Fillable Printable Renewal Student Transfer Application - Fairfax

Renewal Student Transfer Application - Fairfax

INSTRUCTIONS: The parent or guardian is to complete Part I and submit the application to the current school principal no later than April 1.

Read carefully the information provided in the Student Transfer Application Instructions and the Frequently Asked Questions before completing

the application. Reference: Regulation 2230, Exceptions for Attendance at Other Than Base School and Procedure for Applying for

Intracounty Exceptions

RENEWAL STUDENT TRANSFER APPLICATION

APPLICATION MUST BE RECEIVED BETWEEN FEBRUARY 15 AND APRIL 1

Reason for Request: (choose one)

High School Curricular Program:

The student must enroll and remain enrolled for one year in a sequential curricular program from the FCPS Standard Course Offerings. The

course of study must not be offered at the base high school. Requests are not permitted for individual courses or extracurricular activities. A

signed Letter of Understanding must accompany the application.

PART I. STUDENT TRANSFER REQUEST (please print)Date

StudentDOBSex

ID Number

Base SchoolRequested School

Home Phone

Street

StateZIP Code

Student applicants must be enrolled in FCPS.

Student transfers are granted on a space available basis.

Parent or Guardian SignatureDate

I understand if the transfer is approved: 1) transportation is not provided by Fairfax County Public Schools; 2) transfers are valid for one year

only; 3) transfers may be revoked if the reason for the transfer no longer exists, if the student does not attend school regularly, if the student

does not make academic progress, or if the student violates the code of conduct; 4) the student may not be eligible to participate for one year in

secondary school interscholastic athletics.

I certify that all the information on this application is correct to the best of my knowledge. In addition, I certify that the student involved in the

request is not seeking a transfer to participate in extracurricular activities including, but not limited to, athletics.

PART II. SCHOOL REVIEW AND RECOMMENDATION (office use only)

Principal Signature

PART III. PARENT NOTIFICATIONSENT BY REQUESTED SCHOOL (office use only)

Reason

SS/SE-223 (1/13)

Date

LastFirstMI

City

Parent or Guardian

Address

Work Phone

Requested School

Notification sent:

Date

Requested School YearGrade

Male Female

Academy Sequence Foreign Language Sequence

Advanced Placement Program International Baccalaureate Program

NoYes

Denied Code

ApproveDeny

Approved

Child Care Hardship (elementary)

Attach affidavit for Student Transfer Child Care Requests.

EmployeeLocation

Medical, Emotional, or Social Adjustment Attach independent, detailed professional documentation.

FCPS EmployeeProvide work location Senior Status (6th, 8th or 12thgrade)

Sibling Name of Sibling at Requested School Grade

A parent or guardian residing in Fairfax County may request a student transfer renewal for his or her school-aged

child (K-12) for the following school year during renewal season. The student must be attending the requested

school in order to request a renewal.

D. Senior Status - Students who are currently attending the requested school and wish to complete

elementary, middle, or high school at the same location may request senior status for 6

, 8

, or 12

grade. Students must reside within FCPS attendance boundaries to continue attending an FCPS

school.

Additional information, including schools projected to be at enrollment capacity, is available online at

http://www.fcps.edu/fts/dashboard/index.shtml

A student transfer may be revoked if the reason for the transfer no longer exists, the student violates the student

code of conduct, the student does not attend school regularly, or the student does not make academic progress.

The student will be reassigned to the base school if the transfer is revoked.

Please note: FCPS considers all student transfer applications on a space available basis. Applications are

considered annually. Transportation is not provided by FCPS for students attending schools on approved student

transfers.

F. Curricular Program (high school only) - Advanced Placement, International Baccalaureate, foreign

language or academy course sequence. The student must renew for the program or sequence in which

the parent or guardian and student signed a Letter of Understanding. The student must enroll, and

remain enrolled for one year, in the continued sequential curricular program. The course of study

must not be offered at the base high school.

E. Sibling - Parents or guardians may request a student transfer to avoid having children who live in the

same household attend multiple elementary, middle, or high schools. Name(s) and grade level(s) of

sibling(s) must be provided.

C. FCPS Employees (20 or more hours per week) - Parent or guardian must indicate the work

location on the application. Requests must be for employee's children only. Requests can be made for

the school where the parent or guardian is employed or the school nearest the work location

B. Medical, Emotional, or Social Adjustment - Detailed documentation, such as a medical or

psychological treatment plan from a licensed independent professional, is required.

A. Child Care Hardship (elementary only) - Parents or guardians must document child care hardship

using the Affidavit for Student Transfer Child Care Requests (available at

child care within the base school boundaries and any extenuating circumstances. The child care

provider must be located within the requested school boundaries. Full-time, before and/or after

school child care is needed for student transfer consideration. FCPS boundary information is

available at

Student Transfer Renewal requests require documentation and are approved for the following reasons:

Parents or guardians must complete Part I of the Student Transfer Renewal Application between February 15

and April 1 for the following school year. The parent or guardian must submit the application and appropriate

documentation to the requested school principal for review and recommendation. The principal of the requested

school will notify the parent or guardian of the transfer decision in writing.

Renewal Student Transfer Application

Instructions

SS/SE-223 (1/13)2

http://www.fcps.edu/it/forms/se252.pdf). Documentation should include attempts made to secure

http://boundary.fcps.edu/boundary/.