<p> Form JBCD-4</p><p>REQUEST TO CONTINUE ENROLLMENT (Cobb County School District Residents Only)</p><p>School: School Year: Should the parent/guardian of a student enrolled in the District move from one attendance zone to another within the District, the parent/guardian may apply for their student to remain enrolled in his/her current school. Pursuant to Administrative Rule JBCD-R (Transfers) the following student has applied to remain enrolled in his/her current school. For students approved to remain enrolled the following provisions apply:  The parent/guardian must promptly report to the principal or designee any change in circumstances by which the student is no longer a resident of the District;  Transportation for students approved to continue enrollment must be provided by the parent/guardian;  Acceptable attendance, behavior and grades are required in order for the student to be approved and remain on transfer;  The parent/guardian is expected to maintain a cordial and cooperative working relationship with school personnel;  Failure to comply with any provisions of this paragraph shall authorize the principal to immediately withdraw such student; and  If the student transfers at the high school level, he/she must meet Georgia High School Association requirements to participate in competitive interscholastic activities.</p><p>This application must be fully completed. PLEASE PRINT OR TYPE One form per student</p><p>Student Name: Student ID #: (can be found on report card & progress reports) Date of Birth: Grade: Age: Gender: </p><p>Parent/Guardian Name:</p><p>Old Cobb County Address:</p><p>Apartment Complex Name: Apartment Number:</p><p>City: Zip:</p><p>New Cobb County Address:</p><p>Apartment Complex Name: Apartment Number:</p><p>City: Zip: E-mail:</p><p>Phone: Home: Cell:</p><p>Date of Move: [documentation required (e.g. proof of residency)]</p><p>Parent/Guardian Signature: Date: </p><p>PLEASE DO NOT WRITE BELOW THIS LINE SCHOOL USE ONLY ************************************************************************************************************ Approved This transfer is approved for the current school year only and may not be renewed</p><p>7/1/16: Student Support *JBCD-4* Page 1 of 2 Denied Principal Signature: Date: </p><p>Original: To be filed in student record Copy: To be sent to Student Support</p><p>7/1/16: Student Support *JBCD-4* Page 2 of 2</p>