Form 200 - Transfer Rule - 2011 printable pdf download

THIS FORM MUST BE FULLY EXECUTED PRIOR TO PARTICIPATION -

In the case of a student who transfers into your

school after the start of that practice season, this form can NOT render approval. You must request a waiver & include Form 200.

TRANSFER RULE ~ FORM 200

A. The Receiving School Principal completes this section and then forwards to the Sending School Principal.

Receiving Principal__________________________School_____________________Phone _____________________________

School Fax: ____________________________________________________________________________________________

Student’s Name_______________________________ Grade________ Date of enrollment ______________________________

Student’s Address_________________________________________________ Date of Birth ____________________________

The student wishes to participate in the following sports:

Fall: ________________________ Winter:

Spring:

Student’s reason for transfer: _______________________________________________________________________________

B. The sending School Principal & Athletic Director complete this section & returns to Receiving School Principal.

Sending Principal_________________________School_______________________Phone _______________________

List ALL athletic participation since first entering grade 9 (include level of play,

e.g.: F, JV, V, AAU, etc.

& school)

Grade 9 yr:

Grade 10 yr:

Grade 11 yr:

Grade 12 yr:

Fall:

School

Winter:

School

Spring:

School

The Sending School Principal and Athletic Director certify the following by initialing each (complete section 3a-e

check off

box next to section 4):

To our knowledge recruitment, was not involved in any way: ________________________________________

b. At the time of transfer, the student was in good standing: ____________________________________________

The student would be academically eligible at our school ___________________________________________

d. We have no knowledge that the transfer was related to athletics which would cause our objection to eligibility: _

The transfer student would be eligible at our school to participate in athletics: ___________________________

Comments: _______________________________________________________________________________

____________________________________________________________________________________________

(Please

DO NOT

check this box if you completed #3 above). We support the MIAA Transfer Rule 57.1: A student who

transfers from any school to an MIAA member high school is ineligible to participate in any interscholastic athletic contest at

any level for a period of one year in all sports in which that student participated at the varsity level or its equivalent during the

one year period immediately preceding the transfer.

5. Has this student had any Chemical Health Violations since the beginning of the Fall Practice Season?

No___ Yes____ If yes, please list if penalty: has been served

needs to be served (circle one)

6. Sending School A.D.’s signature:________________________________________ Date ________________________

7. Sending School Principal’s signature:_____________________________________ Date ________________________

C. APPROVED (may only be approved when B,3 a through e – ALL have been initialed)

1. The Receiving School Principal certifies (ref. B,3, a-f) Transfer Rule eligibility on: ______/_____/_____

2. The student also is eligible under all other MIAA and local eligibility standards: ________yes _________no

3. Receiving School Principal’s signature:_____________________________________ Date: _______________________

4. Receiving School A.D.’s signature:________________________________________ Date _______________________

D. DENIED (must be denied if B,3 a through e – one or more NOT initialed – OR if box next to number 4 is checked)

1. The Receiving School Principal does not certify (ref. B,3, a-e) Transfer Rule eligibility: _____/_____/_____

2. Receiving School Principal’s signature:_____________________________________ Date: ______________________

3. Receiving School A.D.’s signature:________________________________________ Date _______________________

DO NOT RETURN THIS FORM TO THE MIAA(unless applying for a waiver) PLEASE RETAIN AT THE RECEIVING SCHOOL.

Revised 6/20/11

Form 200 - Transfer Rule - 2011

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