Arizona Public School Enrollment Verification (2020-21)
If a student qualifies to receive a Corporate or PLUS Tax Credit Scholarship by the following eligibility requirement,
The student must have been enrolled in an Arizona public school K-12 as a full-time student for at least 90 days
of the prior fiscal year (or the equivalent of one full semester for that school), & then transferred to a qualified private
school.”
Then, this information is to be completed by the public school. Depending on the student’s current enrollment status,
you may need to provide information for both the current school year and the prior school year. If the student
attended more than one public school during a school year, provide information for all public schools (a separate
form for each school must be attached).
Student Name:
Name of Public School and District:
First day of school year (mm/dd/yy):
Last day of school year (mm/dd/yy):
Student’s Dates of Enrollment for School Year:
Grade:
Student was enrolled for one full semester of the school year. Yes No
If NO, student was enrolled for _______ days of the school year.
Name and Title of Individual Completing Form:
Signature and Date:
Name of Public School and District:
First day of school year (mm/dd/yy):
Last day of school year (mm/dd/yy):
Student’s Dates of Enrollment for School Year:
Grade:
Student was enrolled for one full semester of the school year. Yes No
If NO, student was enrolled for _______ days of the school year.
Name and Title of Individual Completing Form:
Signature and Date:
Send to: TOPS for Kids-67 S Higley Rd Ste 103 #182-Higley, AZ 85296 or fax # 1-888-256-1130 or email to services@topsforkids.com (480) 414-8677
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