Change Form or Withdrawal
1.
Academic Year
09/10 (June '09- May '10)
10/11 (June '10- May '11)
11/12 (June '11- May '12)
08/09 (June '08- May '09) past year
Members prior to 08/09 school year
You must choose from dropdown menu
2.
PACESC Member ID
3.
Update Information or Withdraw
Updating Information with PACESC
Withdrawing from PACESC
4.
Withdrawing to...?
Back to public/ private school
Moving out of state
Transfering to another group
5.
(1) Parent/ Legal Guardian
6.
(2) Parent/ Legal Guardian
7.
New Phone Number
8.
New Alt. Phone
9.
New Email
10.
New Street Address
11.
New City
12.
New State
13.
New Zip
14.
New Mail to: Address
15.
New Mail to: City
16.
New Mail to: State
17.
New Mail to: Zip
18.
New School Districts (A - C)
REQUIRED!!! (18,19,20,or 21)
Abbeville
Aiken
Allendale
Anderson 1
Anderson 2
Anderson 3
Anderson 4
Anderson 5
Bamberg 1
Bamberg 2
Barnwell 19
Barnwell 29
Barnwell 45
Beaufort
Berkeley
Calhoun
Charleston
Cherokee
Chester
Chesterfield
Clarendon 1
Clarendon 2
Clarendon 3
Colleton
19.
New School Districts (D - K)
Darlington
Dillon 2
Dillon 3
Dorchester 2
Dorchester 4
Edgefield
Fairfield
Florence 1
Florence 2
Florence 3
Florence 4
Florence 5
Georgetown
Greenville
Greenwood 50
Greenwood 51
Greenwood 52
Hampton 1
Hampton 2
Horry
Jasper
Kershaw
D - K
20.
New School Districts (L - R)
L - R
Lancaster
Laurens 55
Laurens 56
Lee
Lexington 1
Lexington 2
Lexington 3
Lexington 4
Lexington 5
McCormick
Marion 2
Marion 7
Marlboro
Newberry
Oconee
Orangeburg 3
Orangeburg 4
Orangeburg 5
Pickens
Richland 1
Richland 2
21.
New School Districts (S - Y)
S - Y
Saluda
Spartanburg 1
Spartanburg 2
Spartanburg 3
Spartanburg 4
Spartanburg 5
Spartanburg 6
Spartanburg 7
Sumter 2
Sumter 17
Union
Williamsburg
York 1 (York)
York 2 (Clover)
York 3 (Rock Hill)
York 4 (Fort Mill)
22.
(1) Student Name
23.
(1) Student DOB
24.
(1) Student Grade
25.
(1) Student Will Be:
Homeschooling
In Public School
In Private School
26.
(1) Enrollment Issues
Special Ed/ Disability
Expelled from District
Expulsion Hearing Pending
Foster Child
No Issues
27.
(2) Student Name
28.
(2) Student DOB
29.
(2) Student Grade
30.
(2) Student Will Be:
Homeschooling
In Public School
In Private School
31.
(2) Enrollment Issues
Special Ed/ Disability
Expelled From District
Expulsion Hearing Pending
Foster Child
No Issues
32.
(3) Student Name
33.
(3) Student DOB
34.
(3) Student Grade
35.
(3) Student Will Be:
Homeschooling
In Public School
In Private School
36.
(3) Enrollment Issues
Special Ed/ Disability
Expelled From District
Expulsion Hearing Pending
Foster Child
No Issues
37.
(4) Student Name
38.
(4) Student DOB
39.
(4) Student Grade
40.
(4) Student Will Be:
Homeschooling
In Public School
In Private School
41.
(4) Enrollment Issues
Special Ed/ Disability
Expelled From District
Expulsion Hearing Pending
Foster Child
No Issues
42.
(5) Student Name
43.
(5) Student DOB
44.
(5) Student Grade
45.
(5) Student Will Be:
Homeschooling
In Public School
In Private School
46.
(5) Enrollment Issues
Special Ed/ Disability
Expelled From District
Expulsion Hearing Pending
Foster Child
No Issues
47.
(6) Student Name
48.
(6) Student DOB
49.
(6) Student Grade
50.
(6) Student Will Be:
Homeschooling
In Public School
In Private School
51.
(6) Enrollment Issues
Special Ed/ Disability
Expelled From District
Expulsion Hearing Pending
Foster Child
No Issues
52.
(7) Student Name
53.
(7) Student DOB
54.
(7) Student Grade
55.
(7) Student Will Be:
Homeschooling
In Public School
In Private School
56.
(7) Enrollment Issues
Special Ed/ Disability
Expelled From District
Expulsion Hearing Pending
Foster Child
No Issues
57.
Person completing form:
58.
Date of Application