1. LINCOLN CONSOLIDATED SCHOOLS
Ypsilanti, Michigan
SCHOOL OF CHOICE APPLICATION PROCESS
2012‐2013 SECOND SEMESTER APPLICATION PERIOD—JANUARY 7‐17, 2013
Kindergarten
1) Complete a School of Choice Application for each student in your household. Submit to
the Superintendent of Schools in person, by fax (484‐7014), or by mail no later than
January 17, 2013.
2) You will be notified when the application is approved.
3) You may enroll your student once the application is approved. Second semester
enrollment MUST be finalized by Friday, January 25, 2013.
Grades 1‐12
1) Complete a School of Choice Application, Affirmation of Prior Discipline Record, and
Request for Student Discipline Records for each student in your household. Submit to
the Superintendent of Schools in person, by fax (484‐7014) or by mail no later than
January 17, 2013.
2) Once we receive your completed application materials, we will fax the Request for
Student Discipline Records to the schools the student attended during the prior two
years.
3) The Superintendent will review the student’s discipline records upon receipt from the
prior school and will either approve or deny the application. This could take some time,
as there is often a delay in receiving discipline records. Applications will not be
considered until discipline records are received and reviewed.
4) You will be notified when your application is approved or denied. Denial would be
based on past discipline only.
5) You may enroll your student once the application is approved. Second semester
enrollment MUST be finalized by Friday, January 25, 2013 .
Central Enrollment Office
Brick Elementary School—Administration Office (West Entrance)
8970 Whittaker Road
Ypsilanti, MI 48197
Phone: (734) 484‐7042
Fax: (734) 484‐1212

2. Lincoln Consolidated Schools
2012-2013 Second Semester School of Choice Application
Applications Accepted January 7, 2013 through January 17, 2013
The Lincoln Consolidated Schools Board of Education has opened its doors to all students residing in Washtenaw County
and all contiguous counties. Completed application forms and requested documentation must be returned to the
Superintendent's Office by January 17, 2013. A separate application form must be completed for each student desiring
to attend the Lincoln Consolidated Schools under the Schools of Choice State Aid Act of 1996, P.A. 300, Sections 105
and 105c.
Student Name: Student Date of Birth:
Last First Initial
Permanent Address for Student:
Number Street
City State Zip
Mailing Address (if different):
Number Street
_________________________________________________________________________________________
City State Zip
Home/Cell Phone: Current Grade:
Note for high school: Credit requirements for
District in which you reside: grade level must meet LCS policies.
How did you hear about Lincoln's school of choice option?
Parent/Legal Guardian Name: Work Phone:
Last First
Parent/Legal Guardian Name: Work Phone:
Last First
List previous schools attended with current/most recent first (attach an additional sheet if necessary):
School District City, State Dates Attended Reason for Leaving
Please complete the following:
1. Has the student ever been expelled from another school? If yes, please explain:  Yes  No
2. Has the student been suspended from another school during the preceding two (2)  Yes  No
school years? If yes, please explain:
3. Has the student been truant or had attendance problems at another school during  Yes  No
the preceding two (2) years? If yes, please explain:

3. 4. It is understood that the student may be athletically ineligible for one (1) full semester according  Yes  No
to M.H.S.A.A. rules.
5. Was the applicant previously enrolled in Lincoln Consolidated Schools? If yes, when?  Yes  No
6. Has the applicant received special education service (s) at any time? If so, please list  Yes  No
service(s) and attach IEP form:
7. It is understood that transportation may be provided if the student is dropped off and picked up  Yes  No
at a designated Lincoln bus stop. Students must be pre-registered for this service. School of choice
student transportation depends on seating availability.
8. It is understood that the student will adhere to the attendance policies that are written  Yes  No
in the student handbooks and that tardies/absences will not be excused because of lack
of transportation or weather conditions.
As the parent(s)/legal guardian making application for Schools of Choice under State Aid Act of 1996, P.A. 300, Sections 105 and
105c, my/our signature(s) on this application signifies my/our understanding and agreement to the Schools of Choice language and
guidelines and to all rules and regulations of student handbooks. It is also understood that if Lincoln Consolidated Schools finds any
information that is incorrect or falsified on this application, including affirmation of prior discipline records, this would immediately
terminate enrollment of the student on this form. My/Our signature(s) holds harmless the Lincoln Consolidated Schools, their
employees, and Board of Education members for any decisions made relative to the Schools of Choice language and guidelines. It
also grants Lincoln Consolidated Schools permission to contact our current district to obtain school records for my/our student,
including discipline records.
NOTE: Lincoln Consolidated Schools will accept non-resident students without regard to intellect, academic, artistic, athletic, or
other ability or talent, mental or physical disability, religion, race, color, national origin, sex, height, weight, or martial status. Lincoln
Consolidated Schools reserves the right to deny access to a student residing outside the Washtenaw Intermediate School
District if mutual agreement can not be reached with the student's home district/ISD related to responsibility for added
costs.
Parent /Guardian Signature Date
Parent /Guardian Signature Date
The following items must be submitted in order to complete Please return this application & requested documents to:
your application.
Mrs. Ellen Bonter, Superintendent
 School of Choice Application Lincoln Consolidated Schools
8970 Whittaker Road
 Affirmation of Prior Discipline Record (Grades 1-12 only) Ypsilanti, MI 48197
 Request/Release for Student Discipline Records
For questions or additional information please call the
(Grades 1-12 only)
Superintendent’s Office at (734) 484-7001.
 IEP (if applicable)
 Report Card (Grades 1-8) or Transcripts (Grades 9-12)
(Office Use Only) Application Received: Discipline Release Faxed:
Request is:  Granted  Denied By: ______________________________ Date:
Date notification sent to/picked up by Parent(s)/Legal Guardian:
Date request for student records sent: Name of School: _____________ _____

4. Lincoln Consolidated Schools
8970 Whittaker Road
Ypsilanti, MI 48197
Phone: (734) 484-7001 / Fax: (734) 484-7014
REQUEST FOR STUDENT DISCIPLINE RECORDS
(Grades 1-12 only)
Date: ____/____/____
Student Name:
Name of Former School
Street Address
City/State/Zip
Telephone/Fax
The above-named student has applied to attend Lincoln Consolidated Schools under the schools of
choice program. Please fax the student’s discipline file for the 2010-11, 2011-12, and 2012-13 (first
semester) school years. If there is no discipline on file, please indicate on the bottom of this form and fax
it back to us.
Final acceptance is contingent upon further review of the student’s discipline file and thus, ONLY
discipline information is needed at this time. If accepted as a school of choice student, additional
records will be requested under separate cover. Thank you in advance for your assistance.
PARENTAL PERMISSION
I hereby authorize the release of all discipline records for the above student to Lincoln Consolidated
Schools.
_____/_____/_____
Signature of Parent/Guardian Date
************************************************************************************************************************
____________________________ has no discipline infractions for the 2010-11, 2011-12, and 2012-13
(Student Name) (first semester) school years.
________________________________/____________
Name Date
_____________________________________________
Title
_____________________________________________
School District

5. Lincoln Consolidated Schools
8970 Whittaker Road
Ypsilanti, MI 48197
Phone: (734) 484-7001 / Fax: (734) 484-7014
Affirmation of Prior Discipline Record
(Grades 1-12 only)
Student Name:
Previous School District:
Building:
Address:
Directions:
Please check paragraph 1 or 2, provide all appropriate information, and sign/date.
A willful false statement on this affirmation will result in a report to the appropriate authorities and
possible removal from the Lincoln Consolidated Schools District.
 Paragraph 1: The undersigned affirms that the student has not been suspended or expelled
from any public or private school in Michigan or any other state, for an offense involving weapons,
alcohol or drugs, or for the willful infliction of injury to another person or for any act of violence against
persons and/or property committed on school premises, at any school-sponsored activity, or on a
public or private conveyance providing transportation to and from a school or school-sponsored
activity.
 Paragraph 2: The undersigned affirms that the student has been suspended or expelled from
any public or private school in Michigan or any other state, for an offense involving weapons, alcohol
or drugs, or for the willful infliction of injury to another person or for any act of violence against
persons and/or property committed on school premises, at any school-sponsored activity, or on a
public or private conveyance providing transportation to and from a school or school-sponsored
activity.
If you checked paragraph 2, explain the incident in detail on a separate sheet of paper.
Parent /Guardian Signature Date