2023-2024 RSS Transfer Form

Student Name*

First NameLast Name

Parent/Guardian Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Current Grade*

Does your student have a 504 Plan?*

YesNo

Does your student have an Individual Education Plan (IEP)?*

YesNo

Physical Address*

Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Mailing Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

School Requested*

Current School*

School Zoned for My Address*

To identify your "Zoned" school, please use the following link. "Find My School"

Have you discussed the transfer with the current school administration?*

YesNo

Please select date of discussion*

If the transfer request is for issues within the school, your request will not be processed until the school administrator(s) have been notified and all parties have attempted to reconcile the issue(s).

If approved, I understand that I will be responsible for transportation to and from the new school (if applicable).*

YesNo

1. 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 the Enrollment Specialist. (Tuition is waived)

2. Childcare: The student’s before or after school childcare providers are in closer proximity to the receiving school. Childcare issues that result in an approved reassignment for an elementary student should be resolved prior to enrollment at the middle or high school level. Applications will not be processed, without completed and attached Childcare Verification

3. Medical: Must include medical request packet.

4. Academic: Indicate course(s) with reason.

5. Special Services: In the case of students with disabilities, when the school in which the student is domiciled is not easily accessible or to access specialized services and programming.

6. Anticipated Relocation/Move: Lease agreement or building contract is required.

7. Work Proximity: Parent/guardian’s place of employment is in closer proximity to the receiving school. Verification required.

REQUIREMENTS AFTER TRANSFER APPROVAL: A student with an approved transfer must adhere to the following stipulations:

A. Provide transportation to and from school

B. Comply with the district’s attendance policy

C. Maintain acceptable behavior

D. Maintain the academic average for promotion to the next grade level

E. Maintain acceptable attendance

F. Continued enrollment in requested courses or academy, if applicable. If a student fails to enroll and continue in a requested course, the principal will recommend revocation of the transfer.

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.

APPEAL PROCESS FOR DENIALS: Any parent may appeal a transfer denial decision by completing an appeal request and returning to the reassignment coordinator. The appeal request must be mailed or emailed to the following addresses within five (5) working days of receipt of the transfer denial letter: Rowan-Salisbury Schools, Traci Bost (Traci.Bost@rss.k12.nc.us) or P.O. Box 2349, Salisbury, NC 28145.

Reasons:*

Student/Family Hardship (complete next section)Curriculum/Academic Needs (complete next section)Childcare (upload completed Child Verification Form )Anticipated Relocation (upload contract, lease agreement, etc.)Medical Needs (upload completed Medical Needs Form)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)

Medical Needs Form (Please download, complete, and upload below)

Explanation of Reason*

I understand high school student athletes who are approved for discretionary reassignment 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. Please refer to the NC High School Athletic Association for details about this statewide athletic rule.*

YesNo

Your transfer is outside the 2023-2024 transfer window (February 18, 2022). Please provide rationale for why your transfer should be considered after the deadline. *

Upload Any Requested Documentation (See above)

My signature verifies that I have read and accepted the above policy guidelines governing this request. I certify that all information provided is true. Falsification of information will result in an immediate denial or revocation of the student's discretionary reassignment release. I understand that RSS Board Policy 4150 is available on the district website, at all Rowan-Salisbury Schools and the Central Office. I have also read and understand the restriction when approved for reassignment - including high school student forfeiture of one year (365-days) of all athletic eligibility.*

Clear

WAIT LIST - Rowan-Salisbury Schools In-County Request for Student Transfer 2023-2024

General Information

In-County Transfer Requested

ACCEPTABLE REASONS FOR REASSIGNMENT:

Reason for Request (Please check all that apply)

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