Form 15.5.3 - Request For Eligibility Form
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1ARIZONA INTERSCHOLASTIC ASSOCIATION, INC.
th
7007 North 18
Street, Phoenix, Arizona 85020-5552
Phone: (602) 385-3810
Fax: (602) 385-3779
REQUEST FOR ELIGIBILITY
LEGAL GUARDIANSHIP / WARD OF COURT
PURPOSE OF FORM:
This form is used to request eligibility for a student for whom a COURT OF COMPETENT
JURISDICTION (i.e., an Arizona court for a student for whom guardianship was obtained when the student was living in
Arizona or an out-of-state court for a student for whom guardianship was obtained when the student was living in that state)
granted legal guardianship. If approved, notice of approval will appear in the official minutes of the AIA Executive Board
meeting. (AIA Bylaws; Article 15, Section 15.5, Paragraph 15.5.3, Subparagraph 15.5.3.2)
DIRECTIONS FOR SUBMISSION OF FORM:
Complete and mail this form along with a copy of the court order to the
AIA Office. Documents such as power of attorney or notarized statements of mutual consent are not acceptable for purposes
of legal guardianship and ward of the court under the AIA Bylaws.
Name of Student ________________________________
Receiving School ________________________________
Date of Birth ____________________________________
Sending School __________________________________
Grade _________________________________________
Date of Enrollment
at Receiving School ______________________________
Administrator ___________________________________
Phone _________________________________________
Contact Person _________________________________
Phone _________________________________________
Date Submitted _________________________________
NAME AND DOMICILE OF LEGAL GUARDIAN(S)
NAME OF DOMICILE OF PARENT(S)
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Domicile of legal guardian(s) past five years: _______________________________________________________________
___________________________________________________________________________________________________
Reason given to court for request of legal guardianship: ______________________________________________________
__________________________________________________________________________________________________
Duration of legal guardianship: _____________________
Guardianship status of brothers/sisters:
Schools currently attending:
______________________________________________
______________________________________________
______________________________________________
______________________________________________
Has this student been involved in prior legal guardianships?
No ( )
Yes ( )
If yes, describe:
___________________________________________________________________________________________________
Has this legal guardian been involved in previous guardianships?
No ( )
Yes ( )
If yes, describe:
___________________________________________________________________________________________________
FORM 15.5.3
6/15
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