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    22 views17 pages

    Student Handbook 14-15 038

    Uploaded by

    api-320732143

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 17
    EMERGENCY CONTACTS (Please provide three) Name Phone#t Name - ___ Phone# Name Phone#t Please mark yes or no for each item below O¥es No My child has permission to purehase/charge extra milk. O¥es ONo My child has permission to purchase/charge seconds on their meal OYes No My child has permission to eat school breakfast. OYes No The school has my permission to publish my child’s picture in the local media. DYes No The school has my permission to publish my child’s name in the local media, DYes No The school has my permission to publish my child’s name and picture in the yearbook. Yes No have received and read the Hillcrest Student Handbook PERMISSION FOR ACTIVITIES AND MEDICAL EMERGENCIES give permission for my child to participate in extra-curricular activities during the current school year. This includes permission to practice in sports activities and walk or be bused to and from schools for assemblics, field day and all school functions. I also grant permission for my child to ride the bus to events scheduled out-of-town and will be responsible for their actions. I understand it may sometimes be necessary to leave during school time. I assume responsibility for my child in the event any equipment or school facility is damaged during this time. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment and x-ray examinations for my child. In the event of serious illness, the need for major surgery, or significant accidental injury, I understand that an attempt well be made by the attending physician to contact me in the most expeditious way possible. If said physician is not able to communicate with me, the treatment necessary for the best interest of my child may be given. In the event an emergency arises while at school, an effort will be made to contact the parents or guardians as soon as possible, Permission is granted to the school to provide the needed emergency ‘treatment to the student prior to his/her admission to the medical facilities. DATE SIGNATURE _ (PARENT OR GUARDIAN) Dear Parents/Guardians, Harlowton Public Schools is initiating a new mode of communication to keep families and students informed of announcements'and changes as they happen at the school. Such changes may include open house announcements, concert dates, game schedule or time changes, emergency situation information, ete. The messenger mode works within our Infinite Campus system to send instant messages to email addresses, cell phones, and home phone numbers. Please provide your personal information below and return this form to the school as soon as possible so we can add you to the messenger system, Even though we may have some of the contact information for you, numbers may have changed or it may be incomplete, We will update our files so the information is current. ‘Thank you for your cooperation. Harlowton Public Schools Please print all information. Student Name(s), Parent/Guardian Name(s) Home phone Cell phone: __ Student's cell phone Is it okay to send a text message to the above cell phones: Yes No Parent/Guardian Email Address: COMPUTER ACCEPTABLE USE AGREEMENT Every student, regardless of age, must read and sign below: | have read, understand, and agree to abide by the terms of the Harlowton School District's policy regarding acceptable use of technology. (A copy of Policy #3610 — District Provided Access to Electronic Information, Services, and Networks and Policy #3615 - Acceptable Use of Electronic Networks is available for review in the office and the school website. Should | commit any violation or in any way misuse my access to the District's computer network and/or the Internet, | understand and agree that my access privilege may be revoked and school disciplinary action may be taken against me. Users Name (Print): Home Phone’ User's Signature: Date _ Address’ — Status: Student___Staff__ Patron __ 1am 18 or older___f amunder 18 If am signing this policy when | am under 18, | understand that when | turn 18, this policy will continue to be in full force and effect and agree to abide by this policy. Parent or Legal Guardian. (If applicant is under 18 years of age, a parent/legal guardian must also read and sign this agreement.) As the parent or legal guardian of the above-named student, | have read, understand, and agree that my child shall comply with the terms of the District's policies regarding District-Provided Access to Electronic Information, Services, and Networks and Acceptable Use of Electronic Networks for the student's access to the District's computer network and/or the Internet. | understand that access is being provided to the students for educational purposes only. However, | also understand that it is impossible for the school to restrict access to all offensive and controversial materials and understand my child's responsibility for abiding by the policy. | am, therefore, signing this Agreement and agree to indemnify and hold harmless the District, the Trustees, Administrators, teachers, and other staff against all claims, damages, losses, and costs, of whatever kind, that may result from my child's use of or access to such networks or his/her violation of the District's policy. Further, | accept full responsibility for supervision of my child’s use of his/her access account if and when such access is not in the school setting. | hereby give my child permission to use the building- approved account to access the District's computer network and the Internet. Parent/Legal Guardian (Print): Signature: Home Phone: ‘Address: Date: _ This Agreement is valid for the 2014-2015 school year only. Montana Authorization to Carry and Self-Administer Asthma Medication For this student to carry and self-administer asthina medication on school grounds ot far school sponsored activities, this form must be fully completed by the prescribing physician/provider and an authorizing parent ot legal guardian, Student's Name: - School: Sex: (Please circle) Female/Male CityrTov 7 Birthdate: 0 / School Year: ___(Renew each year) Physician's Authorization: ‘The above named student has my authorization to carry and self administer the following medication: Medication: (1) Dosage: (1), 2 @), Reason for prescription(s) Medication(s) to be used under the following conditions: | confirm that this student has been instructed in the proper use of this medication and is able to self-administer this medication on his own with out school personae! supervision, 1 have provided a written treatment plan for managing asthma or anaphylaxis episddes and for medication use by this student during school hours aud school activities. Signanae ofPhyacan —_.—»PyteiavsPhoneNoniber. = Date Backup Medication ~ The law provides that the chs Realh Ce provder prescribes “backup” medical the schoo, it must be kept ina predetermined location known to the child, parent and schoo! staff | ‘The following backup tnedication has been provided for this student: L For Completion by Parent or Guardian : + As the parent/guardian ofthe above named student, I confirm that this student has been instructed by his/her health care provider on the proper use of this/these medication(s). He/she has demonstrated to me that helshe understands the proper use ofthis medication. Helshe is physically, mentally and behaviorally capable to assume this responsibility. He/she has ‘my permission to self medicate as listed above if needed. If he/she has used an auto-njectible epinephrine, he/she > understands the need to alert an adult that emergency medical personnel need to be calle. If he/she has used his/her asthma inhaler as prescribed and does not have relief from an asthma attack, he/she understands to alert an adult + also acknowledge tha the schoo! district or nonpublic school may not incur liability as result of any injury arising fom the seli-administration of medication by the pupil and that I shall indemmify and hold harmless the school distriet or nonpublic school and its employees and agents against any claims, except a claim based on an actor omission that isthe result of gross negligence, willful and wanton conduct, or an intentional tort, + agree to also work with the schoo! in establishing a plan for use and storage of backup medication if prescribed by my child's physician, This will include a predetermined location to keep back up medication to which my child has access in the event ofan asthma or anaphylaxis emergency. + Authorization is hereby granted to release this information to appropriate school personel and classroom teacbers. + Tunderstand in the event that the medication dosage is altered, a aew “self-administration form” must be completed, or the physician may re-write the order on his prescription pad and I, the parent guardian, wll sign the new forin and assure the new order is attached + Tunderstand its my responsibility to pick up any unused medication at the end of the school year, and that medication that is not picked up willbe disposed of above Parent/Guardian Signature: Date:_ (Original signed authorization fo the school, a copy of the signed authorization to the paren¥guardian and health care provider) 06/08 Applying for Free and Reduced Price School Meals Helping your budget and your community Who Should Apply? Families that meet the income guidelines stated on the application (attached) should consider applying for Free and Reduced Priced Meals. Benefits of School Meals: - School meals could provide your child with up to 10 meals a week (breakfast and lunch). - School Meals meet the Federal Nutrition Standards and provide a healthy and balanced meal. School Meals provide valuable employment for many food service workers across the state, How to Apply: Fill out the application enclosed in this packet and turn it into the school office. If your family qualifies for SNAP benefits (Food Stamps) you do not have to fill out the School Meals application, Just bring in your benefit award letter that you received from the SNAP office to your child's school office. You may also write in your SNAP case number in the space provided on the application. When to Apply: You can apply for Free and Reduced Priced School Meals at any point throughout the year! You may also reapply at any time if your situation changes. School Meals and The Summer Food Service Program Applying for Free and Reduced Price School Meals can help your community beyond the school year. Participation in Free and Reduced Priced School Meals can help a school qualify for The Summer Food Service Program (SFSP), SFSP provides free meals to children during the summer when school is not in session. A school must have a certain number of children eligible for Free and Reduced Priced Meals in order to have ‘a Summer Food site. So signing up for Schoo! Meals can help provide more than just school time nutrition for many families in your community. Remember: If you sign up for School Meals you do not have to use the benefits. You may choose to pay for your child’s meals or pack thelr lunch if you prefer. But by signing up, you can help your school qualify for SFSP. Funding for the Fresh Fruit and Vegetable Program, equipment grants, and many other school grant opportunities are also dependent on the percent of children eligible for Free and Reduced Price Schoo! Meals. = Haroon Hoh Schoo (as) 2.04» FAKE) 82.4816 (tts ete) ear Parent/Guardian: tore Somentery (08) 632-4351 « FAX) 682.4744 Harlowton Public Schools Schoo! Dishict No. 16 — P.O. 0x288 ~ 304 Divslon — Harlowton, Montana $9036-0288 ildren need healthy meals to earn. Harlowton Schoo! District offers healthy meals every school day. Your children may qualify for free meals or jor reduced price meals. Below are some common questions and answers to aid inthe process of determining your ehil’s eligi. 1, 001 NEO TO FILL OUT AN APPLICATION FOR EACH CHILD? No. Use one Free and Reduced Price School Meals Application forall stufents in your household, We cannot approve an application that isnot complete, so be sute to fill out all required information. Return the completed application to one af your children's school. 2. WHO CAN GET FREE MEALS? All children in households receiving benefits from the Supplemental Nutrition assistance Program (SNAP), the Food Distribution Program on Indian Reservations (FDPIR) or, in some States, Temporary Assistance for Needy Families (TANF, can get Free meals regardless of your income. Also, your children can get free meals if your househol’s gross income is within the free limits ‘on the Federal Income Eligibility Guidelines. ifyou have recived @ NOTICE OF OIRECT CERTIFICATION for fee meal rom your chills school, BO NOT complete the QD eviction at diene soo tnow any chen nyourhousehol are not sted onthe tie of Direct Certeaton letter you received 3. CAN FOSTER CHILOREN GET FREE MEALS? Yes, foster chidren that are under the legal responsiblity ofa foster care agency or court, are lige for ree meas 4, CAN HOMELESS, RUNAWAY, HEAD START AND MIGRANT CHILDREN GET FREE MEALS? Yes, children who meet the definition of homeless, runaway, or migrant are elitble for free meals. Hf you believe children in your household meet these descriptions and haven't been told your children wil get free meals, please call or e-mail Harlowton Schoo! District. [WHO CAN GET REDUCED PRICE MEALS? Your children can get reduced price meals your household income is within the reduced price lets on the Federal Eligibility Income Chart, shown on this application, 6. SHOULD IFILL OUT AN APPLICATION IF | RECEIVED A LETTER THIS SCHOOL YEAR SAYING MY CHILDREN ARE APPROVED FOR FREE MEALS? No, but please read the letter you got carefully and follow the instructions. Call your childs school f you have questions 7. MY CHILD'S APPLICATION WAS APPROVED LAST YEAR, DO NEED O FILL OUT ANEW ONE? Yes, Your child's application is only goad for ‘that school year and for the first few days ofthis school year. You must send in @ new application unless the school told you that your chilis eligible for the new schoo! year. 8 |GET WIC, CAN MY CHILDREN GET FREE MEALS? Children in households participating in WIC may be eligible for free or reduced price reals. Please send in an application, 9. WILL THE INFORMATION | GIVE BE CHECKED? Yes and we may also ask you to send written proof. IF! DON'T QUALIFY NOW, MAY | [APPLY LATER? Yes, you may apply at anytime during the school year. For example, children with a parent ar guardian who becomes unemployed may become eligible for free and reduced price meals if the household income drops below the income limit. 10. WHAT IF | DISAGREE WITH THE SCHOOL'S DECISION ABOUT MY APPLICATION? You should talk to schoo! officials. You also may ask for 2 hearing to have the decision reviewed, 11, MAY | APPLY IF SOMEONE IN MY HOUSEHOLD IS NOT A US. CITIZEN? Yes. You or your children do not have tobe U.S. citizens to ‘quality for free or reduced price meals, 42. WHO SHOULO | INCLUDE AS MEMBERS OF MY HOUSEHOLD? You must include all people ving in your househol related or not (such a5 grandparents, other relatives, or fiends) who share income and expenses, You must include yourself and al children living with you. If ‘you live with other people who sre economically independent (for example, people who you do not support, who do not shee income ‘with you or your children, and who pay pro-rated share of expenses), do not include them. : ge ft. "Home of te Engineers" 2. 44, WHAT IF MY INCOME IS NOT ALWAYS THE SAME? Lst the amount that ou normally receve. For example, if you normally make $1000, each month, but you missed some work last month and only made $900, put dawn that you made $1000 per month. if you normally Bet overtime, include i, but do not include if you only wark overtime sometimes, If you have lost a job or had your hours or wages reduced, use your current income, WE ARE IN THE MILITARY. DO WE INCLUDE OUR HOUSING ALLOWANCE AS INCOME? If you get an off-base housing allowance, it must be included as income. However, if your housing is par ofthe Miltary Housing Privatization Initiative, do not include your housing, allowance as income. [My SPOUSE IS DEPLOYED TO A COMBAT ZONE, IS HER COMBAT PAY COUNTED AS INCOME? No, ifthe combat pay i received in Aadaltion to her basi pay because of her deployment and it wasnt received before she was deployed, combat pay is not counted as Income. Contact your child's school for more information IMY FAMILY NEEDS MORE HELP. ARE THERE OTHER PROGRAMS WE MIGHT APPLY FOR? To find out how to apply for ther assistance benefits, contact your local assistance office Ifyou have other questions or need help, call 406-632-4324, Sincere, Julie Wojtowiek PS. Households that qualify for SNAP benefits in Montans automatically receive FREE school meals. Check out the information below to see if your household may qualify for SNAP. Buying Good Food is a SNAP! What is SNAP? SNAP i the Sapplmantal Mutmon Assstonco Program, ‘dosgnad to bolp Moaranans afford hoe food, ‘Former he Food Stomp Pogren) NEW! Online application and pre-screening tool: www.apply.mt.gov How can | participate? SNAP & available 10 people ving on ofa or fixed ian incadng siege pcp, Fries, students, erlos, and people wih dvabiien For mony epplicars, goss ncome mis hove Increased oe hare me lnger a retource Fi “SNAP Income Guidelines 1. Hyou me! he Gross Guideline turn In an eppliaion fo 0 f you ‘io moot te Not Gulden, Applying is easy! ‘Appl in person, online, or by mal or fox = 2, When you apply, « cae worker fl doc portion of your Ing ‘nporss fem yore Pte fo 00 you roe th Nat Cal. Your Net Income for SNAP cannet be calevoted unl yau submit on appltin, a Apply ot ery Ollie of Pubic Astonco or Grow Moxy ie Moni ‘allio reqyas on epplication by al ‘re come inne = ' sigs $958 ‘Apply tine of sev anamiaoe 2 $2,506 siasa “+ Mal or fox in your epplicaton to the (fice of Public assstonce 3 $3,256 $1428 at ents +070 sens You moy bp able 7 do your interview by thane wih previo’ dag member il eed ous Inet seme rons Gadel Cal fe ev Have snothar adult opply on your beh Nga INSTRUCTIONS FOR APPLYING ‘A HOUSEHOLD MEMBER IS ANY CHILD OR ADULT LIVING WITH You. INDIAN RESERVATIONS (FDPIR)}, FOLLOW THESE INSTRUCTIONS: Part d:Ustallchildren inthe household and the name of each childs school iF known), Part 2 List the case number for any household member (including adults) receiving [State SNAP], [State TANF], or [FDPIR] benefits Part 3: Skip ths part. Part 4 Fil out this section and sign the form. The last four digits of a Social Security Number are not necessary. Part S: Answer this question ifyou choose. IF NO ONE IN YOUR HOUSEHOLD GETS [state SNAP], [State TANT], OR [FDPIR] BENEFITS AND IF ANY CHILD IN YOUR ‘| HOUSEHOLD IS HOMELESS, A MIGRANT OR RUNAWAY, OR IN HEAD START FOLLOW THESE INSTRUCTIONS: TF YOUR HOUSEHOLD RECEIVES BENEFITS FROM [State SNAP], [State TANF], OR [THE FOOD DISTRIBUTION PROGRAM ON Part 2 List all children in the household and the name of each chile’ schoal if known). any child you are applying for is homeless, migrant, in Head Start or a runaway check the appropriate box and.call your school [homeless lialson, runaway, head start or migrant coordinator}, Part 2: Skip this part Part 3: Complete only ifa child in your household isn't eligible under Part 1. See instructions forall Other Households, Part : Fill out and sign the form, The last four digits ofa Socal Security Number are not necessary if you dnt need to fil in Part 3, Part 5: Answer this question if you choose. TF YOU ARE APPLYING FOR A FOSTER CHILD, FOLLOW THESE INSTRUCTIONS: Hall children inthe household are foster children Part 1: List all foster children andthe school name for each child. Check the box indicating the child is a foster child Part 2 Skip ths part Part 3 Skip ths pat. Part 4 Fil out and sign the form. The last four cits ofa Social Security Number are not necessary. Part 5: Answer this question if you choose. Hf some ofthe children inthe household are foster children: Part 1: List all children in the household and the name of each child's school if known). Check the box for each foster child. If any child you are applying foris homeless, migrant, in Head Start or a runaway check the appropriate box andif you have questions call Harlowton School District. Part 2:if the household does nat have a case number, skip ths part, Part 3: Complete ony fa child in your household isn’t eligible under Part 1 or 2. See instructions for All Other Households art 4: Adult household member must fill out and sign the farm and lst the last four digits oftheir Social Securty Number (or mark the box i s/he doesn’t have one) Part 5: Answer this question if you choose. ALL OTHER HOUSEHOLDS, INCLUDING WIC HOUSEHOLDS, FOLLOW THESE INSTRUCTIONS Part 1: List all children in the household and the name of each child's school (if known). if any child you are applying for is homeless, migrant, Head Start, a foster child or a runaway check the appropriate box and call Harlowton Schoo! District to follow up. Part 2: the household does not have a ease number, skip this part. Part 3 Follow these instructions to report total household income from this month, lst month. + Name: ist all household members, + Forany person, including children, wth no income, you must check the "No Income" box. + Gross Income and How Often It Was Received: For each household member listed in section 3, lst each type of income received. You ‘must tll us how often the money is recelved—weekly, every other week, twice a month, monthly or yeary (© Earnings: Be sure to lst the gross income, not the take-home pay. Gross income isthe amount earned before taxes and other

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