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Items denoted with a red asterisk
*
are required.
OUT OF STATE TRANSFERS
This form is to be used when a student transfers into CCS from out of State.
Student must be enrolled at your school before completing this form.
**Out of State transfers must be found eligible for EC services by NC law. Therefore, the student will be handled as an initial referral, not a reevaluation.
*
Student NCWISE Number:
*
Student Name:
*
Student Date of Birth
*
Student Social Security Number:
*
Case Manager Name:
*
List Daycare/Preschool if student is PK and not receiving services at a Caldwell County School.
Enter NA if student is not PK.
*
Date You Were Made Aware That The Student Was Considered EC In The Previous State:
This date will begin the 90 day timeline.
*
LEP Student:
Yes
No
REMINDER:
This student will be handled as an "initial referral" and placed in a status of "referral in progress". Therefore, the student will not be active and eligible for funding until you have completed and closed all forms. All forms MUST show a purpose of "INITIAL". If any other purpose is used other than initial, the forms will be deleted and you will have to complete them again.
However, if it is discovered that the student was originally placed into the EC Program within the state of NC, you will be made aware of this and advised how to proceed.
