GILMER HIGH SCHOOL

Parking Permit Application & Consent to Drug Screening 2016-2017 Student Parking at Gilmer High School is a privilege. Students are expected to observe all traffic regulations while on or around the GHS Campus. Failure to observe traffic and parking regulations may result in suspension of parking privileges or other disciplinary actions. Complete ALL ITEMS listed below. Submit this completed and signed form along with Drug Screening Permission form and payment to receive your parking tag. Student Information Date of Birth

Grade:

_______

Last Name __________________________ First Name ________________________ MI ___________ Street Address_

__

Student Phone#

___ Student Email______________________________________

Parent Phone#

___ Parent Email_______________________________________

Driver’s License #

Expiration Date

State

__

Motor Vehicle Information Year

Color

Make

Model

___

Registered Owner’s Name__________________________ Relationship to Driver_________________ License Tag #

State

Insurance Company

VIN # ___________________________

Policy #

___

Permit Costs $40 for entire school year CASH OR MONEY ORDER ONLY! ALL Above Information will be verified I understand and agree that failure to obey traffic rules and Gilmer High School parking policies and guidelines may result in suspension/termination of parking/driving privileges. I further understand what is expected of me as a responsible driver. **School Board Policy … “The Board of Education shall not be responsible for damage to automobiles or other vehicles which are parked or operated on school property.”

Student Signature

Date

Parent/Guardian Signature

Date

(Consent to Drug Screening signature required on back)

(School use only)GHS

Parking Space Number

_______

Full Day/Early Release

GPA__________________

QUALIFICATIONS: To qualify for a parking tag a student must:  Have a valid operator driver's license.  Complete a parking application in full.  Participate in the Gilmer County School Drug Screening Program.  Must be enrolled in grades 9-12.  Have a 2.0 GPA.  Be cleared of all school financial obligations from the previous school year(s).  Pay a $40 fee for the entire school year. PARKING Permit REGULATIONS and guidelines: Parking permits will be sold on a “First Come-First Serve” basis with Seniors being first. Once all spaces are filled, no permits will be sold.  Once issued, parking permits cannot be altered or transferred to another student’s vehicle.  Parking tags must be displayed hanging from the rearview mirror with parking number visible.  Loitering in the parking lot is not permitted. After entering the parking area, all students must leave their cars immediately and report to their designated area, and remain on campus.  Cars are not to be used as lockers. Students should return to their cars only when leaving school at the end of the day or after signing out in the Front Office.  Student parking is in designated areas only. There is no parking on the grass, faculty/staff areas, or in visitor parking.  Parking tags reserve parking space for students only during the school day. Otherwise, this space is open to the public for all other activities.  Parking tags will be revoked if removed from vehicles for any reason other than surrendering it to school administration.  A replacement tag must be purchased if a parking tag is lost or stolen.  Students may receive a parking permit application in the Front Office or online at the GHS website through www.gilmerschools.com.  Students may be towed if parked in an unassigned space. PARKING Permit Citation/SUSPENSION/REVOCATION MAY OCCUR IF: A student fails to register a vehicle with administration. A student has excessive tardies, early sign in/outs and/or unauthorized absences from campus, leaves campus and/or takes other students off campus without permission. A student exceeds the 15 mph speed limit in the parking area. A student transfers, sells or receives a legal, illegal or fraudulent parking permit. A student parks in unauthorized areas. A student engages in reckless driving and/or speeding in the parking lot or within the perimeter of the school grounds. A student's vehicle displaying words or graphics that are in poor taste and/or create a disruption of the school process. A student does not have a current signed Student Code of Conduct form on file. A student fails to maintain/meet qualifications and guidelines (listed above)

Consent to Drug Screening for Privileged Activities I understand that submission to testing for the presence of drugs and alcohol is a condition of participation in privileged/extracurricular activities at Gilmer County Schools. I further understand that if I refuse to take the test I will be ineligible to participate in the designated privileged/extracurricular activities at Gilmer County Schools for one calendar year. At the end of that calendar year, I can only regain eligibility by agreeing to submit to the random testing procedure. If tested positive for drugs in the screening process, I understand I will face action set forth by the drug testing policy as outlined in Level 1 of the Gilmer Board of Education Procedure. By signing and dating this form, I consent to take a urinalysis if randomly selected. Random tests will be conducted three times during the school year on unannounced dates. I hereby consent to the administration of the drug test and to the conditions listed in this consent.

_______________________ Student Signature ______________________Parent Signature _______________________ Date

______________________Date