Student Transfer Form - Buchanan County Public Schools

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Buchanan County Student Admission and Transfer Procedure
Pupils will be enrolled in a school by the principal or an authorized representative. A proper
legal basis, including the location of residence in Buchanan County and identification of parents
or person responsible for the pupil, must be made in accordance with the zoning plan determined
by the school board.
The following additional provisions for enrollment are approved by the school board:
a. A pupil who enrolls in the schools for the first time must have reached legal age as determined
by Virginia school law.
b. No transfer pupil will be accepted if this pupil has been expelled from the last school attended
unless approval is given by the school board after due consideration to all pertinent facts.
Students who have been suspended from their former schools will not be admitted until the time
for their suspension has lapsed.
c. Generally, postgraduate students will not be accepted in the regular day school. They will be
expected to apply for additional courses during the summer and evening school programs. In no
instance will postgraduate pupils be enrolled in the regular day school where all available space
is filled by undergraduate pupils. May not apply to Special Education students.
e. When transfer pupils are received in a school, within fourteen days the school last attended by
them will be requested to send a transcript of their school record. This request shall include a
request for documentation that a certified copy of the pupil's birth record was presented upon the
pupil's initial enrollment. If the birth certificate number has not been recorded on the transcript,
or other documentation is not received, the parents will be subject to the same procedure as those
enrolling in school for the first time listed in part g of this policy.
f. Subject completion or grade level achievement from schools accredited by a state department of
education, regional accrediting agency, or a Virginia Department of Education approved
correspondence school may be transferred into the Buchanan County School Division. Lacking
records of subject completion or grade level achievement, principals may consider the results of
a placement or other appropriate test(s) in placing a student in a grade level or in a subject.
g. The parents of all children entering school for the first time are required to present a certified
copy of the child's birth certificate to teachers, or the principal at a preschool clinic or during the
first two weeks of school. The birth number from the birth certificate will be recorded on the
pupil's permanent school record. h. If notified that a child from Buchanan County is missing,
the school principal will immediately note this on the child's cumulative folder. If a request is
made for the child's records, the principal will immediately notify the Sheriff's Department.
i. The parents of students transferring in from another school system must provide upon
registration, a sworn statement or affirmation indicating whether the student has been expelled
from school attendance at any private or public school for an offense in violation of school board
policies relating to destruction of school property or privately owned property while located on
school property, weapons, alcohol or drugs, or for the willful infliction of injury to another
person. This statement must be made regardless of whether or not the student has been admitted
to another school system subsequent to the expulsion. The registration document shall be
maintained as a part of the student's scholastic record. Any person making a false statement or
affirmation shall be guilty upon conviction of a Class 3 misdemeanor.
j. A student lacking a fixed, regular and nighttime residence is deemed to live in Buchanan County
when the student has a primary nighttime residence located within the school division that is: a
public or private shelter; an institution; or a public or private place that is not meant to be used
for regular sleeping. The Buchanan County Schools will enroll these students and will accept an
alternative address in any form it deems appropriate when provided with an affidavit indicating
that the individual wishing to enroll the child cannot provide a street address.
k. The permanent record folder of a pupil transferred to another school in Buchanan County will be
given to the receiving school principal. Proper note of this should be made and placed in the
transfer file.
Guidelines for Schools
Parent and Student must complete and sign required documents.
1. In-County transfers
a. Parent must fill out form.
b. Inform parent of VHSL transfer rules. Find out from Current School about Student’s
discipline records.
c. Collect records from current school.
d. Enroll Student if no issues from items listed above. (Send School, Student Name, and
Date of Entry to Mr. Street at Central Office)
e. If there is an issue with any of the items listed above, refer to Central Office.
2. Out-of-County Transfersa. Parent must fill out form.
b. Inform parent of VHSL transfer rules.
c. Make contact with Current School about Student’s discipline records.
d. Collect records from current school. (Including Soc. # if parent is willing, Birth
Certificate, Transcripts, etc.)
e. The School Nurse will check Vaccination, Medical Physical Exam, etc. requirements.
f. Enroll Student if no issues from items listed above. (Send School, Previous School,
Student Name, and Date of Entry to Mr. Street at Central Office)
g. If there is an issue with any of the items listed above, refer to Central Office.
3. Out-of-State Transfers
a. Parent must fill out form.
b. Parents must meet with Mrs. Susan Caudill and/or Mr. Street with the following
documents:
i. Copy of Virginia Physical
ii. Soc. Security card (if willing)
iii. Vaccination Record including TDAP if applicable
c. Inform parent of VHSL transfer rules.
d. Make contact with Current School about Student’s discipline records.
e. Collect records from current school. (Including Soc. # if parent is willing, Birth
Certificate, Transcripts, etc.)
f. Read and sign Crime and Violence Prevention Affidavit, and any other attached
affidavit that applies.
g. The School Nurse will check Vaccination, Medical Physical Exam, etc. requirements.
h. Enroll Student if no issues from items listed above. (Send School, Student Name,
and Date of Entry to Mr. Street at Central Office)
i. If there is an issue with any of the items listed above, refer to Central Office.
AFFIDAVIT FOR TRANSFERS
VIRGINIA CODE 22.1-3.2
VIRGINIA SCHOOL CRIME AND VIOLENCE PREVENTION ACT
Commonwealth of Virginia
Buchanan County, to-wit
__________________________, based upon his/her personal knowledge, answers the following
questions as noted in his/her handwriting on this page, which are propounded by duly authorized
officials of the Buchanan County Public School Division concerning a pupil's expulsion from
another public or private school.
1. What is your name? _____________________________________
2. Have you been advised by an official of the Buchanan County School Division, and do you
understand that you are required to answer the questions contained in this Affidavit as a
condition to your enrollment and admission of a pupil in the Buchanan County School
Division.
_______________________
3. Do you understand that if you should make a materially false statement or affirmation in this
Affidavit you could be found guilty of a Class 3 misdemeanor?
_________________________
4. What is the full name of the pupil you wish to enroll in this Division?
__________________________________________
5. To the best of your knowledge has this pupil been expelled from another public or private
school in the state of Virginia, or any other state or country?
_________________________
6. If the answer to the above question is yes, please specify the reason for the expulsion?
_____________________________________________________
_____________________________________________________
7. When did the expulsion occur? _________________________
8. What was the name and the address of the School?
______________________________________________________
______________________________________________________
___________________________
Signature
___________________________
Date
AFFIDAVIT FOR ALTERNATE ADDRESS
Commonwealth of Virginia
Buchanan County, to-wit
________________________________, based upon his/her personal knowledge, answers the
following questions as noted in his/her handwriting on this page, which are propounded by duly
authorized officials of the Buchanan County Public School Division concerning a parent’s
inability to provide a street address.
1.
What is your name? _______________________________________
2.
Have you been advised by an official of the Buchanan County School Division, and do
you understand that you are required to answer the questions contained in this Affidavit
due to your inability to provide a street address?
_____________________________________
3.
What is the full name of the pupil for which no street address is available?
____________________________________
4.
What is the alternate address you wish to provide?
________________________________________
________________________________________
________________________________________
_____________________________
Signature
______________________
Date
Student Transfer Form
*I. Student Information
*1. Student's Name:
(First)
(Middle)
(Last)
(Month)
(Day)
(Year)
*2. Date of Birth :
*3. Student's Gender:
Male
Female
*4. Student's Home Address:
P.O. Box or 911 Address
City
State
Zip Code
* II. Parent Information
*5. Parent/Guardian 1:
(First)
*6. Home Phone Number:
(Middle)
(Last)
Cell Number:
*7. Parent/Guardian 2:
(First)
*8. Home Phone Number:
(Middle)
(Last)
Cell Number:
*III. Transfer Request
*9. Grade Level:
School to be transferred to:
*10. Is your child currently enrolled in Buchanan county Public Schools:
No
Yes
*IV. : Reason(s) for Transfer Request.
*13. Does your student receive any special programming or services as part of his/her program?
No
Yes
If so what?
Special Ed
504 Plan
Physical disabilities, please describe:
Primary Language- ______________________________________________________________
Other Languages Spoken- _________________________________________________________
14. If high school, year student entered 9th grade:
I understand if enrollment is approved: 1) transportation is the responsibility of the parent/guardian and 2) approval of
enrollment does NOT mean Virginia High School League (VHSL) eligibility is granted. A student may not be eligible to
participate in VHSL sponsored activities per VHSL Transfer Rule 28-6-1. Eligibility is determined at the school the student
will attend. I certify that all the information on this application is correct to the best of my knowledge.
Parent/Guardian Signature:
Date:
Info from Current School Attending
School Name:
Phone:
Fax No.:
Address:
*15. Attendance Issues:
No
Yes
If yes Explain
*16. Number of Days Absent to Date:
*17. Number of Days Absent Last School Year:
18. Number of Credits:
*19. Discipline Issues:
Comments:
Signature:
Date:
Person contacting school
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