NEW STUDENT FORM
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1 – For students who change schools after starting 9th grade
YES NO I AM INTERESTED IN PARTICIPATING IN ATHLETICS
To be completed by new students, parents and former school. This form is intended to assist schools in compiling
information to determine eligibility under MHSAA Regulations. Provide copies in new student packets and as soon as possible
the form should be submitted to the athletic director for evaluation. The AD may then contact the MHSAA for assistance.
Consult Int. 65 and 77 or the Residential Change Check List on MHSAA.com (Schools
Parents
Regulations Summary) to
assist in determining if residential changes are full and complete. Int. 37 states two current and complete documents are
prerequisites for participation: Physical Exam/Consent Form or Health Questionnaire/Consent Form and official
school record (transcript) since first enrolling in the 9
th
grade of any school.
SECTION
COMPLETED
BY SCHOOL &
STUDENT –
CHECK
TRANSCRIPT
- Official enrollment date (in school records & attending one or more classes)
- Number of classes for which credit has been given in the previous academic term
- Number of potential classes for a full-time student in the previous high school
- Number of semester’s and/or trimesters in grades 9-12 COMPLETED to date
- In what school year did the student END the 8th grade (and BEGIN grade 9th)
- Has the student REPEATED any grade 9-12?
STUDENT’S NAME __________________________________________________ GRADE ________ BIRTHDATE _____/_____/_____
PHONE (_____)_________________ EMAIL ____________________________________________________________________
CURRENT (NEW) ADDRESS ____________________________________ CITY _____________________ STATE _____ ZIP ________
DATE OF RESIDENCE CHANGE INTO CURRENT (NEW) ADDRESS _________________________________________________________
CURRENT (NEW) PUBLIC SCHOOL DISTRICT IN WHICH YOU RESIDE ______________________________________________________
NEW ADDRESS IS IN A DIFFERENT PUBLIC SCHOOL DISTRICT (OR ATTENDANCE AREA OF A MULTI-HIGH-SCHOOL DISTRICT) Y N
OLD HOME ADDRESS ________________________________________ CITY _____________________ STATE _____ ZIP ________
FORMER RESIDENCE (CHECK ALL THAT APPLY) VACANT SOLD RENTED ALL BELONGINGS MOVED? Y N
FORMER PUBLIC SCHOOL DISTRICT OF RESIDENCE _________________________________________________________________
PARENT(S) OR GUARDIAN(S) ___________________________________________________ PHONE: (_____)_________________
1. The last school the student attended _____________________________________________________________________
2. While enrolled at former school, the student lived with _______________________________________________________
(List ALL people & their relationship to the student - parents, siblings, or others)
YES NO The student lived with the above for at least 30 days during the most recent previous academic term.
3. The student NOW lives with ____________________________________________________________________________
(List ALL people & their relationship to the student - parents, siblings, or others)
SELECT THE APPROPRIATE ANSWER
4. 9x10x11x12 Circle the highest grade in which the student was enrolled at any previous school.
5. YES NO School previously attended was a nonpublic or charter school.
6. YES NO Student is a “Ward of the Court/State” and was placed in this school district by court order.
7. YES NO Student is an international student enrolling from a foreign country. Select VISA: F1 J1
7a. YES NO Student is from an MHSAA Approved International Student Program (AISP).
Program Name: _____________________________ Program is listed on MHSAA.com Y N
8. YES NO Student’s previous school has been closed, dissolved or reorganized. (see Int. 64 & 90)
9. YES NO Student’s parents are DIVORCED. If divorced, give exact decree date: Month____ Day____ Year______
10. YES NO Student is 18 or under; or the 19th birthday is on or after Sept. 1st of this school year.
11. YES NO Last year, the student lived at a boarding school, or while enrolled out of state attended a sports academy.
12. YES NO Student is 18 and moved into this district WITHOUT his or her parents.
13. YES NO Student participated in a cooperative program involving his/her previous school and our school.
14. YES NO Student wishes to discuss her/her situation with the athletic director. OVER