General Instructions

• Submit ONLY ONE application per child
• In the event that a paper and online application is submitted for the same student, the paper application will be voided.
• Post Office box addresses will not be accepted for the student’s address. You MUST have a resident address with house number, street, city, and zip code for the application to be accepted.
• If you are completing a new application enter all information requested. Any changes of address or phone number submitted on the blank application must also be changed at the child's LAUSD school of attendance to be considered valid by November 16, 2012.
• Since applications will be electronically read, please print clearly in CAPITAL LETTERS, using black or blue ink.

The e-mail address you provided on this application form will only be used by Student Integration Services to inform you of the status of your child's application.

*It is the responsibility of the parent or legal guardian to complete the application.

View Online Tutorial on how to fill out the Choices Application.

	Student Information Please enter your child’s last name, first name and middle Initial. Enter your child’s correct address, including the apartment number, if any, city and zip code. It is the parent/legal guardian’s responsibility to verify the student’s address at the current LAUSD school of attendance. Enter the grade your child is in this school year and the grade he or she will be in next school year (2013-2014) Fill in the bubble for your child’s gender. If your child has ever been enrolled in a LAUSD school, please fill in the “Yes” bubble. (This does not include Independent Charter Schools). If your child has never been enrolled in a LAUSD school, please fill in the “No” bubble. Enter the name of the school your child is currently attending. Enter your child’s date of birth in this order: MM/DD/YYYY Enter your telephone number and your work, emergency or cell phone number. Enter the parent or legal guardian’s name and e-mail address. (The e-mail address is optional).
	Ethnicity information Magnet and PWT are Court-Ordered programs that require parents to mark ONE federally identified ethnicity/race category on the application. Fill in the bubble next to the ethnicity or race that best describes the child for which you are applying. You may fill the “Multi-racial/Multi-ethnic” response to indicate the applicant is identified as more than one ethnicity/race but your application WILL NOT be processed unless you select one of the federally identified ethnicity/race categories for the purpose of selection. AMERICAN INDIAN/ALASKAN NATIVE A person having origins in the original peoples of North America, who maintains cultural identification through tribal/ community affiliation. ASIAN A person having origins in the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, e.g., China, India, Japan, Korea and the Philippines. AFRICAN AMERICAN/BLACK, NOT OF HISPANIC ORIGIN A non-Hispanic person having origins in any of the Black racial groups of Africa. HISPANIC/LATINO A person of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish culture or origin, regardless of race. WHITE A non-Hispanic person having origins in any of the original peoples of Europe, North Africa or the Middle East, e.g., England, Egypt, Russia or Iran. NATIVE HAWAIIAN/PACIFIC ISLANDER A person having origins in any of the original peoples of Polynesia, Micronesia or Melanesia.
	Option A | MAGNET PROGRAM ONLY Fill in the bubble ONLY if you are applying for the Magnet Program. This option allows you to select a Magnet Program for your child to attend. Fill in this bubble if you are ONLY interested in applying for a Magnet Program and not any other type of program. You may list up to three different choices of Magnet Schools. Please do not list the same Magnet Program more than once. Please see pages 5-15 for the seven-digit school code and name of the Magnet school. Place one number in each box and write the school name in the box to the right. In order to create a more equitable selection process for all applicants, priority points are only used for the applicant’s first choice. If needed, applicants will all enter a random selection process for their second and third choices. If the applicant does not get selected into a Magnet Program, the applicant will be placed on a waiting list for their First Choice. Any priority points that they may have had will be used, once they are placed on this waiting list. Option B | Magnet Program + NCLB-PSC Fill in the bubbles for BOTH the Magnet Program and NCLB-PSC*. This option allows for the selection of up to three Magnet Programs + NCLB-PSC* (For NCLB-PSC* eligibility, please check pages 18-19. If selected into any Magnet Program, the applicant will automatically be removed from other choices; no waiting list points will be accrued. Please be aware if the applicant is selected into any Choices program, the applicant will not be listed on any Magnet program's Waiting List. The District will select the Non-PI school). This option is only available for on-time applicants. Option C | NCLB-PSC ONLY Fill in the bubble ONLY if you are applying for NCLB-Public School Choice (NCLB-PSC)*. For NCLB-PSC* eligibility, please check pages 18-19. The District will select the Non-PI school. This option is only available for on-time applicants. Option D | PWT - Permits With Transportation Fill in the bubble ONLY if you are applying for the Permits With Transportation (PWT) Program. Once students are accepted into the PWT Program, they are allowed to matriculate to the next school level (elementary to middle or middle to high) without filling out a new application, providing that space continues to be available. Select Magnet Schools/centers. Check Permits With Transportation (PWT) program eligibility. Check NCLB-Public School Choice (PSC) eligibility.
	Sibling information If this applicant has a brother or sister currently enrolled in the same Magnet school, PWT or NCLB-PSC* program for which he/she is applying and the sibling will be continuing next year, please fill in the sibling’s last name, first name, middle initial and birth date. Siblings must reside at the same address at the time of application. It is the parent’s responsibility to verify that the siblings have the same address on file in the district computer system at the current LAUSD school of attendance by the application deadline.
	Information Sharing Depending on seat availability at the particular Magnet Program(s) you have selected, your child may be placed on a waiting list for the 2013-2014 school year. Other Magnet programs of possible interest to you may have space available for the 2013- 2014 school year. Fill in the “yes” bubble if you want to share your child’s information. Note: If you do accept placement at an alternate Magnet, your child’s name will be removed from the original Magnet wait list and all waiting list points will be removed.
	Parent Signature Sign your name and write the date in the box provided to verify that all information submitted on the application is correct. If the applicant is selected, your signature authorizes the transfer of student records to the Magnet, PWT, or NCLB-PSC school. This application must be signed in black or blue ink. Falsification of information will result in the applicant’s removal from the program. Double-check your information. It is the responsibility of the parent or legal guardian to complete the application.

Falsification of information will result in the applicant’s removal from the program. It is the responsibility of the parent or legal guardian to complete the application.