APPEAL FOR ATHLETIC PARTICIPATION

FOR TRANSFERRED/REASSIGNED STUDENTS

DIRECTIONS: (TO BE COMPLETED BY PARENT/GUARDIAN)

Student’s Name: ________________________________________________________________________________________

Last First Middle

Students ID#: _________________________________Grade_____________School Year___________________________

Legal Address of Parent/Guardian:

_________________________________________________________________________________________________________

home no. street apt. city state zip

Residence Business

Telephone: ( ) Telephone: ( )

Base High School: _______________________________________________________________________________

Reassigned High School: _______________________________________________________________________________

LIST SPECIFIC REASONS FOR REQUESTING APPEAL (ATTACH A COPY OF THE STUDENT ASSIGNMENT TRANSFER APPROVAL LETTER AND ANY OTHER DOCUMENTATION)

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

I DO HEREBY DECLARE THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE ABOVE NAMED STUDENT.

SIGNATURE OF PARENT/GUARDIAN_________________________________________________DATE_________________

(1) Take or send the completed information to the Base High School Principal.

(2) The Base High School Principal will send the information to the Reassigned High School Principal.

(3) The Reassigned High School Principal will send the information to Bobby Guthrie, Senior Administrator for Athletics.

The Senior Administrator for Athletics will make every reasonable effort to forward a decision, in writing, to the parent or legal guardian within 5 working days of receipt of the completed form and documentation.

The student shall be ineligible to participate in the athletic program pending approval of the appeal. The decision of the Senior Administrator for Athletics shall be final except where a parent/guardian demonstrates a right to appeal to the Board of Education under G.S. 115C-45(c).

The Senior Administrator for Athletics may revoke a decision to permit a student to participate in athletics if at any time it is determined that the student has transferred for athletic purposes.

APPLICANTS ARE NOT TO WRITE BELOW THIS LINE

Base High School Principal – To your knowledge, has athletics played any part in this request to transfer? Yes No

If yes, please explain. _______________________________________________________________________________________

Reassigned High School Principal – To your knowledge, has athletics played any part in this request to transfer?

Yes No If yes, please explain. _________________________________________________________________________

Athletic Participation Approved by Senior Administrator for Athletics _____

Athletic Participation Denied by Senior Administrator for Athletics _____

If denied, reason for denial: ______________________________________________________________________

Senior Administrator for Athletics_________________________________________________Date_______________________

Date Letter Sent to Parent/Guardian ____________________

Related Board Policy and R&P