Argyle Middle School
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- Óscar Ortiz de Zárate Ferreyra
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1 Argyle Middle School 191 U5 Hwy 377 5, Argyle, TX (Physical) 800 Eagle Drive, Argyle, TX (Mailing) P F Registration Packet Returning Student to Argyle ISO: Student Name: Grade for : Contents of Packet: Registration Form Health Information Student Residency Questionnaire Family Educational Rights & Privacy Acts (FERPA) Form Student "Code of Conduct" Acknowledgement (to view handbook online visit ) Occupational Survey Ethnicity/Race Questionnaire Field Trip and Bus Transportation Form (Required even if you do not plan to ride the bus) Foster Care/Military Connected Form Technology Responsible Use Policy Personal Assistance Form Registration Fee Schedule School Calendar
2 Argyle Middle School Registration Form for School Year Campus Name: Argyle Middle School Campus Phone: (940) Campus Fax: (940) STUDENT INFORMATION Hispanic Pacific Islander Local ID Student Name Grade Level Orig Entry Dt Track SSN White Black Gender Date of Birth Birth Place Age (Sept 1st, 2015) Address: Asian Student Home Phone: American Indian Mailing Address: Student Cell Phone: Student Will your child be using bus transportation to get to school? Yes No PARENT INFORMATION 1. Guardian: Relation: 2. Guardian: Relation: Address: Address: City, St, Zip: City, St, Zip: Employer: Employer: Cell Ph: Home Ph: Bus Ph: Cell Ph: Home Ph: Bus Ph: Other Ph: Phone Preference: Cell Home Business Other Other Ph: Phone Preference: Cell Home Business Other Receive Mailouts: Yes No Language Preference: English Spanish Receive Mailouts: Yes No Language Preference: English Spanish Emergency Contact: Yes No Emergency Contact: Yes No Svc Branch: Rank: Enrolling Person: Svc Branch: Rank: Enrolling Person: Right to Transport: Yes No Driver License #: State: Right to Transport: Yes No Driver License #: State: Vehicle Make: Model: Color: Vehicle Make: Model: Color: Vehicle Plate #: State: Vehicle Plate #: State: EMERGENCY CONTACT INFORMATION 1. Name: Relation: Cell Ph: Home Ph: Bus Ph: Other Ph: Phone Preference: Cell Home Business Other Right to Transport: Yes No Driver License #: State: Vehicle Make: Model: Color: Plate #: State: 2. Name: Relation: Cell Ph: Home Ph: Bus Ph: Other Ph: Phone Preference: Cell Home Business 0 Other Right to Transport: Yes No Driver License #: State: Vehicle Make: Model: Color: Plate #: State: Doctor: Bus Ph: Dentist: Bus Ph: Hospital: Bus Ph: Other Medical: Bus Ph: List any Allergies: SIBLING INFORMATION Brothers/Sisters Grade School Brothers/Sisters Grade School The above information is required for a permanent school record of your child and will be used by school personnel. Presenting false documents, records or information is a violation of state law and may subject you to tuition cost for your child. I certify that the information given above is correct. I authorize the school to contact the person named on this form and the above named physician to render such treatment as may be necessary in an emergency of said child. In the event parents, physician, or other persons named cannot be contacted, school officials are hereby authorized to take whatever action is necessary in their judgment for the health of the above child. I will not hold the school district financially responsible for emergency care and/or transportation. Parent or Guardian Signature Date of Birth Date (For Office Use Only) Teacher Name: Control Nbr: Eligibility Code: Birth Certificate on File: Mil Conn: Foster Care: Immunization on File: Title I: Soc Sec Copy on File: At Risk: Migrant: Hm Lng: Gift: LEP: BIL: ESL: Par Per: Econ: Special Education: Prim: Sec: Tert: Multi:
3 ARGYLE INDEPENDENT SCHOOL DISTRICT HEALTH INFORMATION Use full legal name as shown on birth certificate STUDENT NAME Last First Middle GRADE STUDENT ID # DATE of BIRTH AGE MALE or FEMALE Mailing Address Home Phone Parents/Guardians Students resides with Mother and Father Mom's Cell Dad's Cell Student's Cell Father's Employer Mother's Employer Phone Phone Mom Dad Family Doctor Family Dentist In the event that I cannot be reached, I hereby authorize Argyle ISD to take my child to the above named doctor or dentist or to Hospital and initiate treatment, if necessary. Parent/Guardian Signature: Siblings in Argyle ISD: Name: Name: Grade: Grade: HEALTH INFORMATION DOES CHILD HAVE ANY HEALTH Concerns? YES NO IF SO, EXPLAIN (some examples...asthma, diabetes, ADHD) Does Your Child Take Daily Medications: YES NO DRUGS/DOSAGE/HOW OFTEN DOES CHILD HAVE ANY ALLERGIES? YES NO EPI PEN NEEDED? YES NO FOOD DRUGS ANY OTHER INFORMATION YOU WANT TO GIVE US: I AGREE FOR THIS INFORMATION TO BE SHARED WITH OUR TEACHERS/COACHES ON A NEED TO KNOW BASIS: YES NO. Parent/Guardian Signature: EMERGENCY INFORMATION LIST AT LEAST THREE PEOPLE WHO ARE AUTHORIZED AND WILL PICK UP YOUR STUDENT IN CASE OF AN EMERGENCY IF WE ARE UNABLE TO CONTACT YOU. Name Address Phone Number
4 Argyle ISD Student Residency Questionnaire The information on this form is required to meet the law known as the McKinney-Vento Act 42 U.S.C a(2), which is also known as Title X, Part C, of the No Child Left Behind Act. The answers you give will help the school determine the services the student may be eligible to receive. Presenting a false record or falsifying records is an offense under Section 37.10, Penal code, and enrollment of the child under false documents subjects the person to liability for tuition or other costs. TEC Sec (3)(d). Name of Student: Last First Middle Gender: CI Male CI Female Birth Date: Grade: Social Security #: Month /Day / Year (or student identification number) Check the box that best describes with whom the student resides. (Please note: legal guardianship may be granted only by a court; students living on their own or with friends or relatives who do not have legal guardianship are allowed to enroll in and attend school. The school cannot require proof of guardianship for enrollment or continued attendance.) Parent(s) [Zi Legal Guardians(s) Caregiver(s) who are not legal guardian(s) (Examples: friends, relatives, parents of friends, etc.) Other Name of person with whom student resides: Address: City: ZIP: Home Phone #: Cell Phone #: Other Emergency #: Length of Time at Present Address: Length of Time at Previous Address: Name of the school where student is enrolled or in which student is attempting to enroll: Last District Attended: Last School Attended: Please check only one box that best describes where the student is presently living: c:3 In my own home or apartment, in Section 8 housing, or in military housing with parent(s), legal guardian(s), or caregiver(s) (if you checked this box, check one or both of the boxes below, if applicable:) (CODE=N) My home has no electricity (CODE=U) My home has no running water (CODE=U) In the home of a friend or relative because I lost my housing (examples: fire, flood, lost job, divorce, domestic violence, kicked out by parents, parent in military and was deployed, parent(s) in jail, etc.) (CODE=D) In a shelter because I do not have permanent housing (examples: living in a family shelter, domestic violence shelter, children/youth shelter, FEMA housing) (CODE=S)
5 i-li In transitional housing (housing that is available for a specific length of time only and is partly or completely paid for by a church, a nonprofit organization, or another organization) (CODE=S) In a hotel or motel (examples: because of economic hardship, eviction, cannot get deposits for permanent home, flood, fire, hurricane, etc.) (CODE=HM) In a tent, car, van, abandoned building, on the streets, at a campground, in the park, or other unsheltered location (CODE=U) None of the above describe my present living situation Briefly describe your situation: Factors contributing to the student's current living situation (check all that apply): Natural disaster I:1 Tornado, storm, flood, etc. Hurricane(name): Fire: prairie, forest, grass, lightning strike, etc. Family issues such as divorce, domestic violence, kicked out by parents, student left due to family conflict, etc. Home issues such as lack of electricity, water, heat, adequate home repair due to lack of funds, overcrowding, mold, etc. I:11 Military: Parent/guardian deployed, injured or killed in action Incarceration of parent/guardian I:I Incapacitation of parent or guardian due to health, mental health, drugs/alcohol, or other factors Home fire not due to natural causes (i.e., faulty equipment/appliances/wiring, furnace, stove, fireplace, etc.) Economic hardship: Loss of job resulting in inability to pay rent or mortgage Income from part-time or low paying job does not cover cost of housing in the area Loss of mortgage, including loss of mortgage of landlord if student/student's family is renting Eviction record and/or inability to produce deposits for rent or utilities I;1 High medical bills that leave little or no money for housing Lack of affordable housing in the area Minor student unable to afford housing on my own None of the above describe the main reasons for my present living situation - Briefly explain the contributing factors: Please provide the following information for school -age siblings (brothers and/or sisters) of the student: Name Grade Level School District Signature of Parent/Legal Guardian/Caregiver/Unaccompanied Student Date For School Use Only Signature of Campus Principal Date I certify the above named student qualifies for the Child Nutrition Program under the provisions of the McKinney-Vento Act. McKinney-Vento Liaison Signature Date
6 Argyle ISD Cuestionario Sobre la Residencia del Estudiante La informacion en este formulario se requiere para cumplir con los requisitos establecidos en la ley conocida como McKinney-Vento Act 42 U.S.C a(2), la cual tambien se conoce como Titulo X, Parte C, del Acta No Child Left Behind. Las respuestas que usted proporciona ayudarin a la escuela a determinar los servicios que el estudiante puede ser elegible a recibir. Presentar informacion falsa o falsificar documentos es una ofensa bajo la Seccion del Codigo Penal, y matriculacion del nilio con documentos falsos sujeta a la persona responsable a estar obligada a cubrir el pago de colegiatura o cualquier otro costo relacionado. TEC Sec (3) (d). Nombre del estudiante: Apellido Nombre Segundo Nombre Sexo: 0 Masc. CI Fern. Fecha de nacimiento: Mes Dia Ano Grado: Seguro Social #: (o namero de identificacion del estudiante) Marque la respuesta que describa mejor con quien vive el estudiante. (Favor de notar que un guardian legal solamente puede ser nombrado por la corte. Los estudiantes que viven solos o con amigos o parientes que no han sido nombrados guardianes legales estan permitidos matricularse y asistir a la escuela. La escuela no puede pedir prueba de guardiania legal para inscribirse o para asistencia regular a la escuela.) O Padre(s) de familia O Guardian(es) legal(es) O Proveedor de cuidado que no sea guardian(es) legal(es) (Ejemplo: amigos, parientes, padres de amigos, etc.) O Otro: Nombre de la persona con quien vive el estudiante: Direccion: Ciudad: C6digo Postal: Telefonos: Casa #: Celular #: Otro Emergencia #: Tiempo que vive en direcci6n actual: Tiempo que vive en direccion anterior a la actual: Nombre de Escuela donde estudiante esta matriculado o donde esta intentando matricularse: Ultimo Distrito Escolar que asistio: Ultima Escuela que Asistio: Favor de marcar Unicamente el cuadro que mejor describe donde vive el estudiante actualmente: O En mi casa propia o apartamento, habitacion bajo asistencia de Seccion 8, o en un complejo militar con mis padres, guardian(es) legal(es), o un proveedor de cuidado (si usted marco este cuadro, marque uno o ambos de los cuadros siguientes, si tal es el caso) (CODE - N) O Mi casa no tiene electricidad (CODE U) Mi casa no tiene agua corriente (CODE U)
7 O En la casa de un amigo o pariente, porque yo perdi mi vivienda (por ejemplo: incendio, inundation, perdida de trabajo, divorcio, violencia domestica, echado de la casa por los padres, padre es military ha sido enviado fuera del pais, padre(s) en la cartel, etc.) (CODE D) O En un albergue, porque no tengo vivienda permanente (por ejemplo: viviendo en un albergue familiar, albergue para victimas de violencia domestica, albergue infantil/juvenil, viviendas FEMA) (CODE S) O En una habitation de transition (vivienda que es disponible solamente por un period() de tiempo especifico y es pagada parcialmente o completamente por una iglesia, una organization sin fines de lucro, u otra organization) (CODE=S) O En un hotel o motel (por ejemplo: a causa de problemas econenicos, desalojo, no puede obtener depositos requeridos para instalarse en un apartamento o casa, inundation, incendio, huracan, etc.) (CODE HM) O En una tienda de camparia, auto, furgoneta, edificio abandonado, en la calle, en un parque de campamento, en un parque public, o en cualquier lugar que normalmente no se considera una habitaci6n (CODE U) O Ninguno de los anteriores describe mi tipo de vivienda actual Brevemente describa su situation: Factores que han contribuido al estado actual de vivienda del estudiante: O Desastre natural O Tornado O Huracan y el nombre del mismo: O Incendio: llanura, bosque, cesped, relampago, etc. O Asuntos familiares debido al divorcio, violencia domestica, el estudiante fue echado de la casa por sus padres o salio voluntariamente de la casa por conflictos familiares, etc. O Cuestiones del hogar, como falta de electricidad, agua, calefaccion, falta de reparaci6n de la casa por falta de dinero, atestado por muchas personas en la casa, moho, etc. O Asuntos militares: Padre(s) o guardian(es) mandados al servicio activo fuera de su region o del pais, heridos o matados en action militar O Encarcelacion de padre(s) o guardian(es) O Incapacidad de padres o guardianes por asuntos de salud fisica o mental, alcohol/drogas u otros factores O Incendio de casa por razones no naturales: equipo que falla, aparatos electricos, alambrado, horno, estufa, chimeneas, etc. CI Dificultades economicas: O Perdida de trabajo que resulta en no poder pagar la renta o hipoteca, etc. O Ingresos por trabajo de medio tiempo o baja remuneration que no cubren costos de vivienda en el area O Perdida de la hipoteca, incluyendo perdida de hipoteca del duerio de casa, si el estudiante o la familia del estudiante estan rentando la vivienda. O Registro de desalojo y/o incapacidad para pagar depositos para la renta o utilidades O Planillas medicas altas que dejan poco o nada de dinero para pagar la vivienda. O Falta de viviendas con precios razonables en el area O Estudiante menor de edad que no puede pagar su propia renta O Ninguno de estos describen las razones principales de mi situation de vivienda actual Describe brevenzente los factores que contribuyen a su situation:
8 Por favor proporcione la siguiente informacion de los hermanos y hermanas de edad escolar del estudiante: Nombre Nivel de Grado Escuela Distrito Escolar Firma del Padre/Guardian Legal/Proveedor de Cuidado/ o Estudiante si no acompaliado Fecha Para Uso Exclusivo de la Escuela Firma dcl Director dcl Campo Escolar Fecha Por la presente certifico que el estudiante mencionado en este formulario califica para el Programa de Nutricion del Nino bajo los requisitos del Acta McKinney-Vento. Firma del Coordinador del Acta Mckinney-Vento Fecha
9 Argyle Independent School District Family Educational Rights and Privacy Acts (FERPA) Form State and federal law require the District to notify parents that you may object to the release of certain information about your child. After reading the following, please mark through any directory information on the back of this form that you do not want released and return the signed and dated form with your registration packet. Notice to Parents: Directory Information "Certain information about District students is considered directory information and will be released to anyone who follows the procedures for requesting the information unless the parent or guardian objects to the release of the directory information about the student. If you do not want Argyle ISD to disclose directory information from your child's education records without your prior consent, you must notify the District in writing. Argyle ISD has designated the following information as directory information: Student's Name, Address, Telephone Listing, Photographs, Honors and Awards Received, Grade Level, Enrollment Status, Last School Attended, Participation in Officially Recognized Activities and Sports, Weight and Height of Athletic Teams". To be in compliance with the "No Child Left Behind Act of 2001", the District will release to military recruiters and institutions of higher education, upon request, the name, address, and telephone listing of your child, unless you direct the District NOT to release this information without prior written consent, as indicated below. I direct the District NOT release to any third party the following information without my prior written consent. I have marked through the items I DO NOT want released. 1. Name 6. Participation 2. Address 7. Weight and Height of Athletic Teams 3. Telephone Listing 8. Enrollment Status 4. Date and Place of Birth 9. Honors and Awards Received In School 5. Photographs 10. Last School Attended 11. Video Student Name (Printed): Grade: Parent Name (Printed): Date: Signature of Parent:
10 Argyle Independent School District Student Code of Conduct and Handbook Acknowledgment Dear Student and Parent: As required by state law, the board of trustees has officially adopted the Student Code of Conduct in order to promote a safe and orderly learning environment for every student. We urge you to read this publication thoroughly and to discuss it with your family. If you have any questions about the required conduct and consequences for misconduct, we encourage you to ask for an explanation from the student's teacher or campus administrator. The student and parent should each sign this page in the space provided below, and then return the page with your registration packet. Thank You, Dr. Telena Wright My child and I have accessed and read from the Argyle ISD Student Code of Conduct and Argyle Secondary Handbook. We understand that students will be held accountable for their behavior and will be subject to the disciplinary consequences outlined in the Handbook and Code of Conduct. Printed Name of Student: Signature of Student: Printed Name of Parent: Signature of Parent: Date: Grade Level: **Please contact Argyle ISD at , if you do not have access to the Argyle ISD website and would like a hard copy of the Student Code of Conduct and Handbook.
11 Occupational Surve District: Campus: Grade: Student Name: Date of Birth: Dear Parents, In order to better serve your children, our school district is helping the State of Texas identify students who may qualify to receive additional educational services. The information provided below will be kept confidential. Please answer the following questions and return this form to your child's school. 1. Within the past 3 years have you moved from one city or state to another so that you or your family could work or look for work in agriculture or fishing? No (STOP here and return survey to your child's school.) _...,..., 6.- Yes (Please check all that apply below and continue to euestion Fruit, vegetables, soybeans, sunflower, cotton, wheat, grain, sugar beets, agricultural farms or ranches, fields and vineyards fir 0 V 1rib,, 441 ) Working in a cannery. Working on a dairy farm 4,ilit-T. "9;41"" M Ill - A. _,. MIIICI A,.m 41' t b Akb Working in a fishery, ,, I Th..... Working in a slaughter house i '11 eibuirr4tal c-or -,, Jr Working on a poultry farm,4,7 ---:...,,. 4),, V Working in a plant nursery or orchard; growing or harvesting trees Other similar work, please explain: 2. Did the children in your family go with you or join you at a later date? NO (STOP here and return survey to your child's school.) If you check "Yes" someone will call you. YES (Please complete below.) Best time to contact you: Parent/Guardian Name: Home Address/Apt Name: City: Zip Code: Telephone Number: Mailing Address: City: Zip Code: For School Use Only: Please fax survey with two YES Responses to: Migrant Program
12 Formulario de Trabajo Distrito: Escuela: Nivel: Nombre del Estudiante: Fecha de Nacimiento: Estimados padres, Para mejorar los servicios educativos de sus hijos, el distrito esta colaborando con el estado de Texas para Identificar a los estudiantes que pueden calificar para recibir servicios educativos adicionales. Toda la information proporcionada sera mantenida confidencial. Favor de responder a las siguientes preguntas y devolver esta forma a la escuela de su nino. 1. zdurante los tiltimos tres arios se ha cambiado su familia de ciudad o estado para buscar o encontrar trabajo relacionado con la agricultura o la pesca? No (PARE aqui y envie la encuesta a la escuela.)...,:,......_,.,...-- SI (Seleccione todo que aplica y favor de continuar a la eresunta #2.) Fruita, venduras, soya, girasol, algodon, trigo, betabel, ranchos grandes, granja de agriculturas, campus y vinedos., <:::=) Trabajando enlatando frutas o verduras 4..., Trabajando en una lecheria 4 _,... # 11* --Vri,,,-, I 1-11 I I I pk r iipr 1i ZSI im1 4 1Z Trabajando en la pesca t...%...rieb Trabajando en una casa de mantanza V 44111'. A,, \ Val 1.111pPr NINO Ail lb Trabajando en granjas avicolas. 4...egui Trabajando en un vivero de plantas, plantando o cosechando arbolet ---1 z, Nergqi Otro trabajo similar, explicar: favor de 2. zviajaron sus hijos con usted o los acompatiaron despues? NO (PARE aqui y envie la encuesta a la escuela.) SI (Favor de llenar lo siguiente) Favor de llenar la siguiente information: Mejor hora para llamar: Nombre del Padre/Guardian: Direccion y Apartamentos: Ciudad: C. Postal: Numero de Telefono: Direcci6n Permanente: Ciudad: C. Postal:
13 Texas Education Agency Texas Public School Student/Staff Ethnicity and Race Data Questionnaire The United States Department of Education (USDE) requires all state and local education institutions to collect data on ethnicity and race for students and staff. This information is used for state and federal accountability reporting as well as for reporting to the Office of Civil Rights (OCR) and the Equal Employment Opportunity Commission (EEOC). School district staff and parents or guardians of students enrolling in school are requested to provide this information. If you decline to provide this information, please be aware that the USDE requires school districts to use observer identification as a last resort for collecting the data for federal reporting. Please answer both parts of the following questions on the student's or staff member's ethnicity and race. United States Federal Register (71 FR 44866) Part 1. Ethnicity: Is the person Hispanic/Latino? (Choose only one) Hispanic/Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Not Hispanic/Latino Part 2. Race: What is the person's race? (Choose one or more) American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains a tribal affiliation or community attachment. Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Black or African American - A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. Student/Staff Name (please print) (Parent/Guardian)/(Staff) Signature Student/Staff Identification Number Date This space reserved for Local school observer upon completion and entering data in student software system, file this form in student's permanent folder. Ethnicity choose only one: Race choose one or more: Hispanic / Latino Not Hispanic/Latino Observer signature: American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Campus and Date: Texas Education Agency
14 Agencia de Educacion de Texas Cuestionario de Informacion de Datos Raciales y de Etnicidad de Estudiantes/Miembros de Personal de las Escuelas PUblicas de Texas El Departamento de EducaciOn de Estados Unidos (USDE) requiere que todas las instituciones estatales y locales de educacion, recopilen datos sobre etnicidad y raza de los estudiantes y de miembros de personal. Esta informacion es utilizada para los reportes estatales y federales asi como para reportar a la Oficina de Derechos Civiles (OCR) y a la Comisi6n de Igualdad en el Empleo (EEOC). Al personal del distrito escolar y los padres o representante legal de estudiantes que deseen matricularse en la escuela, se le requiere proporcionar esta informacion. Si usted rehosa proporcionarla, es importante que sepa que el USDE requiere que los distritos escolares usen la observacion para identificackin como Ultimo recurso para obtener estos datos utilizados para reportes federales. Favor de contestar ambas partes de las siguientes preguntas sobre la etnicidad y raza del estudiante asi como del miembro de personal. Registro Federal de Estados Unidos (71 FR 44866). Parte 1. Etnicidad: 4Es la persona Hispana/Latina? (Escoja solo una respuesta) Hispano/Latino Una persona de origen cubano, mexicano, puertorriqueno, centro o sudamericano o de otra cultura u origen espanol, sin importar la raza. No Hispano/Latino Parte 2. Raza. LCual es la raza de la persona? (Escoja uno o mas de uno) Indio Americano o Nativo de Alaska Una persona con origenes o de personas originarias de Norte y Sudamerica (incluyendo America Central), y que mantiene lazos o apego comunitario con una afiliacion de alguna tribu. Asiatic Una persona con origenes o de personas originarias del Lejano Este, Sureste de Asia o el subcontinente Indio, incluyendo, por ejemplo a Cambodia, China, India, Japon, Corea, Malasia, Pakistan, las Islas Filipinas, Tailandia y Vietnam. Negro o Africo-Americano Una persona con origenes de cualquier grupo racial negro de Africa. Nativo de Hawai u otras islas del pacifico Una persona con origenes o de personas originarias de Hawai, Guam, Samoa u otras Islas del Pacifico. Blanco Una persona con origenes de personas originarias de Europa, el Medio Este o el Norte de Africa. Nombre del Estudiante/Miembro de Personal (por favor use letra de imprenta) NOrnero de Identificacion del Estudiante/Miembro del personal Firma (Padre/Representante legal) (Miembro de personal Fecha This space reserved for Local school observer upon completion and entering data in student software system, file this form in student's permanent folder. Ethnicity choose only one: Race choose one or more: Hispanic / Latino Not Hispanic/Latino American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Observer signature: Agencia de EducaciOn de Texas Campus and Date:
15 Argyle Independent School District 800 Eagle Drive Argyle, Texas Please complete this form even if your student does not require bus transportation on a regular basis. Por favor complete esta forma - incluso si su hijo no requiere el transporte en autobas de forma regular Application for Bus and Field Trip Transportation Services Solicitud de autobus servicios de transporte viaje de campo ID# / No de IdentificaciOn del alumna : Campus / Escuela: * Grade / Grado: Student Name / Nombre del alumno :* Last: * First: MI: The AISD Student Code of Conduct and School Bus Safety Rules and Conseauences are posted online at aravleisd.com. I have read the AISD Student Code of Conduct and School Bus Safety Rules and Consequences and agree to abide by those rules. El Codigo de Conducta Estudiantil del AISD y autobas escolar Reg/as de seguridad y consecuencias se publican en linea en argyleisd.com. He leido el Codigo de Conducta Estudiantil del AISD y autobus escolar Reglas de Seguridad y Consecuencias y estoy de acuerdo con eras reglas. Agree / De acuerdo: Required information: lnformacion requerida: Signature of Parent or Guardian / Firma del padre o tutor * Address / Domicilio : Apt. / Lot # / No de Apt. o Lote : * City / Ciudad : * Zip / Codigo Postal : Mailing Address if different / Direcci6n si diferente del Domicilio: #1 Parent / Nombre del padre o tutor : Home Phone / Telefono de su casa : ( Address: Work Phone / Telefono del trabajo : ( Cell/Other / Cell/Otro : ( - #2 Parent / Nombre de la madre o Segundo tutor : Home Phone / Telefono de su casa : ( Address: Work Phone / Telefono del trabajo : ( Cell/Other / Cell/Otro : ( o Check box if transportation is requested on a regular basis. Compruebe caja y completa informacion a continuacion si se solicita el transporte de autobos escolar sobre una base regular. Parent Permission for Educational Field Trip / Permiso de los padres para el Wale al campo educativo I hereby indemnify, hold harmless, release and forever discharge the Argyle Independent School District, (hereinafter the "District") its agents, employees and officers from all claims, demands, actions, right of action, which I may have or which my heirs, executors, administrators, or assigns may have or claim to have against the District which arise out of or are in any way connected with personal injuries, known or unknown, and injuries to property, real or personal, caused by or arising out of, the above described educational field trip. I understand that every reasonable effort will be made to contact me in the event of acute illness or other emergency requiring medical attention. However, if I cannot be reached, I hereby authorize the District to transport or authorize the transport by ambulance of my child to the nearest medical care facility and to authorize any and all necessary medical treatment arising from said emergency. I understand that any and all costs incurred as a result of above mentioned medical care will remain my responsibility. I further understand that these costs may include, but are not limited to, ambulance, private physician, clinic, hospital, dentist, or other urgent care personnel. I, the undersigned, have read this entire release and understand that the terms contained herein are contractual. I consent to medical treatment according to the terms of this agreement and accept responsibility for all costs incurred. I understand that failure to return this form will act as lack of consent for participation and student will not be allowed to participate in field trip. I execute this voluntarily and with full knowledge of its significance. Por este media indemnizar, eximir, liberar y descarga para siempre el distrito escolar independiente de Argyle, (en lo sucesivo el "Distrito") sus agentes, empleados y funcionarios de todos los reclamos, demandas, acciones, derecho de accion, que puede que tenga o que mis herederos, ejecutores, los administradores, o cesionarios pueden tienen o pretenden tener contra el distrito que surjan de o en alguna actividad conectada con lesiones personales, conocidas o desconocido y danos a la propiedad, real o personal, causado por o que se presenta fuera de, el arriba habia descrito excursion educativa. Entiendo que se baron todos los esfuerzos razonables para ponerse en contacto conmigo en caso de enfermedad aguda o de otra emergencia que requieren atencion medico. Sin embargo, si yo no puedo ser alcanzado, por la presente autorizo al distrito de transporte o autorizar el transporte por ambulancia de mi hijo a la instalacion medico mss cercana y a autorizar cualquier tratamiento medico necesario derivadas de dicho emergencia. Yo Entiendo que cualquier y todos los costos incurridos coma resultado de arriba mencionado medico seran siendo mi responsabilidad. AdemOs, entiendo que estos costos pueden incluir, pero no se limitan a, ambulancia, medico privado, clinica, hospital, dentista u otro personal de atencion de urgencia. El abajo firmante, ha leido esta version completa y entiende que los terminos contenidos en este documento son contractual. Me da su consentimiento al tratamiento medico, segon los terminos de este acuerdo y aceptar la responsabilidad de todos los costos incurridos. Yo entiendo que la falta de devolver este formulario actuary coma falta de consentimiento para la participacion y estudiante no podron participar en la excursion. Yo esto ejecuta voluntariamente y con pleno conocimiento de su significado. Insurance and Medical Information / Information medica y seguro Medical Insurance Company Any medications now being used / Ahora se esto utilizando alg6n medicamento: Any Known allergies / Cualquier alergia conocida: Policy number / Winer de poliza: Signature of Parent or Guardian / Firma del padre o tutor: Revised 05/01/2015
16 Argyle Independent School District 800 Eagle Drive Argyle, TX wwwargyleisd.com TO: Parents and Guardians of AISD Students RE: FOSTER CARE AND MILITARY CONNECTED STUDENTS Dear Parents: The Texas Legislature requires that Argyle ISD collect data regarding the foster care status of all students enrolled in AISD (SB 833). In addition, AISD is required to collect data regarding students who are Military Connected (SB 525). If either of the two following items apply to your student, please complete and return this form to your student's school as soon as possible: FOSTER CARE: 1. Is your student currently in the conservatorship of the Department of Family and Protective Services? 0 Yes (please check) Student's Name (please print) Please attach a copy of the Texas DFPS Placement Authorization Form (Form 2085) or a court order that designates the student is in foster care. 2. PK student only: Was your PK student previously in the conservatorship of the Department of Family and Protective Services following an adversary hearing held as provided by Section , Family Code? 0 Yes (please check) Student's Name (please print) Please attach a copy of the verification letter you received from the Texas DFPS and CPS. MILITARY CONNECTED: 1. Is your student a dependent of a member of the United States military serving in the Army, Navy, Air Force, Marine Corps, or Coast Guard on active duty? 0 Yes (please check) 2. Is your student a dependent of a member of the Texas National Guard (Army, Air Guard, or State Guard)? 0 Yes (please check) 3. Is your student a dependent of a member of a reserve force of the United States military (Army, Navy, Air Force, Marine Corps, or Coast Guard)? 0 Yes (please check) 4. PK student only: Is your PK student a dependent of an active duty uniformed member of the Army, Navy, Air Force, Marine Corps, or Coast Guard, or activated/mobilized uniformed member of the Texas National Guard (Army, Air Guard, or State Guard) who was injured or killed while serving on active duty? 0 Yes (please check) If you checked any of the above: Student Name (please print) Grade ID Number Elementary Homeroom Teacher
17 Argyle School District Internet Access and Responsible Use Policy (RUP) Signature Page - Student PURPOSE The purpose of computer network use, including Internet access, shall be to support education and academic research in and among the schools in the Argyle School District by providing unique resources and the opportunity for collaborative work. Network facilities shall be used to support the District's curriculum and to support communications and research for students, teachers, administrators, and support staff. AUTHORITY RESPONSIBLE USE The Argyle School District reserves the right to monitor and log network use and fileserver space utilization by District users. It is often necessary to access user accounts in order to perform routine maintenance and security tasks. User accounts are therefore the property of the Argyle School District. Students should have no expectation of privacy or confidentiality in the content of electronic communications, Internet access, or other computer files sent and received on the school computer network or stored in his/her directory. The school computer network's system operator, or other authorized school employee, may, at any time and without prior warning, review the subject, content, and appropriateness of electronic communications, Internet access or other computer files and remove them if warranted, reporting any violation of rules to the school administration or law enforcement officials. The District reserves the right to remove a user account from the network to prevent further unauthorized or illegal activity if this activity is discovered. The use of the computer network and other digital technology must be in support of education and research and consistent with the educational objectives of the Argyle School District. Use of network and computer resources must comply with the Responsible Use Policy. Network accounts are to be used only by the authorized owner of the account for authorized purposes. Use of unauthorized 3G / 4G networks to access the Internet and its content is prohibited. Use of any District computer and other digital technology, unless and until the individual has signed this form is prohibited. Students are required to submit a responsible use agreement signed by the student and a parent at the beginning of each school year. The responsible use agreement shall remain in effect until a new agreement is signed. The determination as to whether a use is appropriate lies solely within the discretion of the Argyle School District. PROHIBITIONS The use of the computer network for illegal, inappropriate, or unethical purposes by students or employees is prohibited. More specifically, the following uses are prohibited: 1. Use of the network to facilitate or engage in inappropriate or illegal activity. 2. Use of the network for commercial, for-profit or political purposes. 3. Use of the network for nonwork or nonschool related work. 4. Use of the network for hate mail, discriminatory remarks, bullying or threatening, and offensive or inflammatory communication. 5. Unauthorized or illegal installation, distribution, reproduction, plagiarism, or use of copyrighted materials and/or use of any software or Internet site in violation of any applicable licensing agreement or applicable terms of use. 6. Use of the network to access, send, receive or transmit obscene, sexually explicit or pornographic material, or materials harmful to minors, or failure to report (to a teacher for students and to the network administrator for District employees) any time when s/he inadvertently visits or accesses a pornographic site. 7. Use of inappropriate language or profanity on the network. 1
18 8. Use of the network to transmit material likely to be offensive, objectionable, or that presents real or potential disruption to the learning environment 9. Use of the network to intentionally, willfully, maliciously, or through reckless indifference obtain or modify files, passwords, and data belonging to other users. 10. Impersonation of another user, anonymity, and pseudonyms. 11. Use of network facilities for fraudulent copying, communications, or modification of materials in violation of copyright laws. 12. Destruction, modification, or abuse of network hardware and software. 13. Attempting to bypass, disable or circumvent any filter, blocking software or other security measure that may be used or installed by the District 14. Intentionally entering any secure or confidential area of the District's systems, network(s), computers or other digital technology without proper authority. 15. Knowingly infecting any computer with any virus. 16. Deleting or removing any program, application, security feature, or virus protection from any District computer or other digital technology. 17. Planting any virus, pornography, or other prohibited content or software on anyone's corn puter or other digital technology. WEB 2.0/SOCIAL MEDIA Argyle School District social media guidelines encourage students and staff to work, learn, and share information collaboratively using Web 2.0 tools. Our Learning Management System (LMS)* offers many of these tools in a secure, controlled environment. To maintain a safe environment for the students, online activities should take place within the LMS whenever possible. It is important to create an atmosphere of trust and individual accountability, keeping in mind that information produced by Argyle School District students is a reflection on the entire District and is subject to the District's Responsible Use Policy (AUP). The growing use of social media (online posting and collaboration) should be considered an extension of the classroom. Any online activity that would not be appropriate in the classroom should not be conducted online. School policy and consequences extend to the online learning environment. Students should at all times respect the privacy of the community. Do not divulge or post online personal information about any members of the school community without permission. High standards for appropriate online communication must be maintained. Digital information may leave a long-lasting or even permanent record with the possibility of becoming public without your knowledge or consent. CONSEQUENCES The network user shall be responsible for damages to the equipment, systems, and software resulting from deliberate or willful acts. Failure to follow the procedures and prohibited uses previously listed in this policy may result in loss of network access. Illegal use of the network; intentional deletion or damage to files of data belonging to others; copyright violations of theft of services will be reported to the appropriate legal authorities for possible prosecution. Violations of this policy by a student may result in corrective action up to and including suspension, expulsion, or criminal action. ACKNOWLEDGEMENT I have read, understood and agree to abide by the Argyle School District Internet Access and Usage Policy. Learning Management System (LMS)* -- Argyle ISD is currently utilizing Google Apps for Education 2
19 Argyle ISD Responsible Use Policy Signature Page By signing below you are agreeing to the Argyle School District Responsible Use Policy and it's terms. If your child is under the age of 13, and you DO NOT want them to participate in the school's Learning Management System (Google Apps for Education), please check the box below. I DO NOT want my child to participate in Google Apps for Education Student Printed Name: Student Signature: Parent Signature: Date: Date: 3
20 Argyle ISD Personal Assistance Form *You only need to fill this form out if you have a child who needs financial assistance. Throughout the school year various charitable organizations request from the school a list of students who would have financial needs for various programs. We are unable to give names for these programs without signed parental consent. There may be an application process or proof of eligibility required for some services. Any information you share will be kept confidential by the service providers that you share it with. These groups are separate from Argyle Independent School District, but are sources of great help for our students. Please indicate below if you are willing to have your student's name released to various programs. I agree for the name of my child to be released to various charitable groups wishing to assist my family as needs may arise. I do understand that this does not guarantee my student will receive benefits, only that they will be considered when the time for the need arises. Parent /Guardian Signature: Date: Street Address: City: Zip Code: Student Name: Phone: If you have questions or concerns please call your student's school for further information.
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