ALC Change Form
Completion
Detailed Instructions
for Completion of
ALC Change Forms
Intermediate
District 287
As of 2-6-2003
Detailed Instructions
Following is a numbered list which coincides with the section numbers on the ALC
Change Form which is attached. Call Sandy Gaulke at 763-550-7142 if you have
questions.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Current School Year
Today’s Date
Students Full Name
Student’s 287 ID (Leave blank if unknown)
287’s School # for ALC
ALC’s School Name
Complete this section if change is a new address for the student and the
new address is in the same Resident District. If new address is a NEW
resident district, a new ALC Enrollment form must be completed and
signed by the new Resident District Administrator.
Start date of enrollment to be changed
Resident District of Enrollment to be changed
Last Location Code (See Figure C attached)
If enrollment is ending, this is the last day student attended the ALC
Status End Code is code given to an ending enrollment. This code the
default used by 287 is 99. (See Figure E which is attached). DO NOT
use codes 40 or 08, as these would cause duplicate end status with the
traditional school the student is involved in.
Detailed Instructions
Continued
13.
14.
15.
Shaded Gray Fields, should only be completed if information from the
original enrollment form has changed. (See ALC Enrollment Form
Completion Instructions for details)
Multiple records may be recorded on one sheet. Then this form
becomes a log of the students activity. If multiple records are recorded
on one form, then each line becomes a total for a certain time frame.
The form is completed in triplicate. The white copy is forwarded on to
the “Student Accounting” department at the District Service Center for
District 287. The Yellow is retained by the program completing the
form, and the pink copy is forwarded on to the resident district of the
student.
AREA LEARNING CENTER – ALTERNATIVE PROGRAMS
CHANGE TO STUDENT ENROLLMENT STATUS
1.
2.
School Year: __________________________
3.
District 287 Student ID #: __________
4.
Date: ______________________
Student Name:________________________________________________________________________________________________
Last
First
Middle
5.
ALC School Number: ________
6.
ALC School Name: _____________________________
7.
New Address: __________________________________________________________________________
______________________________________________________ Phone: ________________________
13
(NOTE: If new address is in a different resident district a new enrollment form must be completed.)
Enrollment
Status Start Date
8.
Resident Last
District Location
Code
(Complete shaded area if information has changed from original enrollment form.)
Grade
PSEO
Economic
Status
Enrollment
(Post
Level
Indicator
End Code
Status End Date
Secondary
Code
9. 10 11
Education Opt.)
Special Ed
Evaluation
Status
Disability
Code
12
14
15
WHITE - MARSS Office Copy (287)
YELLOW - Program Copy
PINK - Resident District Administration Copy
Instructional
Setting
AREA LEARNING CENTER – ALTERNATIVE PROGRAMS
CHANGE TO STUDENT ENROLLMENT STATUS
School Year: __________________________
Date: ______________________
Student Name:________________________________________________________________________________________________
Last
First
Middle
District 287 Student ID #: __________
ALC School Number: ________
ALC School Name: _____________________________
New Address: __________________________________________________________________________
______________________________________________________ Phone: ________________________
(NOTE: If new address is in a different resident district a new enrollment form must be completed.)
Enrollment
Status Start Date
Resident Last
District Location
Code
WHITE - MARSS Office Copy (287)
(Complete shaded area if information has changed from original enrollment form.)
Grade
PSEO
Economic
Status
Enrollment
(Post
Level
Indicator
End Code
Status End Date
Secondary
Code
Education Opt.)
YELLOW - Program Copy
Special Ed
Evaluation
Status
Disability
Code
PINK - Resident District Administration Copy
Instructional
Setting