ON-LINE ENROLLMENT INSTRUCTIONS

Transcripción

1 BURLINGAME SCHOOL DISTRICT 1825 Trousdale Drive, Burlingame CA (650) (650) bsd.k12.ca.us ON-LINE ENROLLMENT INSTRUCTIONS For Parents Published: 1/30/2013 G.C.

2 Burlingame School District 1825 Trousdale Drive, Burlingame CA (650) (650) bsd.k12.ca.us Go to District website bsd.k12.ca.us then click the New Student tab or the Enroll Now! Icon and you will be redirected to the New Student Registration/Enrollment Information page. On the right hand side of the page you will find the links of your home school s online enrollment page. 2

3 or Log on to your home school by typing this URL: 1. Click New Student Enrollment Change it to your home school e.g. Franklin, Lincoln, McKinley, Roosevelt. For Middle School: burlingameintermediate-school 2. Enter your access key number hit continue 3

4 There are 8 steps to complete. You will receive a green check next to each step when they are completed correctly. 4

5 3. Click #1 New Student Information Form Complete fields Please note - Social Security Number is not mandatory Please note For incoming Kindergarteners: current grade, select 0 and for incoming grade, select 0. (0=Kindergarten) Click Save and Return to home page and you will be directed back to your enrollment screen. 5

6 4. Click #2 Additional Student Information Complete required fields - click for a checkmark at Parent s Acknowledgement and click I agree to return to enrollment screen. 6

7 5. Click #3 Residency Verification Affidavit Complete required fields - click for a checkmark at Parent s Acknowledgement and click I agree to return to enrollment screen. 7

8 6. Click #4 New Student Ethnicity Form Enter Race, Ethnicity and Language through the drop-down menus Answer other information yes or no Click Save when you are done to return to enrollment screen 7. Click #5 Home Language Survey Type in your answers to Numbers 1-4 Choose from the drop down menu for Number 5 (for Kindergarten, it will be No ) Click for a checkmark at Parent s Acknowledgement and click I agree to return to enrollment screen. 8

9 8. Click #6 Affidavit of Parent Residency (Shared home) Follow instructions If this does not apply, click for a checkmark at Parent s Acknowledgement and click I agree to return to enrollment screen. (SEE APPENDIX A FOR FORM SAMPLE) 9. Click #7 Heath Information You can just click for a checkmark at Parent s Acknowledgement and click I agree to return to enrollment screen. (No need to print this now to complete the enrollment process. You may print this document to bring to your child s physician for their report of health examination for school entry. This form is required by the first day of school or after their 5-year checkup. There will be copies of this form in the school office.) (SEE APPENDIX B FOR FORM SAMPLE) 9

10 10. Click #8 Additional Health Information Number 1 - Click the boxes for any conditions which pertain to your child. Click NA if there are None and type the word none in the box at Number 2. If you checked any conditions for your child, type in the answers in the box at Number 2. Your page will not be complete without something typed in the box at Number 2. Click for a checkmark at Parent s Acknowledgement and click I agree to return to enrollment screen. 10

11 11. When steps 1-8 are completed, you will see all green checkmarks. Then click the button Click here to complete enrollment process. 12. On the next screen, click the button Click here to print new enrollment forms. 11

12 You are finished! Take the printed papers to the school office to complete the enrollment of your child. **If you see any errors on your printed papers, you can always go back into any of the steps, fix your error, save the enrollment, and print it again with corrections. (SEE APPENDIX C FOR SAMPLE) Remember to Logout when you are finished. Thank you for your time and patience in completing your child s on-line enrollment. Questions? Call xx. We look forward to having you in our Burlingame Family. 12

13

14 State of California Health and Human Services Agency REPORT OF HEALTH EXAMINATION FOR SCHOOL ENTRY Department of Health Care Services Child Health and Disability Prevention (CHDP) Program To protect the health of children, California law requires a health examination on school entry. Please have this report filled out by a health examiner and return it to the school. The school will keep and maintain it as confidential information. PART I TO BE FILLED OUT BY A PARENT OR GUARDIAN CHILD S NAME Last First Middle BIRTH DATE Month/Day/Year ADDRESS Number, Street City ZIP code SCHOOL PART II TO BE FILLED OUT BY HEALTH EXAMINER HEALTH EXAMINATION NOTE: All tests and evaluations except the blood lead test must be done after the child is 4 years and 3 months of age. IMMUNIZATION RECORD Note to Examiner: Please give the family a completed or updated yellow California Immunization Record. Note to School: Please record immunization dates on the blue California School Immunization Record (PM 286). REQUIRED TESTS/EVALUATIONS Health History Physical Examination Dental Assessment Nutritional Assessment Developmental Assessment Vision Screening Audiometric (hearing) Screening Tuberculin Test (Mantoux/PPD) Blood Test (for anemia) Urine Test Blood Lead Test Other DATE (mm/dd/yy) DATE EACH DOSE WAS GIVEN VACCINE First Second Third Fourth Fifth POLIO (OPV or IPV) DtaP/DTP/DT/Td (diphtheria, tetanus, and [acellular] pertussis) OR (tetanus and diphtheria only) MMR (measles, mumps, and rubella) HIB MENINGITIS (Haemophilus Influenzae B) (Required for child care/preschool only) HEPATITIS B VARICELLA (Chickenpox) OTHER OTHER PART III ADDITIONAL INFORMATION FROM HEALTH EXAMINER (optional) and RELEASE OF HEALTH INFORMATION BY PARENT OR GUARDIAN RESULTS AND RECOMMENDATIONS Fill out if patient or guardian has signed the release of health information. I give permission for the health examiner to share the additional information about the health check-up with the school as explained in Part III. Please check this box if you do not want the health examiner to fill out Part III. Examination shows no condition of concern to school program activities. Conditions found in the examination or after further evaluation that are of importance to schooling or physical activity are: (please explain) Signature of parent or guardian Date Name, address, and telephone number of health examiner Signature of health examiner Date PM 171 A (09/07) (Bilingual) If your child is unable to get the school health check-up, call the Child Health and Disability Prevention (CHDP) Program in your local health department. If you do not want your child to have a health check-up, you may sign the waiver form (PM 171 B) found at your child s school. CHDP website:

15 State of California Health and Human Services Agency INFORME DEL EXAMEN DE SALUD PARA EL INGRESO A LA ESCUELA Department of Health Services Child Health and Disability Prevention (CHDP) Program Para proteger la salud de los niños, la ley de California exige que antes de ingresar a la escuela todos los niños tengan un examen médico de salud. Por favor, pidale al examinador de salud que llene este informe y entregelo a la escuela este informe sera archivado por la escuela en forma confidencial. PARTE I PARA SER LLENADO POR EL PADRE/LA MADRE O EL GUARDIÁN NOMBRE DEL NIÑO/NIÑA Apellido Primer Nombre Segundo Nombre FECHA DE NACIMIENTO Mes/Día/Año DOMICILIO Número y Calle Ciudad Zona Postal Escuela PARTE II PARA SER LLENADO POR EL EXAMINADOR DE SALUD EXAMEN DE SALUD AVISO: Todas las pruebas y evaluaciones excepto el análisis de sangre para el plomo deben ser hechas después de la edad de 4 años y 3 meses. PRUEBAS Y EVALUACIONES REQUERIDAS FECHA(mm/dd/aa) Historia de Salud Examen Físico Evaluación de Dientes Evaluación de Nutrición Evaluación del Desarrollo Pruebas Visuales Pruebas con Audiómetro (auditivas) Pruebas con Tuberculina (Mantoux/PPD) Análisis de Sangre (para anemia) Análisis de Orina Análisis de Sangre para el plomo Otra REGISTRO DE INMUNIZACIONES Aviso al Examinador: Por favor dé a la familia, una vez completado, o a la fecha, el Registro de Inmunización de California en papel amarillo. Aviso a la Escuela: Por favor apunte las fechas de inmunización sobre el Registro de Inmunización de la escuela de California en papel azul. FECHA EN QUE CADA DOSIS FUE DADA VACUNA Primero Segundo Tercero Quarto Quinto POLIO (OPV o IPV) DTaP/DTP/DT/Td (difteria, tétano y [acellular] pertusis [tos ferina]) O (tétano y difteria solamente) MMR (sarampión, paperas, rubéola) HIB MENINGITIS (Hemófilo, Tipo B) (Requerida para centros de cuidado para niños y centros preescolares solamente) HEPATITIS B VARICELLA (Viruelas locas) OTRA OTRA PARTE III INFORMACIÓN ADICIONAL DEL EXAMINADOR DE SALUD (optional) y PERMISO PARA DIVULGAR (DISTRIBUIR) EL INFORME DE SALUD RESULTADOS Y RECOMENDACIONES Yo le doy permiso al examinador de salud para que comparta con la escuela la información adicional Llene esta parte si el padre/la madre o el guardián ha firmado el consentimiento para divulgar de este examen como es explicado en la Parte III. (distribuir) la información de salud de su niño/niña. Por favor marque esta caja si Ud. no desea que el examinador llene la Parte III. El examen reveló que no hay condiciones que conciernen las actividades de los programas escolares. Las condiciones encontradas en el examen o después de una evaluación posterior que son de importancia para la actividad escolar o física son: (por favor explique) Firma del padre/madre o guardián Nombre, domicilo, y teléfono del examinador Fecha Firma del examinador de salud Fecha PM 171 A (3/03) (Bilingual) Si su niño o niña no puede obtener el examen de salud llame al Programa de Salud para la Prevención de Incapacidades de Niños y Jovenes (Child Health and Disability Prevention Program) en su departamento de salud local. Si Ud. no desea que su niño(a) tenga un examen de salud, puede firmar la orden (PM 171 B), formulario que se consigue en la escuela de su niño(a). CHDP website:

16 Burlingame dummy New Student Enrollment Forms Please print a copy, sign the document and bring to the school office. New Student Information Form Student Information First Name Dummy Middle Name Last Name Dummy Birth Date Social Security Number Gender Male Current Grade(if applicable) 0 Incoming Grade 0 Home/Primary Phone Student Cell Phone Student Birth City Burlingame Birth State California Birth Country US Date Student Entered(if birth country not US) Address Information Residential 1825 Trousdale Drive Burlingame California US Mailing 1825 Trousdale Drive Burlingame California US Sibling Information Parent & Guardian Information PARENT1 RelationShip First Name Last Name Employer Highest Education Father Dad Dummy High School Graduate Work Phone Cell Phone Home Phone PARENT2 RelationShip First Name Last Name Employer Highest Education Mother Mom Dummy College Graduate Work Phone Cell Phone Home Phone Sample Completed Form

17 Dummy Dummy New Student Ethnicity Form Ethnicity Information Race Ethnicity Primary Language Other Information Has your child previously been enrolled in classes for identified gifted students? Has your child previously been enrolled in programs or classes requiring and I.E.P.? Has your child previously been enrolled in programs or classes with a 504 plan? Has your child been expelled, or is pending an expulsion hearing, from any school or district? Has your child been suspended, or is pending a suspension, from any school or district? Has your child previously attended any other school for grades Kindergarten thru 12? Has your child previously attended any school in the district? White White English No No No No No No No Sample Completed Form

18 Dummy Dummy Additional Student Information Affidavit of Parent Residency (Shared home) Health Information Residency Verification Affidavit Additional Health Information 1. Please check which of the following conditions your child has had. 2. If you have checked any of the above, please give the approximate age at the time of the illness and whether he/she is still under the care of a physician for this condition. Home Language Survey 1. Which language did your child learn when he/she first began to talk? 2. Which language does your child most frequently speak at home? 3. Which language do you (the parents or guardians) most frequently use 4. Which language is most often spoken by adults in the home? 5. Has your child ever been given the CELDT (California English Language Development Test)? N/A {Type "none" in the box below} None english english english english I/We acknowledge that I/we have read, completed and agreed to all the forms specified above. Parent 1 / Mother Signature Date Parent 2 / Father Signature Date Guardian Date No Sample Completed Form