attachment G) 2. During the appeals process, the student has the right to remain at his/her current school placement pending the final decision. B. The LAUSD Appeal Process 1. All appeals must be submitted in writing. The school administrator will provide the parent with all of the appeal procedures and forms. 2. The Application to Appeal form must be completed and any supplemental documentation must be received by the denying school from the parent within 7 school days from the date of the initial denial letter. 3. If the appeal is received within the timeline, it will be reviewed by the LAUSD school site administrator. Additional information may be requested of the parent at that time. 4. If parents do not appeal within the required time frame, the student will be expected to attend the school of residence. 5. The school site administrator will complete the Administrator Recommendation, in Section B of the Appeal Form. 6. If the appeal is granted, an Intra-district Permit will be issued by the school. 7. If the appeal is denied, the parent will be notified in a written letter (See Sample, Attachment F) by the school site administrator of the reason for the denial within 5 school days. 8. If parents choose to appeal the school s decision to the Local District Operations Administrator, they must submit the initial application, the Appeal Form, the denial of appeal letter from the school administrator and any supporting documents to the Operations Administrator within 14 school days Student Health and Human Services Page 7 of 18 December 20, 2010

8 of the date of the denial of the appeal. 9. The Operations Administrator will issue a response to the appeal request within 5 school days. This response will be sent to the school administrator and the parent in writing. 10. The decision of the Local District Operations Administrator is the final action on the request. Intra-district permits decisions cannot be appealed to OPST or the Los Angeles County Office of Education. VI. ADDITIONAL STUDENT TRANSFER OPTIONS These programs are not under the direction of the OPST and have their own specific requirements and application procedures. Please refer to the office responsible for the program. A. Court-Ordered Integration and Other Specialized Programs. District student integration programs are provided to address the harms of racial isolation and to enhance educational opportunities. PWT and Magnet Schools are voluntary Court-Ordered Integration programs. Satellite Zone and Capacity Adjustments are not permit programs, and students participate at the direction of District administration, with the approval of the Board of Education. Refer to Choices Brochure released in October of each year or refer to the website B. Schools for Advanced Studies Enrollment Transfers The Schools for Advanced Studies Program (SAS) was developed to meet the increasing demands for high-level academic programs that serve the educational needs of the District s highly able learner. Please refer to BUL , Transfer of Elementary and Secondary Students to Schools for Advance Studies, dated August 11, C. Capacity Adjustment Program (CAP) To provide relief for overcrowded schools and to better utilize available space, a number of schools have been designated to participate in Capacity Adjustment Programs. Coordination and guidelines for overcrowded schools are provided by the Office of School Management Services. Please refer to REF-2531 Procedures for Capping School Enrollment, dated May 8, D. Open Enrollment allows parents to apply to schools identified as having available space. The list of schools is generally available at schools and on-line in May. Please refer to BUL Open Enrollment Transfers for Elementary and Secondary Students, dated January 30, Student Health and Human Services Page 8 of 18 December 20, 2010

9 E. City of Angels offers a voluntary instructional strategy by which enrolled students may full fill graduation requirements outside of the regular classroom setting. Please refer to BUL-M Guidelines for Independent Study Programs, dated May 31, F. Charter schools affiliated with the LAUSD are managed by the Innovation and Charter Schools Division. Parents apply directly to the charter school for enrollment. G. Romero Bill Open Enrollment provides another mechanism for transfer to and from specified LAUSD schools. Parents with students enrolled at impacted schools will be notified by letter of this transfer process. VII. RESPONSIBILITY FOR COMMUNICATION The district shall provide information regarding enrollment options. Any questions regarding attendance alternatives shall be addressed by the school or the Local District office. AUTHORITY: This is the policy of the Los Angeles Unified School District. RELATED RESOURCES: BUL , Attendance Policy for Elementary and Secondary Schools, dated February 22, BUL Enrollment/Support of Homeless Children and Youth in schools, dated March 5, BUL-787, Guidelines for School Enrollment of Students In And Out Of Home Care, dated July 1, BUL , Opportunity Transfers (OTs) Policy, dated January 19, BUL , Transfer of Elementary and Secondary Students to Schools for Advance Studies, dated August 11, REF-2531, Procedures for Capping School Enrollment, dated May 8, BUL , Open Enrollment Transfers for Elementary and Secondary Students, dated January 30, BUL-M-128.0, Guidelines for Independent Study Programs, dated May 31, Rules and Regulations Governing Interscholastic Athletics, contact Inter-scholastic Athletics Section. Student Health and Human Services Page 9 of 18 December 20, 2010

10 BUL , Inter-district Permits (District to District) and Transfers in Elementary and Secondary Schools, dated December 13, BUL-5255, Implementation of the Romero Open Enrollment Act, dated October 1, ASSISTANCE: For assistance or further information, please contact Melissa Schoonmaker Coordinator, Permits and Student Transfers Office, at (213) Student Health and Human Services Page 10 of 18 December 20, 2010

11 Office of Permits and Student Transfers Attachment A INTRA-DISTRICT PERMIT APPLICATION PACKET TERMS AND CONDITIONS The Los Angeles Unified School District (LAUSD) offers a wide range of options to meet the educational needs of students and families. Most students needs can be met by their school of residence. Intra-district Permits may be granted for students to attend a school in the LAUSD other than the LAUSD school of residence. These permits are not processed through the Office of Permits and Student Transfers, but are handled by the two schools involved. Permit Application Information is available at any LAUSD school or may be found on-line at: o Permits may be issued at any time for the current school year; however, applications for the upcoming school year will only be accepted after March 1 st. o Permit applications and required documentation must be submitted annually. o A separate permit application packet must be submitted and approved individually for each student. o Permits do not carry sibling privileges. o Intra-district permits do not carry transportation privileges. Parents/guardians are responsible for transporting the student to and from school, attending school conferences and meetings as requested. o Parents must meet with a school administrator at the school of residence to approve the release of the student. o Required supplemental documentation must be submitted with the application packet to the LAUSD school of residence as well as the requested LAUSD school for each student. o Incomplete application packets or those without required supplemental documentation will not be processed. o If the permit request is approved, the parent then takes the signed and stamped application form to the school requested. Approval is needed by the administrator of the school requested prior to registration. o Approval from the school of residence does not guarantee that the requested school will enroll your student. o If a permit request is denied, the parent will be informed of appeal procedures by the school that denied the request. o Processing time for students with special education or medical needs will require additional processing time and will be referred to appropriate offices for further review and approval. o The LAUSD must consider integration regulations, available space and cost factors involved prior to granting a permit. o In a case involving divorced or separated parents, the student may attend the school in the residence area of either parent. No permit is necessary for the student to remain at one school or t o transfer to the other. o Permits may be cancelled, revoked, or denied renewal for the following reasons: a. Issues in error b. Falsified information or documentation c. Any change to the criteria required for the permit issued d. Truancy e. Infractions of school rules and regulations f. Failure to make satisfactory academic progress g. The student is dropped off or picked up beyond regular school hours including before and after school programs. Student Health and Human Services Page 11 of 18 December 20, 2010

12 Office of Permits and Student Transfers Attachment B TYPES OF INTRA-DISTRICT PERMITS AND CRITERIA TYPES OF PERMITS AND CRITERIA CHILD CARE Child Care permits are only issued when both parents are employed full-time or are in school on a full-time basis. When the student lives in one school or district s attendance area, but is cared for before and/or after school by an adult within an LAUSD school s attendance area, then a permit to attend that school may be issued. Required Documentation: 1. The following proof must be attached for both parents a. A copy of a recent pay stub and a letter on the employer s stationery verifying schedule (days and hours) and location of employment or b. If self-employed, attach a copy of a valid current business license and a letter on the parent s business stationery verifying schedule (days and hours) and location of employment or c. Copy of documents showing full-time enrollment in a school or training program. 2. Child care provider must complete the Child Care Affidavit and the parent must sign the form a. Provider may not be a school-based program b. Provider s address must be in the boundaries of the requested school s attendance area PARENT EMPLOYMENT Parent Employment Permits may be issued if at least one parent/guardian is physically employed in the attendance boundary of the requested LAUSD school. Required Documentation: 1. The following proof must be attached for the qualifying parent/guardian: a. A copy of a recent pay stub and a letter on the employer s stationery verifying schedule (hours and days) and location of employment or b. If self-employed, attach a copy of a valid current business license and a letter on the parent s business stationery verifying schedule (hours and days) and location of employment CONTINUING ENROLLMENT Continuing Enrollment permits may be issued when a student moves out of the area of the school of attendance to allow the student to complete the current school year or to continue attendance in the current school (with written approval by both school principals). Required Documentation: 1. The parent is required to submit a copy of a recent report card or progress report as proof of enrollment to the school of residence. SENIOR STATUS Permission may be issued to allow students in the final year of elementary, middle or senior high school to complete the year at the same school they attended the previous year. Required Documentation: 1. The parent is required to submit a copy of a recent report card or progress report as proof of enrollment SPECIALIZED PROGRAM These permits may be issued to allow students access to a special program or opportunity that is not available in their school of residence. The application may require additional information, authorization and/or documentation as requested by the school administrators. SAFETY AND PROTECTION This permit may be issued if the student s school of residence is classified Persistently Dangerous by the LAUSD Office of the Chief Operations Officer. This permit may also be issued if the student is a victim of a violent criminal offense that occurred in or on the grounds of the school of attendance or for the protection or personal welfare of the student. Additional Documentation Required: 1. Parents/guardians shall provide a written statement with the application describing the circumstances which make the student s assignment at the school of residence unsafe. Additional documents may be required by school officials to support request. ADDITIONAL INFORMATION All parents requesting an intra-district permit will be provided the opportunity to apply for one, regardless of the reason they are requesting a permit. Each permit application will be reviewed on its own individual merit. If you believe your particular case warrants an exception to district policy, you may file an appeal. ***Parent must include students name, date of birth, and contact information on all supporting documents. BUL-5347 Student Health and Human Services Page 12 of 18 December 20, 2010

13 Office of Permits and Student Transfers Attachment C INTRA-DISTRICT PERMIT APPLICATION Submit completed application packet for signatures to both the LAUSD school of residence and requested LAUSD school School Year Requested to This is: The first permit application for this student. A renewal of an existing permit. STUDENT INFORMATION Student Last Name First Name Middle Name Date of Birth Grade Requested Home Address Apt. City Zip Code Date Moved to This Address / Month / Year Name of Most Recent School Attended Is student currently designated as Special Education or have an Individual Education Plan (IEP)? Yes No Is this student currently under expulsion from the Los Angeles Unified School District? Yes No Ethnicity: African American/Black American Indian/Alaskan Native Asian Gender: Female Male Caucasian/White Hispanic/Latino Native Hawaiian/Pacific Islander Other Name of Mother/ Guardian Name of Father/Guardian Home Address Apt. Home Address Apt. City, Zip Home Phone Work/Cell Phone ( ) ( ) Address (optional) City, Zip Home Phone Work/Cell Phone ( ) ( ) Address (optional) PERMIT REQUESTED ***Check for Additional Required Documents*** Child Care Parent/Guardian Employment Safety and Protection Continuing Enrollment Senior Status Specialized Program Reason for Request: From: (School of Residence) To: (School Requested) Note: All Intra-District Applications Require Recommendations from Both Schools Recommended by School of Residence YES NO Recommended by Requested School YES NO Signature of Administrator, School of Residence Date Print Name of Administrator, School of Residence Signature of Administrator, Requested School Date Print Name of Administrator, Requested School School Stamp Here School Stamp Here PARENT/GUARDIAN ACCEPTANCE OF TERMS I have read and understand the terms and conditions governing intra-district permits. I understand that the mere act of completing this application and providing all the required documentation DOES NOT guarantee that the request will be approved. I certify under penalty of perjury that the information I supplied is true and correct and that falsification of information is grounds for immediate denial or revocation of permit. LAUSD personnel may verify any or all information provided. Signature of Parent/Guardian Date BUL-5347 Student Health and Human Services Page 13 of 18 December 20, 2010

14 Office of Permits and Student Transfers CHILD CARE AFFIDAVIT Attachment D Child Care permits are only issued when both parents are employed full-time or enrolled in school on a full-time basis. When the student lives in one schools attendance area, but is cared for before and/or after school by an adult within another school s attendance area, then a permit to attend that school may be issued. The child care may not be schoolbased. Required Documentation: 1. The following proof must be attached for both parents a. A copy of a recent pay stub and a letter on the employer s stationery verifying schedule (hours and days) and location of employment or b. If self-employed, attach a copy of a valid current business license and a letter on the parent s business stationery verifying schedule (hours and days) and location of employment or c. Copy of documents showing full-time enrollment in a school or training program. 2. Child Care provider must complete the Child Care Affidavit (available on-line) a. Provider may not be a school-based program b. Provider s address must be in the boundaries of the requested school s attendance area CHILD CARE AFFIDAVIT Student Last Name First Name Middle Name Date of Birth Grade Requested Name of Child Care Provider Telephone Number Address of Child Care Apt. City Zip Code I agree to provide all necessary care for this student before and/or after school. I understand that falsification or information will result in the immediate denial or revocation of permit; I declare under penalty of perjury that the information above is correct and that LAUSD may verify any or all information provided. Signature of Child Care Provider Date PARENT/GUARDIAN ACCEPTANCE OF TERMS I certify under penalty of perjury that the information supplied is true and correct and that falsification of information is grounds for immediate denial or revocation of permit. I understand that LAUSD personnel may verify any or all information provided. I will notify the school immediately of any change of residence, contact information or the criteria related to this permit. Signature of Parent/Guardian Date ****Parent must include student s name, date of birth, and contact information on all supporting documents. Student Health and Human Services Page 14 of 18 December 20, 2010

15 Office of Permits and Student Transfers INTRA-DISTRICT PERMIT APPEALS PROCESS Attachment E General Information If an intra-district permit application has been denied, cancelled or revoked, you have the right to appeal if you believe that an exception to district policy is warranted or that their circumstances fall within district guidelines. You must appeal to the LAUSD school that denied, cancelled or revoked your permit request. During the appeals process, the student has the right to remain at their current school placement pending the final decision. LAUSD Appeal Process. 1. If your application is denied, the administrator will provide you with written notification with the reason for the denial. 2. All appeals must be submitted in writing. The school administrator will provide you with the Intra-district Appeals Process and the required Intra-district Application to Appeal form. The forms are also available on line at 3. The Application to Appeal form must be completed and any supplemental documentation must be received by the school within 7 school days from the date of the initial denial. 4. If the appeal is received within the time frame, it will be reviewed by the LAUSD school site administrator. Additional information may be requested of you at that time. 5. If you do not appeal within the required time frame, the student will be expected to enroll/attend the school of residence immediately. The staff at your school of residence will assist you with registration and enrollment. 6. The school site administrator will complete the Administrator Recommendation section on the Intra-district Application to Appeal form. 7. If your appeal is granted, you will be issued an intra-district permit by the school. 8. If the appeal is denied, you will be notified in writing by the school site administrator of the reason for the denial within 5 school days. 9. If you choose to appeal the school s decision to the Office of Permit and Student Transfers (OPST), you must submit the initial application, the Appeal form and any supporting documents to the OPST within 14 school days after the denial of the appeal. The application will be mailed to: LAUSD Office of Permits and Student Transfers, P.O. Box 3307, Los Angeles, CA The OPST will issue a response to the appeal request within 5 school days. This response will be sent to the school administrator and the parent in writing. 11. The decision of the OPST Permit Appeals Committee is the final action on the request. Intra-district Permits decisions cannot be appealed to the Los Angeles County Office of Education. Student Health and Human Services Page 15 of 18 December 20, 2010

16 Office of Permits and Student Transfers Attachment F Use School Letterhead Notification of Permit Denial Parent Name Address City, State Zip Re: Student Name Request for an Intra-District Permit based on Permit Type From School of Residence to Requested School Dear Parents/Guardians, The permit application for your child has been received and given careful consideration. Unfortunately, we are not able to accommodate your request due to Enter Reason Permit was Denied. Consequently, your application must be denied. You have the right to appeal this denial if you believe that an exception to district policy is warranted or that your circumstances fall within district guidelines. The appeal must be in writing and received in this office within two calendar weeks of the date of this notice The appeal procedures and required forms are available in our school office, or on line at If you do not appeal within the required time, Student Name will be expected to attend School of Residence. The staff there will assist you with registration and enrollment. If you have any questions, please call me or the Office of Permits and Student Transfers at Sincerely, Signature Name, Principal Name of School Student Health and Human Services Page 16 of 18 December 20, 2010

17 Office of Permits and Student Transfers Attachment G (Page 1 of 2) APPLICATION TO APPEAL AN INTRA-DISTRICT PERMIT REQUEST OR CANCELLATION Type of Intra-District Permit Requested: Student Last Name First Name Date of Birth Grade Home Address City State Zip Code School District of Residence Name of School School District Requested Name of School Requested Name of Mother/ Guardian Name of Father/Guardian Home Phone Cell Phone Home Phone Cell Phone Mother/Guardian Employment Information Name of Employer Father/Guardian Employment Information Name of Employer Title: Physical Work Address: Title: Physical Work Address: Work Telephone: Work Days and Hours: Work Telephone: Work Days and Hours: Is childcare a factor in this appeal? Yes No If yes, please attach childcare affidavit, located on the application website. What other LAUSD school would you consider? If this appeal is not granted, what is the educational plan for this student? Have you been accepted into the school/program you are requesting? Yes No I have been provided with the following documents: A written explanation of the permit application denial by the school or Office of Permits and Student Transfers A copy of the LAUSD permit appeal process Continue on next page Student Health and Human Services Page 17 of 18 December 20, 2010

18 Office of Permits and Student Transfers Attachment G (Page 2 of 2) In the space below, please explain why your child should be granted permission to leave the school or district of residence to attend the requested district or school. Attach additional documentation or supporting documents as necessary. In the space below, please state your understanding of why this permit was denied. Signature of Parent or Guardian Date Completed appeals form and supplemental documents must be received by the school from the parent within 7 school days of the initial denial letter. Administrative Recommendation Granted Denied Reason for denial: Signature of Administrator, School Print Name of Administrator Date School Stamp Required Here If appeal is denied by the local school, the parent may appeal to the: Los Angeles Unified School District Office of Permits and Transfers P.O. Box 3307 Los Angeles, CA Intra-district appeals must be received by the OPST within 14 school days of the administrative appeal denial. OPST Appeal Date Received: CC PEP CE SS SP SAP Granted Denied Date : Reviewed by: Student Health and Human Services Page 18 of 18 December 20, 2010