CARROLL COUNTY PUBLIC SCHOOLS 605-9 PINE STREET HILLSVILLE, VIRGINIA Telephone: (276) 728-3191 (276) 730-3200 (276) 236-8145

Fax: (276) 730-3210

APPLICATION FOR ADMISSION AS AN ATTENDANCE ZONE TRANSFER For School Year Student’s Name LAST

FIRST

Date of Birth

MIDDLE Age

MONTH

DAY

Male

Female

YEAR

Name of Parent(s) or Legal Guardian(s) Current Legal Address (911) Mailing Address Home Telephone

Work Telephone

Cell Phone

Attendance Zone In Which You Reside Name, Address, and Telephone Number of School Last Attended By Student:

Sibling(s) Currently Enrolled in Carroll County Public Schools (List Sibling(s) Name(s), School(s) and Grade(s) Currently Attending):

Reason for Leaving Previous School:

If the Student Has Been Enrolled in Any Special Education Programs in the School(s) Last Attended, Please specify:

Carroll County School Requesting to Attend:

Grade:

Why Are You Applying for Transfer?

I certify that the information in this application is true and accurate to the best of my knowledge and that I have been provided, read, understood, and signed the Student School Assignment Guidelines.

Date

Signature of Parent/Guardian

I affirm that the above name student has not been suspended or expelled from school attendance at a private or public school nor has been assigned to any correctional facility or placed on probation by the court system.

Date

Signature of Parent/Guardian

OFFICE USE ONLY Approved Superintendent/Designee Not Approved Date

Comment (OVER)

REVISED 03/13/18

CARROLL COUNTY PUBLIC SCHOOLS STUDENT SCHOOL ASSIGNMENTS SCHOOL BOARD POLICY: JCC ATTENDANCE ZONE STUDENT TRANSFERS GENERAL Each student who resides in Carroll County will be assigned to a school based upon the attendance area of the student's residence. Students should attend the schools to which they are assigned. Changes in the attendance areas are determined by the School Board, upon recommendation of the superintendent based on the need to provide for the orderly administration of the schools, the instructional needs of the students, and the health, safety, best interests, and general welfare of all students. ATTENDANCE ZONE TRANSFER STUDENT REQUESTS Consideration of an attendance zone transfer request to transfer a student between schools in Carroll County is contingent upon the following: 1.

Completion of an APPLICATION FOR ADMISSION AS AN ATTENDANCE ZONE TRANSFER. Applications must be returned to the Office of the Division Superintendent by MAY 1ST for the upcoming school year and priority will be given to request in the order of which they are received. Permission for students to attend schools out of their regular attendance zone is only granted by the division superintendent. No student can be enrolled in a school not in his/her attendance zone unless the parent/guardian has applied for and been granted permission by the division superintendent.

2.

Availability of space in the grade level and/or program which is indicated by current placement. Acceptance and/or continued enrollment of an attendance zone transfer student will not require the initiation of a new program, the employment of additional personnel, the alteration of existing facilities, or the payment of special services beyond those provided in the Carroll County Public Schools. The approval of an attendance zone transfer student request will be subject to maintaining available space in a grade level/program for students who may move into the attendance area.

3.

Continued enrollment of an attendance zone transfer student is subject to annual review. All attendance zone transfer student applications will be subject to renewal on an annual basis. Applications must be received in the Office of the Superintendent within the designated timeline otherwise the application will be processed as a new request. Continued placement in a school outside of the attendance area of the student's place of residence will be contingent upon available space, programs, discipline, and school attendance including tardies and early dismissals. Students are subject to all policies, regulations, and guidelines of the school division and the Carroll County Public Schools Student Handbook. Notification of approval will be on an annual basis.

4.

The superintendent may grant transfers to students whose parents are CCPSD employees and who request student admission and transfer consideration for their children if space is available in the receiving school.

5.

The superintendent may grant transfers based upon documented hardships including but not limited to military deployment of one or more parent/guardian, a change in custody of the student, a temporary custody transfer or a family emergency. The application deadlines may be waived based upon the documented undue hardship.

6.

The superintendent will approve or deny attendance zone transfer student applications based upon a review of the application, recommendation by school principal or others as necessary, and the availability of space and/or programs.

7.

Approval of attendance zone transfer student status may be revoked. Attendance zone transfer students would be expected to return to the attendance area in which they reside when their enrollment creates any of the conditions described above in numbers two and three. Transfer to another school in Carroll County is subject to the same approval process.

8.

Transportation of attendance zone transfer students is the responsibility of the parent or guardian. Attendance zone transfer students may board a bus at a bus stop that serves the school they have been approved to attend.

9.

Any transfer request that is received and/or approved based upon false or misleading information will be declared void and the transfer will be rescinded.

10. The superintendent reserves the right to remove the privilege of an attendance zone transfer student. 11. Failure to meet any of the above criteria will result in an immediate return of the student to the school located in the student’s attendance zone.

_____________________ DATE

___________________________________ Signature Parent or Guardian ADOPTED:

03/13/2018