JFABA-E - School Choice Policy Form

Acton School Department Choice Application

Please complete this application form for all initial requests for school choice.  To be considered, applications must be returned to the Acton School prior to February 14th.  In the event the number of school choice applicants exceeds the available school choice openings, participation will be determined via lottery.  Lottery results will be communicated to families no later than March 1st.

Name of Student: _______________________________________________________________Grade Entering: ___________

Address of Residence: _______________________________________________________________________________________

___________________________________________________________________________________________________________________

Mailing Address (if different from above):_______________________________________________________________

__________________________________________________________________________________________________________________

Parent/Guardian’s Name: __________________________________________________________________________________

Parent/Guardian’s E-mail Address: ______________________________________________________________________

Parent/Guardian’s Phone Number: ______________________________________________________________________

Current School Attending: _________________________________________________________________________________

School Choice Desired: _____________________________________________________________________________________

For tuition assistance, private schools must be designated as ‘non-sectarian’.  The parent/guardian of the student, not the Acton School Department is solely responsible for ensuring that the school chosen by the student/parent/guardian is approved by the Maine Department of Education to receive public funds for the school year in question.  For students with Individual Education Plans, the chosen school must be approved to provide special education services.   Approved schools can be found at 

[ https://www.maine.gov/doe/schools/schooling ]

Is admission already accepted?   Yes______________   No ______________

Does the student have a sibling who is already accessing school choice?  Yes_________No_________

               If Yes:  Name of Sibling: ____________________________________________________________________________

 School Sibling Attends: ____________________________________________________________________________

Parent/Guardian Signature: ____________________________________________________Date: _____________________

The deadline for submission of school choice application is February 14th

Reference:   Policy JFABA – School Choice

Adopted:   March 12, 2019