Choices Application

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Choices Application
2014-2015
Space Available Application
Student Integration Services now offers the Space Available Application. Starting
December 2, 2013, parents may apply to Magnet programs on the eChoices
website or complete a Choices paper application. The Space Available process
will allow applicants to apply for a single Magnet program. Space Available
applicants are not assigned priority points and do not accrue any priority points.
Space available seats will open after all of the students on the Waiting list have
been offered placement at the selected school site. Each Magnet’s openings are
determined by the need to maintain a racially balanced enrollment as mandated
by the Court Order, and by available space. Please be aware that filling out a
space available application does not guarantee student placement. Applicants
will be called by the school site when an opening becomes available. This may
occur after April 2014 through January 2015.
To proceed with the Space Available application, download the following
application and mail it in after December 2, 2013 to LAUSD Administrative
Building, Student Integration Services- 25th floor, 333 S. Beaudry Ave, Los Angeles,
CA 90017 or mail the Choices paper application found in the Choices brochure.
You may also apply online. To apply online, go to the 2014-2015 Space Available
Application link on the eChoices main webpage at eChoice.lausd.net. When you
apply online, you will receive a receipt of application with a confirmation number.
Applicants will also be able to view their application online.
2014-2015 Choices | Application Instructions

STUDENT INFORMATION
 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 address at the
current LAUSD school of attendance.
 Enter the grade level your child is in this
school year and the grade level he or she
will be in next school year (2014-2015)
 Fill in the bubble for your child’s gender.
 If your child has ever been enrolled in an
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STUDENT’S ETHNICITY/RACE
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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 “Multiracial/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.
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LAUSD school, please fill in the “Yes” bubble.
(This does not include Independent Charter
Schools).
If your child has never been enrolled in an
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
format: 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.
Fill in the “YES” bubble if you would like to
receive all correspondence from Student
Integration Services via e-mail.
Due to recent legislation, the minimum age
for Kindergarten and First grade has been
changed for the 2014-2015 school year.
Students entering Kindergarten should be
age 5 by September 1, 2014 and students
entering First grade should be age 6 by
September 1, 2014 .
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.

PROGRAM SELECTION
SELECT EITHER OPTION A, B, C or D
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 have the option to list up to three
different choices of Magnet Programs.
Please do not list the same Magnet
Program more than once.
 Please see pages 6-17 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 used for the applicant's first
choice. If the applicant is selected to their
first choice, choice two and three are not
considered. If needed, applicants will enter
a random selection for their second or third
choice. If the applicant is selected into any
program of their choice, the student will
not be placed on any waiting list.
 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.
 Applicants currently attending a Magnet
and selected into another Magnet will
automatically be dropped from current
Magnet program.
 Continuous Enrollment Magnet Schools.
You may now continuously apply to select
Magnet schools. Priority will be given to
students residing within each continuous
enrollment school’s attendance boundary.
All other eligible LAUSD students will be
selected provided there is space available.
The participating schools are: Carthay ES,
Crenshaw HS, Lee ES, Los Feliz ES, Irving
MS, King MS (Film/Media), Sun Valley MS
Engineering Arts/Technology, Sun Valley
MS Environmental Studies, Wright MS, and
Westchester HS.
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SIBLING INFORMATION FOR
MAGNET, PWT OR NCLB - PSC

INFORMATION SHARING
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's computer system at the current
LAUSD school of attendance by the application
deadline.
Depending on seat availability at the particular
Magnet Program(s) you have selected, your
child may be placed on a waiting list for the
2014-2015 school year. Other Magnet programs
of possible interest to you may have space
available for the 2014-2015 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.

SIGNATURE OF PARENT/
LEGAL GUARDIAN
 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
correctly.
 Your signature on the application signifies
that you have read and understood the
Choices Application Guidelines and
Instructions.
Please contact Student Integration
Services at (213) 241-4177 if you
have any questions.
NOTE:
Option B | Magnet Program + NCLB-PSC
Fill in the bubble for BOTH the Magnet Program
and NCLB-PSC. This option allows for the
selection of up to three Magnet Programs +
NCLB-PSC. 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 schools.
Applications must be complete and postmarked
or received by Student Integration Services by 5:00
p.m. Friday, November 15, 2013 to be considered
eligible. Please use the following address if an
envelope is not provided inside this booklet:
Student Integration Services
333 S. Beaudry Ave. 25th Floor
Los Angeles, CA 90017
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 criteria including a list of PI
schools, please visit eChoices.lausd.net or call
(213) 241-6572. The District will select the
Non-PI school.
By the month of March, parents and/or legal
guardians will be notified, in writing, as to
whether the student has been accepted or
placed on a waiting list.
Option D | PWT - Permits With Transportation ONLY
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. Please visit: eChoices.lausd.
net or call (213) 241-6572 to find out about
your eligibility.
Submit an original application only, no
copies will be accepted; or, apply online at
eChoices.lausd.net
No late applications are accepted for Magnet,
PWT, or NCLB-PSC.
WHEN FILLING OUT THE APPLICATION:
DO THIS 
X
NOT THIS 
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Student Integration
Services will be closed
from December 24, 2013
to January 3, 2014
18
2014-2015
CHOICES
APPLICATION
THIS APPLICATION MAY ONLY BE
SUBMITTED FOR THE 2014-2015
SCHOOL YEAR. OTHER APPLICATIONS WILL NOT BE PROCESSED.
REMOVE FORM AT PERFORATION
1
PROGRAM PARTICIPATION IS ONLY FOR STUDENTS WHO LIVE WITHIN
THE BOUNDARIES OF THE LOS ANGELES UNIFIED SCHOOL DISTRICT
You may apply online at echoices.lausd.net or by completing this application
• ONLY one application will be accepted and must be for the grade the applicant will be in during the 2014-2015 school year.
• Application must be complete. Submit an original application only, no copies will be accepted.
• Return by U.S. mail using the enclosed envelope. Please make and retain a copy of this application for future reference.
• Applications must be postmarked or received by the Los Angeles Unified School District by FRIDAY, November 15, 2013.
• Select one of the following options: A. Magnet, B. Magnet + NCLB-PSC, C. NCLB-PSC Only, or D. PWT Only.
STUDENT INFORMATION - Please complete the information below.
1. STUDENT’S LAST NAME
STUDENT’S FIRST NAME
2. STUDENT’S ADDRESS – NUMBER AND STREET (P.O. BOXES WILL NOT BE ACCEPTED)
APARTMENT NO.
NUMBER
ST RE ET
NAME
3. CITY
MI
4. GRADE THIS
SCHOOL YEAR
2013-2014
ZIP CODE
5. GRADE NEXT
SCHOOL YEAR
2014-2015
6. STUDENT’S GENDER
Male
7. SCHOOL NOW ATTENDING
Female
Has your child ever been enrolled in an LAUSD school?
Yes
8. STUDENT’S BIRTHDATE
MONTH
DAY
9. HOME TELEPHONE NUMBER
YEAR
AREA CODE
10. WORK OR EMERGENCY TELEPHONE NUMBER
No
EXTENSION
AREA CODE
11. PARENT/LEGAL GUARDIAN’S LAST NAME
PARENT/LEGAL GUARDIAN’S FIRST NAME
12. PARENT/LEGAL GUARDIAN’S EMAIL ADDRESS
MI
13. Receive correspondence via email only?
YES
No
We may use the email address you provide to inform you of the status of your child’s application.
2
STUDENT’S ETHNICITY/RACE – FILL IN ONLY ONE
Hispanic/Latino
Asian
White
Native Hawaiian/
Pacific Islander
3
Multi-racial/
Multi-ethnic
PROGRAM SELECTION - SELECT ONE OF THE FOLLOWING OPTIONS: A. Magnet, B. Magnet + NCLB-PSC, C. NCLB-PSC or D. PWT
A. MAGNET PROGRAM – TRANSPORTATION MAY BE PROVIDED (SEE PAGE 3)
MAGNET
This option allows you to select a Magnet program by making up to three choices. Print the school code and the full name of the Magnet Program for which the student is
applying. School codes are located in front of the school name on pages 6-17. (If applying to a gifted/high ability/highly gifted Magnet, please see requirements on page 8).
1ST CHOICE: SCHOOL CODE
FIRST MAGNET SCHOOL YOU ARE REQUESTING (Please print school name exactly as it appears on pages 6-17).
2ND CHOICE: SCHOOL CODE (OPTIONAL)
(OPTIONAL) SECOND MAGNET SCHOOL YOU ARE REQUESTING (Please print school name exactly as it appears on pages 6-17).
3RD CHOICE: SCHOOL CODE (OPTIONAL)
(OPTIONAL) THIRD MAGNET SCHOOL YOU ARE REQUESTING (Please print school name exactly as it appears on pages 6-17).
FOLD
USE BLACK OR BLUE INK TO FILL OUT THE FORM FO L D
FO L D
African American/Black
You may fill in “Multi-racial/Multi-ethnic”; however, by Court
Order, you MUST also bubble ONE federally identified ethnicity/
race category to the left for the purpose of Magnet/PWT
selection. Application will not be processed unless an
ethnicity/race is also indicated.
FOLD
American Indian/Alaskan Native
B. MAGNET + NCLB-PSC – TRANSPORTATION WILL BE PROVIDED FOR NCLB PSC SCHOOLS (SEE PAGE 3)
This option allows for selection of up to three Magnets above, and NCLB-PSC. To see if you are eligible to apply for NCLB-PSC, please visit eChoices.
MAGNET
NCLB-PSC
lausd.net or call (213) 241-6572. The District will assign a school for your child to attend.
C. NO CHILD LEFT BEHIND – PUBLIC SCHOOL CHOICE (NCLB-PSC) Program – TRANSPORTATION WILL BE PROVIDED (SEE PAGE 3)
NCLB-PSC
This option allows for the selection of a NCLB-PSC Program ONLY. To see if you are eligible to apply for NCLB-PSC, please visit eChoices.lausd.net or call
(213) 241-6572. This choice cannot be combined with any other option.
D. PERMITS WITH TRANSPORTATION (PWT) PROGRAM – TRANSPORTATION WILL BE PROVIDED (SEE PAGE 3)
PWT
4
This option allows you to select a PWT Program. Please fill in this bubble ONLY if you live in a PWT Sending Area. Call (213) 241-6572 to check and see
if your address qualifies. The District will assign a school for your child to attend. This choice cannot be combined with any other option.
SIBLING INFORMATION FOR MAGNET OR PWT OR NCLB-PSC
If the above applicant has a brother or sister currently enrolled in the same program for which he/she is applying and the sibling will be continuing next year, please fill out the sibling’s information below.
SIBLING’S LAST NAME
SIBLING’S FIRST NAME
MI
SIBLING’S BIRTHDATE
MONTH
5 If your
INFORMATION
child is placedSHARING
on a Magnet waiting list, do you want his/her name shared with other schools that may have space available?
DAY
See information on page 16.
If your child is placed on a Magnet waiting list, do you want his/her name shared with other schools that may have space available? See information on page 18.
6
YEAR
Yes
No
SIGNATURE
79215
For the student to be eligible for selection or assignment, all information must be complete and accurate. The application must be signed in ink.
Falsification of information will result in an application not being processed and/or an applicant’s removal from the program. It is the responsibility of the parent/legal guardian to complete the application correctly or it will be rejected.
SIGNATURE OF PARENT OR LEGAL GUARDIAN (USE BLACK OR BLUE INK)
DATE
MONTH
DAY
YEAR
19