Application For Student Transfer - Gwinnett County Public Schools printable pdf download

GWINNETT COUNTY PUBLIC SCHOOLS

Stock #90963

Revised 03/09

APPLICATION FOR STUDENT TRANSFER

Top portion of application should be completed by parent and submitted to school where student is presently attending

Student Information

Student Name (Last, First, Middle -Nickname)

Student ID number

Date

Date of Birth

Grade / Age

Parent daytime phone number

Address

City

Zip Code

 Yes

 No

Apartment Complex:

Is this a temporary residency?

Apt #:

School presently attending:

School transfer requested to:

Give justification for your transfer request (attach a separate page if needed)

This form is not to be used for Public School Choice (AYP/NCLB) transfers. By signing this form, I understand that by accepting one of the

transfer types listed below that my student is NOT eligible for public school choice transfer under NCLB.

Under Board Procedure (JBCD) Student Transfers to another school will only be considered for approval under those

conditions listed on the reverse side

I have read and understand the conditions and provisions on the reverse side of this form.

I understand this transfer request must be submitted yearly. I further understand that this transfer may be revoked by the receiving school

Principal at any time if the student does not stay in good standing in regards to academics, attendance, timely arrival to school, and/or

discipline, or if the parent has provided false information on this application.

Signature of Parent _______________________________________________________________________ Date: ___________________________

PARENT : PLEASE DO NOT WRITE BELOW THIS LINE

SCHOOL USE ONLY - FOR DATA INPUT AND RECORDS - COMPLETED BY CURRENT SCHOOL

Is the student in good standing in the following categories:

(If student is not in good standing in any of the areas, please attach reports to indicate areas of concern)

YES

NO

Attendance:

YES

NO

Discipline:

YES

NO

Academics:

TRANSFER TYPE: Students Residing In-County

Child Care Hardship (1)

Employee-GCPS Addr (6)

SPED-GCPS Addr (A)

Medical/Legal (3)

New Street (8)

Jr.-Sr. Option (C)

Permissive (4)

Redistricting (9)

In-County Move/Other (D)

Students Residing Out-of-County

Employee-Non GCPS Addr (7)

SPED-Non GCPS Addr (B)

Out-of-County Move/Other (E)

Signature of Current Principal:________________________________________________________ Date: _________________________________

COMPLETED BY APPROVING SCHOOL OFFICIAL

 Transfer Approved

Transfer Not Approved

School Number (Current School)

School Number (Receiving School)

Transfer Effective for School Year

Comment:

Signature/Date of Approving Official

Application For Student Transfer - Gwinnett County Public Schools

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