2016 - 2017 ____________________________________ __________ __________________ Student Name Grade Teacher NEW STUDENT __________ Enrollment Form __________ Parents Application for Student Transfer (If from another district) __________ Request for Student Records __________ Discipline Authorization __________ Classroom Discipline Plan __________ Authorization for Emergency Care for Minor __________ Child Pick Up Permission Form __________ Talent Release __________ Release of All Claims (Climbing Wall) __________ Impact Aid Survey Form __________ Title VII (506) __________ Internet Safety Policy __________ Parent-School Compact __________ Enrollment (After School Program) __________ After-School Emergency & Trip Authorization __________ Lunch Application/Letter to Household (Only one per household) – Separate Sheets Information Sheets Included in Enrollment Packet: Immunization Schedule, School Calendar, School Supply List Please provide copies: __________ Social Security Card __________ Birth Certificate __________ CDIB Card __________ Citizenship – Card or Certificate __________ Shot Records Revised 6/2016
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NEW STUDENT - Cloud Object Storage | Store & Retrieve ... DISCIPLINE POLICY 1st Trip to Office – Verbal warming and 30 minutes detention 2nd Trip to Office – Parent conference
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Enter information in this section regarding the parent/guardian if either person was on active duty in the Uniformed Services of the United States on
the survey date.
Parent/Guardian’s Last Name First Name and M.I. Branch of Service Rank
PARENT/GUARDIAN EMPLOYMENT INFORMATION: FOREIGN MILITARY
Enter information in this section regarding the parent/guardian if either person was both an accredited foreign government official and a foreign
military officer on the survey date.
Parent/Guardian’s Last Name First Name and M.I. Branch of Service Rank
Name of Foreign Government
PARENT/GUARDIAN EMPLOYMENT INFORMATION: FARMING, GRAZING, LUMBERING AND MINING
Enter information in this section if either the parent or guardian spent more than 50 percent of his or her working time on federal property (whether as
an employee or self-employed) engaged in farming, grazing, lumbering or mining.
Parent/Guardian’s Last Name First Name and M.I. Name of Parent's/Guardian’s Employer
Address of Parent/Guardian’s Employer City State Zip Code
Name of federal property Address of federal property
Permit Number Township Range Section
This information is the basis for payment to your school district of federal funds under the Impact Aid Program (Title VIII of the Elementary and
Secondary Education Act), and may be provided to the U.S. Department of Education if your school district’s application for payment is audited.
This form must be signed and dated for your school district to receive funds based on this information.
Signature of Parent/Guardian________________________________Date_________________
Cottonwood Public School Internet Safety Policy
The following is a contract between the student parent or guardian, and the school system. Please read carefully before signing. With access to such vast storehouses of information and instant communication with millions of people from all over the world, material will be available that may not be considered to be of educational value by the District or which is inappropriate for distribution to children. Cottonwood has taken available precautions, including but not limited to enforcing the use of filters that block access to obscenity, child pornography and other materials harmful to minors. However, on a global network, it is impossible to control all material and an industrious user may obtain access to inappropriate information or material. The District firmly believes that the value of the information and interaction available on the Internet far outweighs the possibility that students and employees may procure material which is not consistent with our educational goals. It is all staff members’ responsibility to educate students about appropriate online behavior, including interactions with other individuals on social networking sites/chat rooms, and cyber bullying awareness and response. This may be done in a variety of ways, such as once a year short training sessions, one-on-one education with individual students, and/or via educational handouts. It is also the responsibility of all staff members to monitor students’ online activity for appropriate behavior.
As a student I agree to the following terms and conditions: I will not use the Internet for transmission of any materials in violation any federal or state
regulations. Transmission of copyrighted material threatening or obscene materials, materials protected by trade secrets, product advertisement or political lobbying is also prohibited.
I will refrain from using profanity and vulgarities on the Internet. I will not use the Internet for illegal activities.
I will not give my home address, location of my school phone number or any personal information about myself or and other student or school personnel to anyone via the Internet.
I understand that use of e-mail or any other communications over the Internet are not private; any messages related to or in support of illegal activities may be reported to authorities.
I understand that I am prohibited from conducting any actions that may endanger my safety, or the safety of other students/staff members while using any component of the school’s internet access and/or network (email, chat rooms, etc.).
I will not use the Internet in a way that would disrupt the use of the network by others.
I will respect the trademark and copyrights of materials on the Internet and assume anything accessed via the network is private property.
The school system and service provider are not responsible for any damages or losses resulting from using Internet services or information obtained from the Internet.
If you discover any way to access unauthorized information or defeat any security measures you must inform the lab teacher immediately. You must not share any unauthorized information with any other user.
Vandalism of any kind is prohibited.
These terms and conditions shall be governed and interpreted in accordance with the laws of the state and the United States of America.
I understand access to the Internet through Cottonwood Public School is a privilege. School authorities can deny any student access to the Internet at any time, and their decisions are final.
My instructor/school sponsor has explained the terms and conditions for using the Internet to me and I agree to abide by them. Student's Signature: _____________________________________________________ Date ________________ I have read the above forms and conditions and understand that violation of these can result In the denial of Internet privileges. I also agree not to hold the school, state and local boards of education or the Internet provider responsible for the consequences resulting from the violation of these terms and conditions by the student Parent/Guardian's Signature: ______________________________________________ Date __________________
Please note: This Internet Safety Policy agreement will remain in effect as long as your child
is attending Cottonwood Public School.
Cottonwood School Parent-School Compact
It is important that families and schools work together to help students achieve high academic standards.
Through a process that included teachers, families, students, and community representatives, the following are
agreed upon roles and responsibilities that we as partners will carry out and to support student success in school
and in life.
As a STAFF MEMBER, I will provide your child with every opportunity to learn and grow by:
Maintaining a quiet and organized workplace;
Having a high expectation of myself and my students;
Giving instruction and assignments appropriate for the skill and development required by state and
district standards;
Monitoring student work on a daily basis to ensure success and progress; and
Reporting regularly to parents with returned work, written notices, and conferences.
As a STUDENT, I will keep my focus on what is important in meeting my goal of learning by:
Being in class on time, every day, with my homework in hand and prepared to work;
Allowing the teacher to teach and everyone in class to learn;
Completing my work on time and accurately;
Keeping my hands, feet, objects and comments to myself; and
Respecting others and their property.
As a PARENT/GUARDIAN, I will support Cottonwood School’s programs and activities that give my child the
optimum opportunity for learning by:
Expecting my child to complete daily homework assignments independently and discuss his/her results
for improved learning, and check for a timely return to school;
Accentuating the positive events at school and help my child resolve issues of concern and conflict;
Supporting the discipline policy and reinforcing the highest expectations for the school staff;
Reading to and listening to my child read daily as a way of building a lifelong interest and joy of
reading;
Seeing that my child gets adequate rest and is in school on time with a positive outlook;
Attending conferences to discuss my child’s progress and attending events which showcase my child’s
work and learning experiences; and
Providing and maintaining accurate information on my child’s records for contact.
Parent/Guardian: Date:
Student: Date:
Teacher: Date:
Principal: Date:
COTTONWOOD PUBLIC SCHOOL
AFTER-SCHOOL ENROLLMENT FORM Available: Monday – Thursday 4:15 to 5:15PM
CHILD’S NAME __________________________________________ DATE_______________________
PLACE OF EMPLOYMENT______________________________________________________
WORK PHONE_________________________________________________________________
SOCIAL SECURITY #___________________________________________________________
PLEASE CHECK ALL THAT APPLY: RACE
___________MALE _______WHITE
___________FEMALE _______BLACK
_______HISPANIC
_______NATIVE AMERICAN
_______CDIB
_______ASAIN
_______OTHER__________________________
TRANSPORTATION
______ I WILL PICK UP MY CHILD.
______ MY CHILD WILL RIDE THE COTTONWOOD BUS.
______ MY CHILD WILL RIDE THE BIG FIVE BUS.
ATTENDANCE
______ MY CHILD WILL ATTEND ONE OR MORE DAYS A WEEK.
______ MY CHILD WILL NOT ATTEND AT LEAST ONE DAY A WEEK.
COTTONWOOD PUBLIC SCHOOL AFTER SCHOOL EMERGENCY RELEASE &
FIELD TRIP PERMISSION
CHILD’S NAME___________________________________________________ DATE_______________________________________ PARENT/GUARDIAN’S NAME_________________________________________ IN CASE OF EMERGENCY, PLEASE CALL