Release/Acceptance “Out of County” Application for School Year 2022-2022 Solicitud de liberación/aceptación "fuera del condado" para el año escolar 2022-2022

Student Name (Nombre del estudiante) *

First Name (Nombre) Last Name (Apellido)

Parent/Guardian Name (Nombre del padre/tutor) *

First Name (Nombre) Last Name (Apellido)

Phone Number (Número de teléfono)

Please enter a valid phone number.

Grade for 2022-2023 (Grado actual 2022-23) *

Email (Correo electrónico) *

example@example.com

Does your child have a 504 Education Plan? (¿Su hijo tiene un plan educativo 504?) *

Yes (Si) No

Does your child have an Individualized Education Plan (IEP)? (¿Su hijo tiene un Plan de Aprendizaje Individualizado (IEP)?) *

Yes (Si) No

Does your child receive EL (English Learner) Services? (¿Su hijo recibe servicios de inglés como segundo idioma (EL)?) *

Yes (Si) No

Does your child receive AIG Services? (¿Su hijo recibe servicios de clases avanzadas (AIG)?) *

Yes (Si) No

I am requesting to be released from the following school and county: *

I am requesting to be accepted to the following school and county: *

Physical Address (Dirección física) *

Address (Dirección)

Street Address Line 2 (Dirección de la calle Línea 2)

City (ciudad) State / Province (Estado / Provincia)

Postal / Zip Code (Código Postal / Postal)

Mailing Address (if different than above) (Dirección postal (si es diferente a la anterior)

Street Address (Dirección)

Street Address Line 2 (Dirección de la calle Línea 2)

City (Ciudad) State / Province (Estado / Provincia)

Postal / Zip Code(Código Postal / Postal)

If approved, I understand that I will be responsible for transportation to and from the new school (if applicable). (Si se aprueba, entiendo que seré responsable del transporte hacia y desde la nueva escuela.) *

Yes (Si) No

Student Athletes - After initial entry to high school, student athletes who are approved for Discretionary Assignment/Release forfeit for one year all athletic eligibility in any sport. Eligibility is restored 365 days from the date of the Board of Education’s approval. Do you understand the athletic eligibility stipulation? Please refer to the North Carolina High School Athletic Association for details about this statewide athletic rule. *

Yes (Si) No

A) Release from a Rowan County School for Admission to Another Rowan County School:
Current RSSS Employee: Parent/guardian is a current permanent employee with Rowan County Schools. Discretionary Admission is only acceptable within district in which the parent/guardian works. Employment will be verified by Student Assignment office. (Tuition is waived)

Childcare Proximity: The student’s before or after school child care providers are in closer proximity to the receiving school. Verification of child care provider is required with application and will be verified. Child care issues that result in an approved
reassignment for an elementary student should be resolved prior to enrollment at the middle or high school level.

Anticipated Relocation/Move: Lease agreement or building contract is required.
Work Proximity: Parent/guardian’s place of employment is in closer proximity to the receiving school. Verification may be required.

B) Release from Rowan County Schools to Another County:
Childcare Proximity (see above)
Completion of School Year (see above)
Employed by Another School System: Parent/guardian is currently employed by another school system.
Work Proximity (see above)
Other (see above)

C) Admission into Rowan County Schools from Another County (TUITION IS REQUIRED UNLESS OTHERWISE NOTED).
Childcare Proximity (see above)
Work Proximity (see above)

Anticipated Relocation/Move (see above)
Other (see above)

A PRINCIPAL CAN RECOMMEND TO THE ENROLLMENT SPECIALIST THAT A TRANSFER BE REVOKED IF ANY OF THE STIPULATIONS ARE NOT MET, THE TRANSFER WAS REQUESTED FOR ATHLETIC OR SOCIAL REASONS, OR THE TRANSFER WAS GRANTED UPON FALSE OR MISLEADING INFORMATION.

Please direct questions to Traci Bost at Traci.Bost@rss.k12.nc.us.

Reasons: *

Child of other school district employee. Childcare (upload completed Child Verification Form ) Anticipated Relocation (upload contract, lease agreement, etc.) Child of RSS Employee (identify school/site in next section) Work Proximity (identify employer in next section) Other (complete next section)

Childcare Verification Form(Please download, complete, and upload below)

Formulario de verificación de cuidado infantil

Explanation of Reason:(Explicación de la razón) *

Upload Any Requested Documentation (See above) (Cargar cualquier documentación solicitada (ver arriba)

I have read and accepted the policy guidelines governing this discretionary admission/release application. I understand that Policy 4150 is available on the district website, at all Rowan-Salisbury Schools, and at the Central Office. I understand that half or total tuition is due no less than a week before the upcoming semester and that this is a contract with Rowan-Salisbury Schools because my primary residence is not in Rowan County. *

Clear

Release/Acceptance “Out of County” Application for School Year 2022-2023

General Information (Información general)

ACCEPTABLE REASONS FOR REASSIGNMENT: (RAZONES ACEPTABLES PARA LA REASIGNACIÓN:)

Reason for Request (Please check all that apply) (Motivo de la solicitud (por favor, marque todos los que correspondan)

Disclosure: The Rowan-Salisbury School System Board of Education is authorized to approve or deny requests for student release or acceptance applications.