Form 14-15pct - Principals' Concurrence Regarding Transfer Form
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12014-15 Principals’ Concurrence Regarding Transfer
USE THIS FORM TO OBTAIN PRINCIPALS’ CONCURRENCE WITH A STUDENT TRANSFER
When a student transfers to a member school from any other high school, the Receiving School principal/official representative must
promptly complete and exchange this form with the principal/official representative of the sending school. Note: A student is not
eligible to participate in an interscholastic contest until the Principals’ Concurrence Regarding Transfer Form is fully
executed by both principals and is on file in the offices of the school to which the student transfers.
REMINDER:
CONCURRENCE WITH THE TRANSFER BY BOTH PRINCIPALS/OFFICIAL REPRESENTATIVES IS REQUIRED BUT DOES NOT
GUARANTEE OR ASSURE ELIGIBILITY. In accordance with the IHSA Constitution, only the IHSA’s Executive Director may
issue an official ruling. If there is any question regarding the student’s eligibility, the receiving school should request a ruling
from the Executive Director.
(Please Note: "Receiving School" refers to the school into which the student transfers; "Sending School" refers to the school from
which the transfer is made.)
Section 1 -- To be completed by Receiving School and sent to the Sending School for concurrence.
1.
Student's Name: ______________________________________________________________________________________
2.
Receiving School (Indicate Town and School): ______________________________________________________________
3.
Sending School (Indicate Town and School): ________________________________________________________________
4.
Date of Transfer (when student actually began attending class in your school): _____________________________________
5.
Date School Year Began at Your (Receiving) School: _________________________________________________________
6.
Student's Birth Date: /____/____/____/
Student's School Grade: ___9
___10
___11
___12
7.
____ Yes
____ No
Does the student reside full-time with parents, custodial parent or court appointed legal
guardian? List address here:
_______________________________________________________________________
8.
____ Yes
____ No
Has there been a change in guardianship or custody in conjunction with this transfer?
9.
____ Yes
____ No
Do you know of any basis for objecting to the student's eligibility? If yes, explain:
_______________________________________________________________________
_______________________________________________________________________
10.
____ Yes
____ No
Do you concur with this transfer? If No, please explain:
_______________________________________________________________________
11.
________________________________________________
________________________
Signature of Receiving School Principal/Official Representative
Date
Section 2 -- To be completed by Sending School and returned to Receiving School
12.
____ Yes
____ No
To your knowledge, is the information provided in Section 1 true and correct?
13.
____________________
Date School Year Began at Your (Sending) School.
14.
____ Yes
____ No
Was this student ineligible for or suspended from school or athletics at the time of the
transfer OR would the student have been ineligible or suspended from school or athletics
if he/she remained at your school?
If yes, explain and indicate the penalty for the
student’s violation: (By-law 3.047) ____________________________
_______________________________________________________________________
14.1
What penalty was imposed or would have been imposed? ______________________________________________
14.2
What is the date on which the period of ineligibility or suspension will be completed? _________________________
15.
____ Yes
____ No
Did this student participate in a try-out, practice or contest this school year prior to the
transfer? If so, what sport(s): _______________________________________________
16.
____ Yes
____ No
Do you have evidence of recruiting which influenced this transfer? If yes, explain and
attach available documentation: _____________________________________________
_______________________________________________________________________
17.
____ Yes
____ No
Do you have any reason to object to this student's eligibility? If yes, explain and attach
available documentation: __________________________________________________
_______________________________________________________________________
18.
____ Yes
____ No
Do you concur with this transfer? If No, please explain:
_______________________________________________________________________
19.
_______________________________________________
__________________
Signature of Sending School Principal/Official Representative
Date
THIS FORM MUST BE RETAINED ON FILE BY THE RECEIVING SCHOOL UNTIL THE STUDENT GRADUATES.
14-15PCT
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