SANTA FE INDEPENDENT SCHOOL DISTRICT Required Documents for Enrollment

Tamaño: px
Comenzar la demostración a partir de la página:

Download "SANTA FE INDEPENDENT SCHOOL DISTRICT Required Documents for Enrollment"

Transcripción

1 SANTA FE INDEPENDENT SCHOOL DISTRICT Required Documents for Enrollment Proof of Identification Any of the following documents are acceptable for proof of identification and age (TEA: SAAH 3.3): Birth certificate Driver s License Passport School ID card, records or report card Military ID Hospital birth record Adoption records Church baptismal record or Any other legal document that establishes identity For a student who is under 11 years of age and enrolling in school for the first time, per the Texas Code of Criminal Procedure, Article , certain additional requirements related to documentation of identity and age apply. The district is required to notify you that you will have up to 30 days from enrollment or up to 90 days if your child is born outside of the United States, to provide a certified copy of a child s birth certificate or other acceptable proof of the child s identity and age. For proof other than the birth certificate, you will also need to enclose a signed note explaining why you are unable to produce a certified copy of the birth certificate. Social Security Card If not provided, your child will be assigned a state identification number. Proof of Residence A mortgage or lease agreement or a current utility bill (within 2 months of enrollment date), with the parent/guardian s name and service address (not mailing address) listed on the light, water, gas or cable bill. No phone bills or disconnect notices will be accepted. If you live in a household with someone else, you and that person will need to bring one of their current utility bills stating the service address of the property where you and your child are living along with their driver s license and complete a proof of residency form that will be notarized at that time. Up To Date Immunization Record See list of immunizations, in this packet, that are needed for your child based on their age. Driver s License The person enrolling the child must present their driver s license. revised 8/17

2 Please note!! You should be aware of the following requirements from Chapter 25 of the State Education Code, Section 125: If a child is enrolled under a name other than the child s name as it appears in the identifying documents or records, the school district shall notify the missing children and missing person s information clearinghouse of the child s name on the identifying document or records and the name under which the child is enrolled. The information in the notice is confidential and may be released only to a law enforcement agency. If the information required by Subsection (a) is not furnished to the district within the period of time provided by that subsection, the district shall notify the police department of the municipality or sheriff s department of the county in which the district is located and request a determination of whether the child is reported missing. When accepting a child for enrollment, the school district shall inform the parent or other person enrolling the child that presenting false documentation or false records under this section is an offense under Section Penal Code, and that enrollment of the child under false documentation subjects the person to liability of tuition or costs under Section (b). NOTICE TO PARENTS PEST CONTROL INFORMATION As part of our commitment to provide your child with a safe, pest-free learning environment, the Santa Fe Independent School District may periodically apply pesticides to help manage insects, weeds, or pathogens. Pesticide applications are part of our integrated pest management (IPM) program, which relies largely on non-chemical forms of pest control. Pesticide applications on Santa Fe Independent School District property are made only by trained and licensed technicians. Should you have questions about this district's pest management program or wish to be notified in advance of pesticide applications, you may contact our IPM coordinator: Bob Atkins Director of Maintenance and Operations Bob.atkins@sfisd.org

3 Santa Fe ISD New Student Enrollment Packet Checklist Required Documents for Enrollment (Copy for Parents) Application for Admission Home Language Survey Ethnicity and Race Data Questionnaire Immigrant Status Migrant Survey Immunization Status (Copy for Parents) revised 6/16

4 SANTA FE INDEPENDENT SCHOOL DISTRICT APPLICATION FOR ADMISSION PLEASE PRINT STUDENT INFORMATION: FOR SCHOOL USE ONLY Legal Last Name CAMPUS: Legal First Name Date of Registration: Legal Middle Name Local ID: Generation Code (Jr. III, etc.) Grade Level: Date of Birth SS# or State ID#: Gender: Male Female Bus # Home: Place of Birth (City & State) Entering Grade (Current year) Check List Social Security Number Proof of Residence Country of Birth Proof of Identification Is Student a U.S. Citizen? Yes No (If No, please present documentation form) Health Records (Immunizations) Previously Attended SFISD Yes No Social Security Card School Last Attended: Year: Out-of-District Transfer Grades Student Has Repeated: Parent Identification Schools Attended This Year: Ethnicity/Race Questionnaire Legal Documentation (If needed) Was Your Student Enrolled in One of The Following Programs This or Last School Year: Gifted/Talented Speech Visual/Audio Impaired Dyslexia Intervention Title I ESL/Bilingual Special Ed Section 504 Name of Person Enrolling Student: Relationship: 1) Parent/Guardian Name: Relationship: Father Mother Step-Parent Guardian Other Home Phone: Work Phone: Cell Phone: Address: City: State: Zip: Mailing Address: City: State: Zip: Address: Parent s Birth date: / / Family Access: I am requesting Family Access: Yes No if yes, address and date of birth are required above. 2) Parent/Guardian Name: Relationship: Father Mother Step-Parent Guardian Other Home Phone: Work Phone: Cell Phone: Address: Address: City: State: Zip: Mailing Address: City: State: Zip: Address: Parent s Birth date: / / Family Access: I am requesting Family Access: Yes No if yes, address and date of birth are required above. * Student Lives With: Both Parents Mother Father Other (Specify) *Notice: (If student lives with someone other than parents, appropriate notarized or legal documentation MUST be attached.) List Names and Ages of Siblings enrolled in Santa Fe ISD: Emergency Contact Name: Phone #: Emergency Contact Name: Phone #: I understand that my student is conditionally enrolled until all necessary documentation is received. My signature signifies all the information provided on this form is correct. (Signature of Parent, Legal Guardian, Person Having Lawful Control) (Date) Approved by: Date Enrolled: (Administrator/Registrar) rev. 6/16

5 SANTA FE INDEPENDENT SCHOOL DISTRICT HOME LANGUAGE SURVEY-19TAC Chapter 89, Subchapter BB TO BE COMPLETED BY PARENT OR GUARDIAN (OR STUDENT IF GRADES 9-12): The state of Texas requires that the following information be completed for each student that enrolls for the first time in Texas public schools. This survey shall be kept in each student s permanent record folder. NAME OF STUDENT STUDENT ID# ADDRESS TELEPHONE # CAMPUS 1. What language is spoken in your home most of the time? 2. What language does your child speak most of the time? Signature of Parent/Guardian Date Signature of Student if Grades 9-12 Date Cuestionario del idioma que se habla en la hogar DEBE DE COMPLETARSE POR EL PADRE/MADRE/ O REPRESENTANTE LEGAL: (O POR EL ESTUDIANTE SI ESTA EN LOS GRADOS 9-12): El estado de Texas requiere que la siguiente información se complete para cada estudiante que se matricula por primera vez en una escuela pública de Texas. Este cuestionario se archivará en el expediente del estudiante. NOMBRE DEL ESTUDIANTE_ DIRECCION TELEFONO #ID ESCUELA 1. Qué idioma se habla en su hogar la mayoría del tiempo? 2. Qué idioma habla su hijo/a (usted) la mayoría del tiempo? Firma del Padre/Madre/ o Representante Legal Firma del estudiante si está en los grados 9-12 Fecha Fecha

6 SANTA FE INDEPENDENT SCHOOL DISTRICT 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: American Indian or Alaska Native Hispanic / Latino Asian Black or African American Not Hispanic/Latino Native Hawaiian or Other Pacific Islander White Observer signature: Campus and Date: Texas Education Agency March 2010

7 SANTA FE INDEPENDENT SCHOOL DISTRICT Agencia de Educación de Texas Cuestionario de Información de Datos Raciales y de Etnicidad de Estudiantes/Miembros de Personal de las Escuelas Públicas de Texas El Departamento de Educación de Estados Unidos (USDE) requiere que todas las instituciones estatales y locales de educación, recopilen datos sobre etnicidad y raza de los estudiantes y de miembros de personal. Esta información es utilizada para los reportes estatales y federales así como para reportar a la Oficina de Derechos Civiles (OCR) y a la Comisión 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 información. Si usted rehúsa proporcionarla, es importante que sepa que el USDE requiere que los distritos escolares usen la observación para identificación como último 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 así como del miembro de personal. Registro Federal de Estados Unidos (71 FR 44866). Parte 1. Etnicidad: Es la persona Hispana/Latina? (Escoja solo una respuesta) Hispano/Latino Una persona de origen cubano, mexicano, puertorriqueño, centro o sudamericano o de otra cultura u origen español, sin importar la raza. No Hispano/Latino Parte 2. Raza. Cuál es la raza de la persona? (Escoja uno o más de uno) Indio Americano o Nativo de Alaska Una persona con orígenes o de personas originarias de Norte y Sudamérica (incluyendo America Central), y que mantiene lazos o apego comunitario con una afiliación de alguna tribu. Asiático Una persona con orígenes o de personas originarias del Lejano Este, Sureste de Asia o el subcontinente indio, incluyendo, por ejemplo a Cambodia, China, India, Japón, Corea, Malasia, Pakistán, las Islas Filipinas, Tailandia y Vietnam. Negro o Áfrico-Americano Una persona con orígenes de cualquier grupo racial negro de África. Nativo de Hawai u otras islas del pacífico Una persona con orígenes o de personas originarias de Hawai, Guam, Samoa u otras Islas del Pacífico. Blanco Una persona con orígenes de personas originarias de Europa, el Medio Este o el Norte de África. Nombre del Estudiante/Miembro de Personal (por favor use letra de imprenta) Número de Identificación 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 American Indian or Alaska Native Not Hispanic/Latino Asian Black or African American Native Hawaiian or Other Pacific Islander White Observer signature: Campus and Date: Agencia de Educación de Texas Marzo 2009

8 SANTA FE INDEPENDENT SCHOOL DISTRICT Immigrant Status Student Information Please Print Legibly Student s Name Last First Middle Generation Please answer the following questions about the student? 1) Is the student age 3-21? Yes No 2) Was he/she born outside of the United States? Yes No 3) Has the student attended a US School for 3 full academic years? Yes No Note: The three years do not have to be consecutive. Note: A US Department of Defense school that is not located within the fifty states or the District of Columbia is not considered a US School. If the answer to question 3 is No: When did the student first enter a U.S. school? / / Month Day Year Signature of Parent/Guardian Date Rev. 6/16

9 FAMILY SURVEY District Name: Date: School Name: Dear parents, In order to better serve your children, the school district would like to identify students who may qualify to receive additional educational services. The information provided will be kept confidential. Please answer the following questions and return this survey form to your child s school. If you would like more information, call. 1. Have you moved within the last 3 years? Yes No 2. If yes, have you done agricultural or fishing-related work since your move (e.g., field work, canneries, lumbering, dairy work, meat processing)? Yes No 3. Do you have a child who is under the age of 22 and lacks a US-issued high school diploma or General Education Development (GED) certificate? If so, your child may be eligible to receive a free public education in Texas if he or she meets the criteria of Out of School Youth. Yes No If you answered yes to the questions above, an education representative will contact you to provide additional information. Please provide the following information: Name of child Age Grade Parent/guardian name Telephone number Best time to contact you

10 ENCUESTA DE FAMILIA Distrito escolar: Fecha: Escuela: Estimados padres, Para mejorar los servicios educativos de sus hijos, el distrito escolar de quisiera identificar estudiantes que puedan calificar para recibir servicios educativos adicionales. Toda la información proporcionada será mantenida confidencial. Favor de responder a las siguientes preguntas y devolver esta forma a la escuela de su hijo/a. Si desea obtener más información, llame a. 1. Ha cambiado de residencia en los últimos tres años? Sí No 2. Si contesto sí a la pregunta número 1, ha trabajado en la agricultura o en la pesca (por ejemplo, la labor, fábrica de conservas, explotación de bosques, trabajo en una lechería, el proceso de carne)? Sí No 3. Tiene un hijo/a menor de 22 años de edad, que no se ha graduado de secundaria en los Estados Unidos o ha obtenido un certificado de GED? Si es así, el estudiante puede ser elegible para recibir una educación pública gratis en el estado de Texas si el estudiante cumple los requisitos de jóvenes fuera de la escuela (OSY). Sí No Si contesto "sí" a las preguntas, un representante del distrito escolar se comunicará con usted para proveerle más información. Favor de completar la siguiente información: Nombre del estudiante Edad Grado Nombre del padre/guardián Número de teléfono La mejor hora para localizarlo

11 Texas Minimum State Vaccine Requirements for Students Grades K - 12 This chart summarizes the vaccine requirements incorporated in the Texas Administrative Code (TAC), Title 25 Health Services, This document is not intended as a substitute for the TAC, which has other provisions and details. The Department of State Health Services (DSHS) is granted authority to set immunization requirements by the Texas Education Code, Chapter 38. Diphtheria/Tetanus/Pertussis 1 (DTaP/DTP/DT/Td/Tdap) Polio 1 Vaccine Required (Attention to notes and footnotes) Measles, Mumps, and Rubella 1, 2 (MMR) Hepatitis B 2 1, 2, 3 The Varicella Meningococcal 1 (MCV4) Hepatitis A 1, 2 IMMUNIZATION REQUIREMENTS A student shall show acceptable evidence of vaccination prior to entry, attendance, or transfer to a child-care facility or public or private elementary or secondary school in Texas. Minimum Number of Doses Required by Grade Level Grades K - 6th Grade 7th Grades 8th - 12th K doses or 4 doses 3 dose primary series and 1 Tdap / Td booster within the last 5 years 4 doses or 3 doses 2 doses 2 doses 3 doses 2 doses 1 dose 3 dose primary series and 1 Tdap / Td booster within the last 10 years Notes on the back page, please turn over. Notes For K 6 th grade: 5 doses of diphtheria-tetanus-pertussis vaccine; 1 dose must have been received on or after the 4 th birthday. However, 4 doses meet the requirement if the 4th dose was received on or after the 4 th birthday. For students aged 7 years and older, 3 doses meet the requirement if 1 dose was received on or after the 4th birthday. For 7 th grade: 1 dose of Tdap is required if at least 5 years have passed since the last dose of tetanus-containing vaccine. For 8 th 12 th grade: 1 dose of Tdap is required when 10 years have passed since the last dose of tetanus-containing vaccine. Td is acceptable in place of Tdap if a medical contraindication to pertussis exists. For K 12 th grade: 4 doses of polio; 1 dose must be received on or after the 4 th birthday. However, 3 doses meet the requirement if the 3 rd dose was received on or after the 4 th birthday. For K 12 th grade: 2 doses are required, with the 1 st dose received on or after the 1 st birthday. Students vaccinated prior to 2009 with 2 doses of measles and one dose each of rubella and mumps satisfy this requirement. For students aged years, 2 doses meet the requirement if adult hepatitis B vaccine (Recombivax ) was received. Dosage (10 mcg /1.0 ml) and type of vaccine (Recombivax ) must be clearly documented. If Recombivax was not the vaccine received, a 3-dose series is required. 1 st dose of varicella must be received on or after the 1 st birthday. For K 12 th grade: 2 doses are required. For 7 th 12 th grade, 1 dose of quadrivalent meningococcal conjugate vaccine is required on or after the student s 11 th birthday. Note: If a student received the vaccine at 10 years of age, this will satisfy the requirement. The 1st dose of hepatitis A must be received on or after the 1 st birthday. For K 8 th grade: 2 doses are required. Rev. 03/2017

12 NOTE: Shaded area indicates that the vaccine is not required for the respective age group. 1 Receipt of the dose up to (and including) 4 days before the birthday will satisfy the school entry immunization requirement. 2 Serologic evidence of infection or serologic confirmation of immunity to measles, mumps, rubella, hepatitis B, hepatitis A, or varicella is acceptable in place of vaccine. 3 Previous illness may be documented with a written statement from a physician, school nurse, or the child s parent or guardian containing wording such as: This is to verify that (name of student) had varicella disease (chickenpox) on or about (date) and does not need varicella vaccine. This written statement will be acceptable in place of any and all varicella vaccine doses required. Exemptions Texas law allows (a) physicians to write medical exemption statements that the vaccine(s) required would be medically harmful or injurious to the health and well-being of the child or household member, and (b) parents/guardians to choose an exemption from immunization requirements for reasons of conscience, including a religious belief. The law does not allow parents/guardians to elect an exemption simply because of inconvenience (for example, a record is lost or incomplete and it is too much trouble to go to a physician or clinic to correct the problem). Schools should maintain an up-to-date list of students with exemptions, so they may be excluded in times of emergency or epidemic declared by the commissioner of public health. Instructions for requesting the official exemption affidavit that must be signed by parents/guardians choosing the exemption for reasons of conscience, including a religious belief, can be found at under School & Child-Care. The original Exemption Affidavit must be completed and submitted to the school. For children claiming medical exemptions, a written statement by the physician must be submitted to the school. Unless it is written in the statement that a lifelong condition exists, the exemption statement is valid for only one year from the date signed by the physician. Provisional Enrollment All immunizations should be completed by the first date of attendance. The law requires that students be fully vaccinated against the specified diseases. A student may be enrolled provisionally if the student has an immunization record that indicates the student has received at least one dose of each specified age-appropriate vaccine required by this rule. To remain enrolled, the student must complete the required subsequent doses in each vaccine series on schedule and as rapidly as is medically feasible and provide acceptable evidence of vaccination to the school. A school nurse or school administrator shall review the immunization status of a provisionally enrolled student every 30 days to ensure continued compliance in completing the required doses of vaccination. If, at the end of the 30-day period, a student has not received a subsequent dose of vaccine, the student is not in compliance and the school shall exclude the student from school attendance until the required dose is administered. Additional guidelines for provisional enrollment of students transferring from one Texas public or private school to another, students who are dependents of active duty military, students in foster care, and students who are homeless can be found in the TAC, Title 25 Health Services, Sections and Documentation Since many types of personal immunization records are in use, any document will be acceptable provided a physician or public health personnel has validated it. The month, day, and year that the vaccination was received must be recorded on all school immunization records created or updated after September 1, Texas Department of State Health Services Immunization Unit MC-1946 P. O. Box Austin, TX (800) Stock No Rev. 03/2017

13 Requisitos mínimos de vacunas en el estado de Texas de para estudiantes de kínder a 12.o grado Esta gráfica resume los requisitos de vacunación incorporados al Código Administrativo de Texas (TAC), título 25, Servicios de salud, secciones a Este documento no tiene como propósito sustituir al TAC, el cual contempla otras disposiciones y detalles. El Código de Educación de Texas, capítulo 38, confiere al Departamento Estatal de Servicios de Salud (DSHS) la autoridad para establecer los requisitos de inmunización. Polio 1 Vacuna requerida (Vea las notas y notas de pie de página) Difteria, tétanos, tos ferina 1 (DTaP, DTP, DT, Td, Tdap) Sarampión, paperas y rubeola 1, 2 (MMR) Hepatitis B 2 La 1, 2, 3 Varicela Vacuna antimeningocócica 1 (MCV4) Hepatitis A 1, 2 REQUISITOS DE INMUNIZACIÓN Los estudiantes deberán mostrar comprobantes de vacunación aceptables antes de inscribirse, asistir o ser transferidos a una guardería o una escuela primaria o secundaria pública o privada de Texas. Número mínimo de dosis requeridas por nivel de grado De kínder a 6. o grado 7. o grado De 8. o a 12. o grado Notas K dosis o 4 dosis 2 dosis Una serie primaria de 3 dosis y 1 refuerzo de la vacuna Tdap / Td dentro de los últimos 5 años 4 dosis o 3 dosis 2 dosis 3 dosis 2 dosis Una serie primaria de 3 dosis y 1 refuerzo de la vacuna Tdap / Td dentro de los últimos 10 años 1 dosis Notas al reverso, por favor dé la vuelta. Para los grados kínder a 6. o : 5 dosis de la vacuna contra la difteria, el tétanos y la tosferina; debe haberse recibido 1 dosis en o después del 4. o cumpleaños. Sin embargo, con 4 dosis se cubre el requisito si la 4. a dosis se recibió en o después del 4. o cumpleaños. Para los estudiantes de 7 años de edad o más, con 3 dosis cumplen con el requisito si recibieron 1 de las dosis en o después del 4. o cumpleaños. Para el 7. o grado: Se requiere 1 dosis de la vacuna Tdap si han pasado al menos 5 años desde la última dosis de una vacuna que contenga tétanos. Para los grados 8. o a 12. o : Se requiere 1 dosis de la vacuna Tdap cuando hayan pasado 10 años desde la última dosis de una vacuna que contenga tétanos. La vacuna Td es aceptable en lugar de la vacuna Tdap si existe una contraindicación médica para la vacuna contra la tosferina. Para los grados kínder a 12. o : 4 dosis de la vacuna contra la polio; debe recibirse 1 dosis en o después del 4. o cumpleaños. Sin embargo, con 3 dosis se cumple con el requisito si la 3. a dosis se recibió en o después del 4. o cumpleaños. Para los grados kínder a 12. o : Se requieren 2 dosis de la vacuna, la 1. a de las cuales debe recibirse en o después del 1. er cumpleaños. Los estudiantes que fueron vacunados antes de 2009 con 2 dosis contra el sarampión y una dosis contra la rubeola y una dosis contra las paperas cumplen con este requisito. Para los estudiantes de 11 a 15 años de edad, con 2 dosis cumplen con el requisito si recibieron la vacuna contra la hepatitis B para adultos (Recombivax ). Tanto la dosis (10 mcg / 1.0 ml) como el tipo de vacuna (Recombivax ) deben documentarse claramente. Si la vacuna recibida no fue Recombivax, se requiere una serie de 3 dosis. 1. a dosis de la vacuna contra la varicela debe recibirse en o después del 1. er cumpleaños. Para los grados kínder a 12. o : Se requieren 2 dosis. Para los grados 7. o a 12. o, se requiere 1 dosis de la vacuna antimeningocócica tetravalente conjugada en o después del 11. o cumpleaños del estudiante. Nota: Si un estudiante recibió la vacuna a los 10 años de edad, esto satisface el requisito. La 1. a dosis de la vacuna contra la hepatitis A debe recibirse en o después del 1. er cumpleaños. Para los grados kínder a 8. o : Se requieren 2 dosis. Rev. 03/2017

14 NOTA: Las casillas sombreadas indican que no se requiere la vacuna para el grupo de edad correspondiente. 1 Recibir la dosis hasta (e inclusive) 4 días antes del cumpleaños satisfará el requisito de inmunización para inscribirse en la escuela. 2 Son aceptables en lugar de la vacuna una prueba serológica de infección o la confirmación serológica de inmunidad al sarampión, las paperas, la rubeola, la hepatitis B, la hepatitis A o la varicela. 3 Si se ha tenido la enfermedad previamente, puede documentarse con una declaración escrita de un médico, un enfermero escolar o uno de los padres o tutor del niño, la cual diga algo como: Esto es para comprobar que (nombre del estudiante) tuvo la enfermedad de la varicela (varicella o chickenpox) el (fecha) o alrededor de esa fecha y no necesita la vacuna contra la varicela. Dicha declaración escrita será aceptable en lugar de alguna o todas las dosis requeridas de la vacuna contra la varicela. Exenciones La ley de Texas autoriza a que (a) los médicos redacten declaraciones de exención médica para una vacuna o vacunas requeridas que podrían ser médicamente dañinas o perjudiciales para la salud y el bienestar del niño o miembro del hogar, y (b) los padres o tutores opten por una exención de los requisitos de inmunización por razones de conciencia, incluidas las creencias religiosas. La ley no permite que los padres o tutores opten por una exención simplemente para evitarse inconvenientes (por ejemplo, cuando un registro se haya perdido o esté incompleto y sea mucha molestia ir con un médico o a una clínica para corregir el problema). Las escuelas deben mantener una lista actualizada de los estudiantes con exenciones, de forma que se les pueda excluir en casos de emergencias o epidemias declaradas por el comisionado de salud pública. Encontrará las instrucciones para solicitar la declaración jurada de exención oficial, la cual debe ser firmada por los padres o tutores que elijan la exención por razones de conciencia, incluidas las creencias religiosas, en en el enlace para Escuelas y guarderías. El original de la declaración jurada de exención debe llenarse y entregarse en la escuela. En el caso de los niños para quienes se reclamen exenciones médicas, es necesario presentar a la escuela una declaración escrita del médico. A menos que en la declaración conste por escrito que existe una afección de por vida, la declaración de exención es válida solo por un año a partir de la fecha en que el médico la firmó. Inscripción provisional Todas las inmunizaciones deben haberse completado antes del primer día de asistencia. La ley exige que los estudiantes estén completamente vacunados contra las enfermedades específicas. Un estudiante puede inscribirse de manera provisional si cuenta con un registro de inmunización que indique que el estudiante ha recibido al menos una dosis de cada vacuna específica apropiada para su edad según lo exige esta regla. Para seguir inscrito, el estudiante debe completar las dosis posteriores requeridas de cada serie de vacunas a tiempo según el calendario y tan rápidamente como sea médicamente posible, y debe proporcionar a la escuela un comprobante aceptable de que ha sido vacunado. Un enfermero escolar o administrador escolar revisará cada 30 días el estado de inmunización de los estudiantes inscritos de manera provisional para garantizar el cumplimiento ininterrumpido de la aplicación de las dosis de vacunas requeridas. Si, al final del periodo de 30 días, un estudiante no ha recibido una dosis posterior de la vacuna, el estudiante no está cumpliendo con las normas, y la escuela excluirá al estudiante de su asistencia a la escuela hasta que se le administre la dosis requerida. Las normas adicionales para la inscripción provisional de estudiantes transferidos de una escuela pública o privada de Texas a otra, estudiantes que dependen de militares en servicio activo, estudiantes que viven en hogar de acogida y estudiantes en situación sin hogar, se encuentran en el TAC, título 25, Servicios de salud, secciones y Documentación Dado que se usan muchos tipos de registros de inmunización personales, cualquier documento es aceptable si un médico o el personal de salud pública lo ha validado. Debe registrarse el mes, día y año en que se recibió la vacuna en todos los registros de inmunización escolares creados o actualizados después del 1 de septiembre de Texas Department of State Health Services Immunization Unit MC-1946 P. O. Box Austin, TX (800) Stock No Rev. 03/2017

Texas Minimum State Vaccine Requirements for Child-Care Facilities

Texas Minimum State Vaccine Requirements for Child-Care Facilities 2016-2017 Texas Minimum State Vaccine Requirements for Child-Care Facilities This chart summarizes the vaccine requirements incorporated in the Texas Administrative Code (TAC), Title 25 Health Services,

Más detalles

Texas Minimum State Vaccine Requirements for Students Grades K-12

Texas Minimum State Vaccine Requirements for Students Grades K-12 2015-2016 Texas Minimum State Vaccine Requirements for Students Grades K-12 This chart summarizes the vaccine requirements incorporated in the Texas Administrative Code (TAC), Title 25 Health Services,

Más detalles

Aransas Pass ISD. Student Enrollment. Parent/Guardian. Student Information. Parent/Guardian 1: Permission to contact electronically: Yes No

Aransas Pass ISD. Student Enrollment. Parent/Guardian. Student Information. Parent/Guardian 1: Permission to contact electronically: Yes No Aransas Pass ISD Student Enrollment This Space for Office Use Only ID# Date of Enrollment Re-Entry Date Copy of Driver s License for person enrolling student Student Information Student s Name Student

Más detalles

February 20, Dear Parents/Guardians of Students in Texas Schools, Kindergarten through 12th Grade:

February 20, Dear Parents/Guardians of Students in Texas Schools, Kindergarten through 12th Grade: February 20, 2018 RE: Required Immunizations for the 2018-2019 School Year Dear Parents/Guardians of Students in Texas Schools, Kindergarten through 12th Grade: State law requires students in Texas schools

Más detalles

MVISD BACK TO SCHOOL IMMUNIZATIONS

MVISD BACK TO SCHOOL IMMUNIZATIONS MVISD BACK TO SCHOOL IMMUNIZATIONS Texas law requires all public-school children to have current immunizations to attend class. Generally, if your child is on schedule with shots, he/she will be needing

Más detalles

Texas Minimum State Vaccine Requirements for Child-Care and Pre-K Facilities

Texas Minimum State Vaccine Requirements for Child-Care and Pre-K Facilities 2017-2018 Texas Minimum State Vaccine Requirements for Child-Care and Pre-K Facilities This chart summarizes the vaccine requirements incorporated in the Texas Administrative Code (TAC), Title 25 Health

Más detalles

Texas Minimum State Vaccine Requirements for Students Grades K-12

Texas Minimum State Vaccine Requirements for Students Grades K-12 2014-2015 Texas Minimum State Vaccine Requirements for Students Grades K-12 This chart summarizes the vaccine requirements incorporated in the Texas Administrative Code (TAC), Title 25 Health Services,

Más detalles

TEXAS DEPARTMENT OF STATE HEALTH SERVICES

TEXAS DEPARTMENT OF STATE HEALTH SERVICES TEXAS DEPARTMENT OF STATE HEALTH SERVICES JOHN HELLERSTEDT, M.D. COMMISSIONER P.O. Box 149347 Austin, Texas 78714-9347 1-888-963-7111 TTY: 1-800-735-2989 www.dshs.state.tx.us July 19, 2016 RE: Required

Más detalles

Huntington Union Free School District

Huntington Union Free School District 2018-2019 School Year Immunization Requirements for all HUFSD Students Immunization Requirements for Students in Kindergarten, Grades 1, 2, 3, & 4 New York State Law Section 2164 requires certain immunizations

Más detalles

*School City State YOU MUST HAVE THE FOLLOWING DOCUMENTATION FOR ENROLLMENT

*School City State YOU MUST HAVE THE FOLLOWING DOCUMENTATION FOR ENROLLMENT a. A. b. PALESTINE HIGH SCHOOL STUDENT REGISTRATION 2015-2016 Student First Name: Student Middle Name Student Last Name: Grade Level: *What School District are you coming from? *School City State YOU MUST

Más detalles

GUIDE TO THE REQUIREMENTS OF THE CALIFORNIA SCHOOL IMMUNIZATION LAW FOR Parents of Children In or Entering School or Child Care REFERENCE Health and Safety Code, Division 105, Part 2, Chapter 1, Sections

Más detalles

PALESTINE HIGH SCHOOL STUDENT REGISTRATION STUDENT INFORMATION

PALESTINE HIGH SCHOOL STUDENT REGISTRATION STUDENT INFORMATION a. A. b. PALESTINE HIGH SCHOOL STUDENT REGISTRATION 2018-2019 STUDENT INFORMATION Grade Level: First Name: Middle Name: Last Name: YOU MUST HAVE THE FOLLOWING DOCUMENTATION FOR ENROLLMENT RESIDENCY: Proof

Más detalles

Opp Elementary School APPLICATION FOR STUDENT ENROLLMENT PLEASE PRINT Must be completed by Parent/Legal Guardian SCHOOL YEAR:

Opp Elementary School APPLICATION FOR STUDENT ENROLLMENT PLEASE PRINT Must be completed by Parent/Legal Guardian SCHOOL YEAR: Opp Elementary School APPLICATION FOR STUDENT ENROLLMENT PLEASE PRINT Must be completed by Parent/Legal Guardian SCHOOL YEAR: 2017-18 DATE: _ SCHOOL: OPP ELEMENTARY SCHOOL GRADE: FIRST NAME: MIDDLE NAME:

Más detalles

CELINA ISD REGISTRATION INFORMATION GRADES PK - 12

CELINA ISD REGISTRATION INFORMATION GRADES PK - 12 CELINA ISD REGISTRATION INFORMATION GRADES PK - 12 Parent/Guardian must provide: 1) withdrawal form from previous school (if during actual school year, not in summer) 2) copy of student s certified birth

Más detalles

June 7-12 Waterstone Community Church June 7 12 Waterstone Community Church COLORADO LAW REQUIRES THAT THIS FORM BE COMPLETED FOR EACH STUDENT ATTENDING COLORADO SCHOOLS Name Date of Birth Parent/Guardian

Más detalles

West Linn-Wilsonville School District 3Jt Administration Building

West Linn-Wilsonville School District 3Jt Administration Building West Linn-Wilsonville School District 3Jt Administration Building April 2017 Dear Parent, Every year Immunization data is collected by the State of Oregon for each school. We are now required to make this

Más detalles

CAPS Referral Form for Georgia s Pre-K Program School Year to This form should be completed and submitted by the Parental Authority not the Pre-K provider. If you currently receive assistance through the

Más detalles

CELINA ISD REGISTRATION INFORMATION GRADES PK - 12

CELINA ISD REGISTRATION INFORMATION GRADES PK - 12 CELINA ISD REGISTRATION INFORMATION GRADES PK - 12 Revised May, 2018 Parent/Guardian must provide: 1) withdrawal form from previous school, if enrolling during the school year. *not required in summer

Más detalles

For Parents and Caregivers

For Parents and Caregivers Who Qualifies How to Enroll WHO QUALIFIES FOR WIC: HOW TO ENROLL IN WIC: You must Bring the infant or child to the WIC office to complete initial enrollment. If the infant or child can t be there because

Más detalles

Influenza (Flu) Hepatitis A (Hep A)

Influenza (Flu) Hepatitis A (Hep A) MINIMUM NUMBER OF DOSES REQUIRED FOR CERTIFICATE OF IMMUNIZATION Kindergarten through 12 th grade: 2016-17 SY - Required for School Attendance RECOMMENDED VACCINES FOR THE BEST PROTECTION AGAINST VACCINE-

Más detalles

Enrollment Forms Packet

Enrollment Forms Packet Enrollment Forms Packet Texas Virtual Academy @ Southwest Enrollment Processing Center 104 Industrial Blvd, B-2 Sugar Land, TX 77478 Ph. 866.360.0161 Fx. 877.257.4612 www.txva.org Please review the table

Más detalles

Inspire.Innovate.Engage KINDERGARTEN PRE-REGISTRATION

Inspire.Innovate.Engage KINDERGARTEN PRE-REGISTRATION 1 2018-2019 KINDERGARTEN PRE-REGISTRATION Packet Must Be Returned By February 1 st, 2018 for Program Consideration District Office, Door A-2, 1936 Green Bay Rd, Highland Park, IL 60035 Monday Thursday

Más detalles

DANBURY MIDDLE SCHOOL

DANBURY MIDDLE SCHOOL Danbury Independent School District Student Data Form 2015 6 DANBURY MIDDLE SCHOOL For Middle School Students Only STUDENT INFORMATION Student Name: First Middle Last SSN: Date of Birth: Grade Level: Students

Más detalles

Santa Fe ISD New Enrollees Packet

Santa Fe ISD New Enrollees Packet Santa Fe ISD New Enrollees Packet 2013 14 Checklist 1. Application for Admission 2. Home Language Survey 3. Ethnicity and Race Data Questionnaire (English/Spanish) 4. Migrant Education Program Employment

Más detalles

Forma de Registro para PRE-K -Perryton ISD

Forma de Registro para PRE-K -Perryton ISD Forma de Registro para PRE-K -Perryton ISD Primer Nombre Legal: Segundo Nombre: Apellido Legal: Seguro Social: Sexo: Fecha de Nacimiento: Lugar de Nacimiento: Información de Padres/Guardián 1. Relación

Más detalles

Formulario de Certificado de Residencia

Formulario de Certificado de Residencia 16717 Ella Blvd. Houston, Texas 77090 www.springisd.org Formulario de Certificado de Residencia 2017-18 Fecha (Mes, Día, Año) NOMBRE DEL ESTUDIANTE NOMBRE DE LA ESCUELA GRADO Por la presente certifico

Más detalles

Phelan Language Academy DUAL LANGUAGE IMMERSION Providing a World of opportunities for students DUAL LANGUAGE IMMERSION APPLICATION FORM

Phelan Language Academy DUAL LANGUAGE IMMERSION Providing a World of opportunities for students DUAL LANGUAGE IMMERSION APPLICATION FORM Phelan Language Academy DUAL LANGUAGE IMMERSION Providing a World of opportunities for students DUAL LANGUAGE IMMERSION APPLICATION FORM PLEASE NOTE: Applications need to be received by the due date and

Más detalles

How many kids at Centennial CTP School are vaccinated?

How many kids at Centennial CTP School are vaccinated? 10 9 8 7 6 5 4 3 2 1 How many kids at Centennial CTP School are vaccinated? MARCH 2018 DTaP/Tdap Polio Varicella Measles Mumps/ Rubella % Nonmedical Exemptions % Vaccinated 10 10 10 10 10 10 Number of

Más detalles

FERRIS INDEPENDENT SCHOOL DISTRICT NONRESIDENT STUDENT REQUEST TO TRANSFER INTO THE DISTRICT SCHOOL YEAR

FERRIS INDEPENDENT SCHOOL DISTRICT NONRESIDENT STUDENT REQUEST TO TRANSFER INTO THE DISTRICT SCHOOL YEAR FERRIS INDEPENDENT SCHOOL DISTRICT NRESIDENT STUDENT REQUEST TO TRANSFER INTO THE DISTRICT SCHOOL YEAR 2018-2019 1. STUDENT S NAME: 2. CURRENT ADDRESS: 3. SCHOOL DISTRICT IN WHICH THE STUDENT RESIDES:

Más detalles

Inscripción para la evaluación preescolar

Inscripción para la evaluación preescolar Inscripción para la evaluación preescolar INFORMACIÓN GENERAL E INSTRUCCIONES: El padre, la madre o el tutor del menor debe llenar la página 1 del formulario de inscripción. La página 2 es para uso exclusivo

Más detalles

Application for Admissions School Year: Class of 2020

Application for Admissions School Year: Class of 2020 For Office Use Only: Date Received: Administration Fr. Tom Schrader, President Ms. Karen Hopson, Principal Mr. Michael Beaven, Vice Principal/ Dean of Students 708 N. 18th Street Kansas City, KS 66102

Más detalles

Child-Care Facilities

Child-Care Facilities 2009-2010 Texas Minimum State Vaccine Requirements for Child-Care Facilities AUTHIZATION INSTRUCTIONS This chart summarizes the vaccine requirements incorporated in Title 25 Health Services, 97.61-97.72

Más detalles

Texas Education Data Standards (TEDS) Public Education Information Management System (PEIMS)

Texas Education Data Standards (TEDS) Public Education Information Management System (PEIMS) Texas Education Data Standards (TEDS) Public Education Information Management System (PEIMS) Appendix 8.F PEIMS Supplemental Information for Ethnicity and Race Data Reporting December 1, 2013 Prepared

Más detalles

Encl.: Teacher/Teacher Assistant Information Request Form

Encl.: Teacher/Teacher Assistant Information Request Form To: All Parents/Legal Guardians in Title I Schools From: Charlotte-Mecklenburg Schools Title I Department Date: September 27, 2017 Subject: Right to Know Notification to Parents of Teacher and Teacher

Más detalles

Frequently Asked Questions Vaccine Exemption for Reasons of Conscience

Frequently Asked Questions Vaccine Exemption for Reasons of Conscience Q. How do I obtain a vaccine exemption for reasons of conscience? Frequently Asked Questions Vaccine Exemption for Reasons of Conscience A. You must request a vaccine exemption affidavit form by submitting

Más detalles

DCHHS. Safe families, healthy lives. Dallas County Health and Human Services. April 1, Dr. Steven Harris Medical Director

DCHHS. Safe families, healthy lives. Dallas County Health and Human Services. April 1, Dr. Steven Harris Medical Director Medical April 1, 2011 To parents of school-aged children: would like to remind you that state law requires school-aged children to be immunized before they are allowed to attend classes at the beginning

Más detalles

PARENT / GUARDIAN INFORMATION. FIRST NAME / PRIMER NOMBRE* LAST NAME / APELLIDO* BIRTHDATE mm/dd/yyyy / FECHA DE NACIMIENTO mm/dd/aaaa

PARENT / GUARDIAN INFORMATION. FIRST NAME / PRIMER NOMBRE* LAST NAME / APELLIDO* BIRTHDATE mm/dd/yyyy / FECHA DE NACIMIENTO mm/dd/aaaa PARENT NAME / PADRE NOMBRE PARENT ID ** / ID DE PADRE *** PARENT / GUARDIAN INFORMATION **If you were given a login that looks like this: 12345@osd Please enter just the numbers here. *** Si le dieron

Más detalles

Raul Yzaguirre Schools for Success ENROLLMENT FORMS

Raul Yzaguirre Schools for Success ENROLLMENT FORMS Has student ever been enrolled in Raul Yzaguirre Schools for Success Yes No The information on this form is pertinent to your child s cumulative record, if enrolled. Please fill out as accurately as possible.

Más detalles

Verification Worksheet V4 D I

Verification Worksheet V4 D I Last Name: First Name: ID: (print clearly) 2018 2019 Verification Worksheet V4 D I Before your financial aid for the 2018/2019 award year can be finalized, federal regulations require that certain data

Más detalles

TEXAS DEPARTMENT OF STATE HEALTH SERVICES

TEXAS DEPARTMENT OF STATE HEALTH SERVICES TEXAS DEPARTMENT OF STATE HEALTH SERVICES DAVID L. LAKEY, M.D. COMMISSIONER P.O. Box 149347 Austin, Texas 78714-9347 1-888-963-7111 TTY: 1-800-735-2989 www.dshs.state.tx. us March 10,2011 RE: Required

Más detalles

Matriculación de alumnos- Lista de requisitos. Matriculación de alumnos- Lista de requisitos

Matriculación de alumnos- Lista de requisitos. Matriculación de alumnos- Lista de requisitos 141 Old San Antonio Road 830-357-4600 phone Boerne, TX 78006 830-357-4699 fax Matriculación de alumnos- Lista de requisitos Alumnos serán asignados a un salón cuando todos los documentos requeridos en

Más detalles

New Student/Parent Enrollment Instructions

New Student/Parent Enrollment Instructions New Student/Parent Enrollment Instructions Instruciones para Inscripción de Nuevo Estudiante/Padre al distrito 1) If you don t have a Skyward user id and password and have never had a student at LISD,

Más detalles

Back to School Night August 17, :00-7:00pm

Back to School Night August 17, :00-7:00pm THUNDER NEWS Back to School Night August 17, 2015 6:00-7:00pm School starts Thursday August 20, 2015 at 7:55am CONTENTS INFORMATION......2 CALENDAR...3 BACK TO SCHOOL NIGHT.3 BELL/LUNCH SCHEDULE..4 IMMUNIZATIOS.4

Más detalles

Current Grade Date of Birth / / Grade entering

Current Grade Date of Birth / / Grade entering Frontier School of Innovation 6700 Corporate Dr. Phone: 816-363-1907 (E): 816-241-6202 (MS) Fax: 816-363-1165 (E): 816-241-6207 (MS) http://www.kcfsi.org STUDENT INFORMATION Frontier STEM High School 6455

Más detalles

APPENDIX F. Supplemental Information for Reporting Ethnicity and Race Data Reporting

APPENDIX F. Supplemental Information for Reporting Ethnicity and Race Data Reporting APPENDIX F Supplemental Information for Reporting Ethnicity and Race Data Reporting Summary of Requirements 1. The USDE requires that ethnicity and race be collected separately using a specific two-part

Más detalles

Civil Rights Complaint Form

Civil Rights Complaint Form Civil Rights Complaint Form Title VI of the 1964 Civil Rights Act and related non-discrimination statutes and regulations require that no person in the United States shall, on the ground of race, color,

Más detalles

Revised 04/12/2010 Page 1 of 2. Birth Certificate ID # Immunization Records. Residential Address / La Dirección Residencial

Revised 04/12/2010 Page 1 of 2. Birth Certificate ID # Immunization Records. Residential Address / La Dirección Residencial Revised 04/12/2010 Page 1 of 2 MAGNOLIA INDEPENDENT SCHOOL DISTRICT FOR OFFICE USE ONLY ENROLLMENT DOCUMENTS INITIAL STUDENT REGISTRATION & EMERGENCY INFORMATION FORM MAGNOLIA SIXTH GRADE CAMPUS 110 S.

Más detalles

Transitional Kindergarten Program Parent Request

Transitional Kindergarten Program Parent Request Date Received: / / Time Received: am / pm FOR OFFICE USE ONLY Transitional Kindergarten Program Parent Request Child s Name: (Please Print) First Middle Last Birth Date: / / Sex: M F Month Day Year Home

Más detalles

Nombre del estudiante

Nombre del estudiante Distrito Escolar de West Linn-Wilsonville Lista de Cotejo de Registro para Jardín de Niños 2018-2019 Le damos la bienvenida a Ud. y a su niño al Jardín de Niños! Sera un maravilloso año lleno de experiencias

Más detalles

PRE EVENT STUDENT SURVEY. Strongly Agree

PRE EVENT STUDENT SURVEY. Strongly Agree For each question, please check only one answer. 1. I identify as PRE EVENT STUDENT SURVEY American Indian or Alaskan Native Asian Black or African American Hispanic Native Hawaiian or Pacific Islander

Más detalles

Harden Middle School AVID APPLICATION

Harden Middle School AVID APPLICATION Incoming 7 th Date Submitted: Time: Person at HMS who received it: Harden Middle School AVID APPLICATION Your student is being recommended to participate in the AVID program at Harden Middle School. AVID

Más detalles

Rogers Public Schools where all belong, all learn, and all succeed

Rogers Public Schools where all belong, all learn, and all succeed Rogers Public Schools where all belong, all learn, and all succeed Dear Parent/Guardian: The District performs vision and hearing screenings on Kg, 1 st, 2 nd, 4 th, 6 th and 8 th grade students and transfer

Más detalles

Sample Parental Consent Letters

Sample Parental Consent Letters Sample Parental Consent Letters 2015-16 The following links provide sample parental consent letters that clients are welcome to edit for their own purposes. Under applicable federal, state, and local laws,

Más detalles

INTERNATIONAL ADMISSIONS

INTERNATIONAL ADMISSIONS INTERNATIONAL ADMISSIONS ADMISIONES INTERNACIONALES IMPORTANT: ENTIRE APPLICATION MUST BE COMPLETED. PLEASE READ CAREFULLY. IMPORTANTE: SE DEBE COMPLETAR TODA LA SOLICITUD. FAVOR DE LEER CON DETENIMIENTO.

Más detalles

Barbara Quaid. March 1, Dear Ventura County Teachers:

Barbara Quaid. March 1, Dear Ventura County Teachers: March 1, 2018 Dear Ventura County Teachers: The Ventura County Fair invites students to earn free carnival rides through our reading program, Read & Ride for local kindergarten through 8 th grade students.

Más detalles

Tyler ISD! Bienvenido a. Paquete de inscripción del estudiante

Tyler ISD! Bienvenido a. Paquete de inscripción del estudiante Bienvenido a Tyler ISD! 2015-2016 Paquete de inscripción del estudiante Favor de traer lo siguiente cuando venga a inscribir a su hijo(a): Acta de nacimiento del niño(a)-original Tarjeta del seguro social

Más detalles

Dos Palos Oro Loma Joint Unified School District Choice and SES

Dos Palos Oro Loma Joint Unified School District Choice and SES Dos Palos Oro Loma Joint Unified School District Choice and SES (Public School of Choice and Supplemental Educational Services) NCLB Report on Participation in Public School Choice and Supplemental Educational

Más detalles

Identity and Statement of Educational Purpose Instruction Sheet

Identity and Statement of Educational Purpose Instruction Sheet Identity and Statement of Educational Purpose Instruction Sheet You must appear in person at Midwestern State University Financial Aid Office (MSU-FAO) to present your governmentissued ID (such as driver

Más detalles

Diana Walsh-Reuss, Ed.D. Associate Superintendent

Diana Walsh-Reuss, Ed.D. Associate Superintendent Memorandum June 6, 2016 TO: FROM: Steven A. Hovey Chief Personnel Officer Division of Personnel Services Diana Walsh-Reuss, Ed.D. Associate Superintendent Division of Children and Family Services and Division

Más detalles

OREGON CITY SCHOOL DISTRICT DUAL LANGUAGE IMMERSION PROGRAM

OREGON CITY SCHOOL DISTRICT DUAL LANGUAGE IMMERSION PROGRAM OREGON CITY SCHOOL DISTRICT DUAL LANGUAGE IMMERSION PROGRAM 2016-17 Kindergarten Dual Language Immersion Program Application Dear Applicant, The Oregon City School District Dual Language Immersion Program

Más detalles

Gender: Female Ethnicity: Birthdate: (Mon/Date/Year) (Number) (Street) (City) (Zip)

Gender: Female Ethnicity: Birthdate: (Mon/Date/Year) (Number) (Street) (City) (Zip) Application Form Due March 17 th, 2017 Student's Name (Last, First): Gender: Female Ethnicity: Birthdate: Male (Mon/Date/Year) Home Address: (Number) (Street) (City) (Zip) Phone Number: ( ) Alt. Phone

Más detalles

HABERSHAM COUNTY SCHOOLS LAS ESCUELAS DEL CONDADO DE HABERSHAM ENROLLMENT/STUDENT INFORMATION FORM FORMA DE MATRICULACION

HABERSHAM COUNTY SCHOOLS LAS ESCUELAS DEL CONDADO DE HABERSHAM ENROLLMENT/STUDENT INFORMATION FORM FORMA DE MATRICULACION HABERSHAM COUNTY SCHOOLS LAS ESCUELAS DEL CONDADO DE HABERSHAM ENROLLMENT/STUDENT INFORMATION FORM FORMA DE MATRICULACION CHILD LIVES IN SCHOOL DISTRICT (PLEASE GIVE NAME OF ELEMENTARY SCHOOL) (distrito

Más detalles

STUDENT RESIDENCY QUESTIONNAIRE/AFFIDAVIT

STUDENT RESIDENCY QUESTIONNAIRE/AFFIDAVIT STUDENT RESIDENCY QUESTIONNAIRE/AFFIDAVIT This document is intended to address the McKinney-Vento Assistance Act. Your answers will help determine documents necessary to enroll your child quickly and determine

Más detalles

Civil Rights Complaint Form

Civil Rights Complaint Form Civil Rights Complaint Form It is the policy of the Greater Derry Salem Cooperative Alliance for Regional Transportation (CART) to uphold and assure full compliance with Title VI of the Civil Rights Act

Más detalles

Who: 3rd - 5th Where: TBD

Who: 3rd - 5th Where: TBD Who: 3rd - 5th Where: TBD Tuesdays, 3:15 p.m. - 4:15 p.m. Feb 5th - Apr 2nd Cost: FREE Club Organizer: Claudia Ortiz claudia.ortiz@austinisd.org We are capped at 16 students Registration forms due Jan

Más detalles

Employer Employer Address Phone. Phone: Home Work Cell

Employer Employer Address Phone. Phone: Home Work Cell PATIENT REGISTRATION Last Name First Name MI Date of Birth Age Social Security # Gender Marital Status Address Street Apt# City State Zip Phone: Home Work Cell E-Mail Occupation Retired: Yes No Employer

Más detalles

School Year New York State Immunization Requirements for School Entrance/Attendance 1

School Year New York State Immunization Requirements for School Entrance/Attendance 1 2016-17 School Year New York State Immunization Requirements for School Entrance/Attendance 1 NOTES: Children in a prekindergarten setting should be age-appropriately immunized. The number of doses depends

Más detalles

Frequently Asked Questions Vaccine Exemption for Reasons of Conscience

Frequently Asked Questions Vaccine Exemption for Reasons of Conscience Frequently Asked Questions Vaccine Exemption for Reasons of Conscience Q. How do I obtain a vaccine exemption for reasons of conscience for my child? A. Parents or guardians need to request a vaccine exemption

Más detalles

VERIFICATION WORKSHEET V4 custom VERIFICATION GROUP

VERIFICATION WORKSHEET V4 custom VERIFICATION GROUP 2017-2018 VERIFICATION WORKSHEET V4 custom VERIFICATION GROUP We ve reviewed your 2017 2018 Free Application for Federal Student Aid (FAFSA) and your application was selected for a review process called

Más detalles

Encl.: Teacher/Teacher Assistant Information Request Form. Turning Point Academy 8701 Moores Chapel Road Charlotte, North Carolina 28214

Encl.: Teacher/Teacher Assistant Information Request Form. Turning Point Academy 8701 Moores Chapel Road Charlotte, North Carolina 28214 To: All Parents/Legal Guardians in Title I Schools From: Charlotte-Mecklenburg Schools Title I Department Date: August 24, 2017 Subject: Right to Know Notification to Parents of Teacher and Teacher Assistant

Más detalles

Formulario de Postulación Universidad Católica Santo Toribio De Mogrovejo Estudiante de Intercambio Application Form / Exchange Student

Formulario de Postulación Universidad Católica Santo Toribio De Mogrovejo Estudiante de Intercambio Application Form / Exchange Student Formulario de Postulación Universidad Católica Santo Toribio De Mogrovejo Estudiante de Intercambio Application Form / Exchange Student Información Personal Personal Information: Nombre FIrst Name Apellido

Más detalles

CHANGE OF HOUSEHOLD COMPOSITION PACKET INSTRUCTIONS TO REMOVE A MEMBER

CHANGE OF HOUSEHOLD COMPOSITION PACKET INSTRUCTIONS TO REMOVE A MEMBER CHANGE OF HOUSEHOLD COMPOSITION PACKET INSTRUCTIONS TO Participant: REMOVE A MEMBER In an effort to ensure you and your household are served in a timely manner, we are requesting that you completely fill

Más detalles

SFGH FHC Healthy Children Vaccination Program Frequently Asked Questions

SFGH FHC Healthy Children Vaccination Program Frequently Asked Questions SFGH FHC Healthy Children Vaccination Program Frequently Asked Questions The Family Health Center (FHC) Healthy Children Vaccination Program at SF General Hospital (SFGH) provides immunization services

Más detalles

SECTION SD. HEALTH SERVICES

SECTION SD. HEALTH SERVICES SECTION SD. HEALTH SERVICES Note: Only Next-of-Kin Interviews (n=1,209). Some questions may have missing values if the section was not completed. Only n=7 observations were included in the final data sets

Más detalles

Basic Life Skills Lessons. Voice Mail Systems

Basic Life Skills Lessons. Voice Mail Systems Basic Life Skills Lessons Voice Mail Systems Voice Mail Systems Learning Objective: 1) Understand when and how to leave a, knowing what to include to ensure a call back 2) Know how to set-up an out-going

Más detalles

Eligibility List (EL) Application

Eligibility List (EL) Application Division of Early Learning Services Early Care and Education Parent(s) Information First Name: Middle Initial (MI): Last Name : Male Female Male Female Birth Date: Work Phone: Cell/Message: E-mail: Married:

Más detalles

Tips to Complete the USI International Student Application Consejos para completar la solicitud de admisión como estudiante internacional en USI

Tips to Complete the USI International Student Application Consejos para completar la solicitud de admisión como estudiante internacional en USI Tips to Complete the USI International Student Application Consejos para completar la solicitud de admisión como estudiante internacional en USI University of Southern Indiana no longer accepts paper applications.

Más detalles

(School District Name) (School District Address) (School District Phone Number) HOME LANGUAGE SURVEY

(School District Name) (School District Address) (School District Phone Number) HOME LANGUAGE SURVEY HOME LANGUAGE SURVEY STAFF MEMBERS: This form must be completed for all students registering in To Be Completed by Parent of Guardian: Student Name: Date of Birth Last First Middle Mo. Day Yr. Parent(s)

Más detalles

TRENTON BOARD OF EDUCATION ''Children Come First, Los Niños son Primeros." Lucy Feria Micah Bradley-Freeman, MSN RN Interim Superintendent of School Supervisor of Nurses 609.656.4900 609.989.2682 fax lferia@trenton.k12.nj.us

Más detalles

Home Access Center Matriculación Electrónica Verificación Del Estudiante

Home Access Center Matriculación Electrónica Verificación Del Estudiante Home Access Center Matriculación Electrónica Verificación Del Estudiante Los padres o tutores que tienen una cuenta de correo electrónico existente en los archives de la escuela de su hijo/a recibirán

Más detalles

Benedictine College Financial Aid

Benedictine College Financial Aid 2018 2019 Institutional Verification Document V4 Dependent Your 2018 2019 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law states that

Más detalles

Child-Care Facilities

Child-Care Facilities 2010-2011 Texas Minimum State Vaccine Requirements for Child-Care Facilities AUTHIZATION This chart summarizes the vaccine requirements incorporated in Title 25 Health Services, 97.61-97.72 of the Texas

Más detalles

WHCS. Washington Heights Choir School Escuela de Coro de Washington Heights. an after school program un programa después de la escuela

WHCS. Washington Heights Choir School Escuela de Coro de Washington Heights. an after school program un programa después de la escuela WHCS Washington Heights Choir School Escuela de Coro de Washington Heights an after school program un programa después de la escuela APPLICATION FORM FORMULARIO DE INSCRIPCIÓN Please print neatly and complete

Más detalles

Online Registration Inscripción Electrónica

Online Registration Inscripción Electrónica Online Registration Inscripción Electrónica For Parents that already have or had students in LISD Para los Padres que ya tienen o tenía estudiantes en LISD 1. Login to the Family Portal using your Login

Más detalles

EXCHANGE STUDENT APPLICATION FORM

EXCHANGE STUDENT APPLICATION FORM EXCHANGE STUDENT APPLICATION FORM (FORMULARIO DE INSCRIPCIÓN ESTUDIANTES DE INTERCAMBIO) Date of application: / / (Fecha de inscripción) (dd) (mm) (yy) Personal Data (Datos personales) Last names: (Apellidos)

Más detalles

The Home Language Survey (HLS) and Identification of Students

The Home Language Survey (HLS) and Identification of Students The Home Language Survey (HLS) and Identification of Students The Home Language Survey (HLS) is the document used to determine a student that speaks a language other than English. Identification of a language

Más detalles

Employee s Injury Report / Informe de lesión de empleado

Employee s Injury Report / Informe de lesión de empleado Claims Administrative Services Phone: 800-765-2412 Fax: 903-509-1888 501 Shelley Drive Claims Administrative Services, Inc. Tyler, Texas 75701 Our reputation for excellence is no accident. / Nuestro prestigio

Más detalles

Formulario de matricula estudiantil

Formulario de matricula estudiantil Formulario de matricula estudiantil This Space for Office Use Only Student s Current Grade ID# Date of Enrollment / / Withdrawal Date / / Datos del estudiante Nombre del estudiante: Apellido Nombre de

Más detalles