LAKE VIEW HIGH SCHOOL
4015 North Ashland Avenue | Chicago, Illinois 60613
Telephone 773.534.5440 | Fax 773.534.5908 | www.lakeviewhs.com
_________________________________________________________________________________________________ Scott Grens, Principal | Angela Newton, Assistant Principal | Meghan Sovell, Assistant Principal | Toney Vast-Binder, Assistant Principal
Transfer Application Section I: STUDENT INFORMATION Student Name: _______________________________________ Date of Birth: _____________________ Month/Date/Year Parent/Guardian Name: ________________________________ Grade Level: ____ (9, 10, 11, 12) Home Address: ______________________________________________________________________ Street City Zip code Daytime Telephone Number: ________________________ Parent/Guardian Email: _______________________ Current School Name: ________________________________ Is Current School in CPS? Yes No Section II: HIGH SCHOOL PERFORMANCE INFORMATION THE COUNSELOR OR SCHOOL ADMINISTRATOR OF YOUR SCHOOL MUST SUBMIT THE FOLLOWING INFORMATION. A. MOST RECENT STANDARDIZED TEST RESULTS Yes No EXPLORE, PLAN, and ACT Score Report (EPAS) OR equivalent standardized test scores if EPAS is unavailable. B. HIGH SCHOOL ACADEMIC TRANSCRIPT Yes No All high school grades and credits to date. C. INDIVIDUALIZED EDUCATION PLAN (IEP) and/or 504 PLAN Yes No If the student receives specialized services. D. BEHAVIOR/DISCIPLINE REPORT Yes No E. CURRENT MEDICAL RECORD(s) Yes No CPS Verify Report or other official school discipline/behavior report. Section III: DIRECTIONS FOR SUBMITTING APPLICATION Mail this completed form and ALL of the following information to (Incomplete applications will not be considered): Lake View High School | Admissions Office | 4015 N. Ashland Ave. | Chicago, IL | 60613 A.
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Most Recent Standardized Test Results [Explore Score Report (10th grade); PLAN Score Report (11th grade)] High School Academic Transcript (All high school grades and credits to date) Individualized Education Plan (IEP) and/or 504 Plan (If the student receives specialized services) Behavior/Discipline Report (CPS Verify Report or other official school discipline/behavior report) Current Medical Record(s) Section IV: VERIFICATION OF INFORMATION I hereby certify that all the information provided is complete and accurate. I understand that any falsifications of personal or academic information through omissions of misstatement by me, or anyone who may have assisted me in the submission of this application, may result in not being admitted to Lake View High School. ____________________________ Student’s Signature Date ________________________________ Parent/Guardian’s Signature Date Honor | Ownership | Mastery | Education
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