Bells ISD
Bells ISD District Name
091-901 County-District Number Texas Education Agency Division of Equal Education Opportunity Application for Transfer 2018-2019
Authority for Data Collection: Texas Education Code 21.061; Civil Action 5281, Section A Planned Use of Data: To complete the report required by Federal Court Order Civil Action 5281 Superintendent of the receiving district must circle approved or disapproved and sign the transfer. For further information contact the Division of Accreditation at (512)463-9671. Student Name: _____________________________________________Grade Level (2018-2019) _______ The school district the student currently lives in is _____________________________________________ In 2017-18 the pupil attended this school district _______________________________________________ In 2017-18 the pupil attended this campus ____________________________________________________ Student Name: _____________________________________________Grade Level (2018-2019) _______ The school district the student currently lives in is _____________________________________________ In 2017-18 the pupil attended this school district _______________________________________________ In 2017-18 the pupil attended this campus ____________________________________________________ Student Name: _____________________________________________Grade Level (2018-2019) _______ The school district the student currently lives in is _____________________________________________ In 2017-18 the pupil attended this school district _______________________________________________ In 2017-18 the pupil attended this campus ____________________________________________________
This section must be completed by parent or guardian: Transfer Fee Not Required I have been informed of the receiving district’s policy concerning tuition charges, if any, for a transferred student whose grade is taught in the student’s district of residence; and I accept responsibility of tuition. I am also aware of the conditions on the back of this form. Signed____________________________________________________________________________ Parent’s (Guardian’s) Signature Street Address______________________________________________________________________ City, State, Zip_____________________________________________________________________ Phone__________________________________ This section must be completed by the receiving district superintendent: The above transfer (s) was
Approved/Disapproved on the ________day of__________2018
Joe D. Moore
Receiving District Superintendent
903-965-7721
Campus Principal Approval Signature: ________________________________ Date: _____________
Bells Independent School District
1550 Ole Ambrose Road
Bells, Texas 75414
(903) 965-7721
PLEASE DO NOT MAIL TO THE TEXAS EDUCATION AGENCY
Please read the conditions for transfer as stated below. The transfer will be denied if it is determined that the choice shown on this application would cause Bells ISD to be out of compliance with Federal Court Order United States v Texas, Civil Action 5281, as based on enforcement of Title VI of the Civil Rights Act of 1964. The transfer may be denied for the following reasons: 1) admission of the student would cause overcrowding of classes; 2) admission of the student would cause the district to hire additional personnel; 3) the student’s prior attendance record; 4) the student’s prior conduct record; 5) and other lawful reasons determined by the district. Student eligibility for participation in athletics will be determined by the receiving campus according to UIL rules and regulations. Falsification of any information shall cause this application for transfer to be denied and/or revoked. In addition, falsification of documents or records is a criminal offense under Section 37.1., Penal Code, and subjects the person to liability for tuition costs under Section 25.001 (h), Texas Education Code. Transportation is to be provided by the parent/guardian for approved transfers.
I have read and agree to the above conditions. Parent’s (Guardian’s signature) ________________________________________________________________
Bells Independent School District
1550 Ole Ambrose Road
Bells, Texas 75414
(903) 965-7721
091-901 County-District Number Texas Education Agency Division of Equal Education Opportunity Application for Transfer 2018-2019
Authority for Data Collection: Texas Education Code 21.061; Civil Action 5281, Section A Planned Use of Data: To complete the report required by Federal Court Order Civil Action 5281 Superintendent of the receiving district must circle approved or disapproved and sign the transfer. For further information contact the Division of Accreditation at (512)463-9671. Student Name: _____________________________________________Grade Level (2018-2019) _______ The school district the student currently lives in is _____________________________________________ In 2017-18 the pupil attended this school district _______________________________________________ In 2017-18 the pupil attended this campus ____________________________________________________ Student Name: _____________________________________________Grade Level (2018-2019) _______ The school district the student currently lives in is _____________________________________________ In 2017-18 the pupil attended this school district _______________________________________________ In 2017-18 the pupil attended this campus ____________________________________________________ Student Name: _____________________________________________Grade Level (2018-2019) _______ The school district the student currently lives in is _____________________________________________ In 2017-18 the pupil attended this school district _______________________________________________ In 2017-18 the pupil attended this campus ____________________________________________________
This section must be completed by parent or guardian: Transfer Fee Not Required I have been informed of the receiving district’s policy concerning tuition charges, if any, for a transferred student whose grade is taught in the student’s district of residence; and I accept responsibility of tuition. I am also aware of the conditions on the back of this form. Signed____________________________________________________________________________ Parent’s (Guardian’s) Signature Street Address______________________________________________________________________ City, State, Zip_____________________________________________________________________ Phone__________________________________ This section must be completed by the receiving district superintendent: The above transfer (s) was
Approved/Disapproved on the ________day of__________2018
Joe D. Moore
Receiving District Superintendent
903-965-7721
Campus Principal Approval Signature: ________________________________ Date: _____________
Bells Independent School District
1550 Ole Ambrose Road
Bells, Texas 75414
(903) 965-7721
PLEASE DO NOT MAIL TO THE TEXAS EDUCATION AGENCY
Please read the conditions for transfer as stated below. The transfer will be denied if it is determined that the choice shown on this application would cause Bells ISD to be out of compliance with Federal Court Order United States v Texas, Civil Action 5281, as based on enforcement of Title VI of the Civil Rights Act of 1964. The transfer may be denied for the following reasons: 1) admission of the student would cause overcrowding of classes; 2) admission of the student would cause the district to hire additional personnel; 3) the student’s prior attendance record; 4) the student’s prior conduct record; 5) and other lawful reasons determined by the district. Student eligibility for participation in athletics will be determined by the receiving campus according to UIL rules and regulations. Falsification of any information shall cause this application for transfer to be denied and/or revoked. In addition, falsification of documents or records is a criminal offense under Section 37.1., Penal Code, and subjects the person to liability for tuition costs under Section 25.001 (h), Texas Education Code. Transportation is to be provided by the parent/guardian for approved transfers.
I have read and agree to the above conditions. Parent’s (Guardian’s signature) ________________________________________________________________
Bells Independent School District
1550 Ole Ambrose Road
Bells, Texas 75414
(903) 965-7721
