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Miami Senior High School Instructor: Ms.

Northcut
12450 SW 1st St. Room: 2104
Miami, Fl. 33135 Direct Phone: (305) 642-2811
Phone: (305) 649-9800 E-mail: northcut@dadeschools.net
Fax: (305) 649-9475

Cosmetology Course Syllabus


Course Title: Grooming and Salon Services Core 1 (.5 credit)
Course Description: This course is designed to provide instruction in safety rules and procedures, school, classroom/laboratory procedures. It is
also designed to provide the student with an opportunity to become familiar with competencies in employability, communication, math and science
skills required to succeed in industry. Additionally, it is designed to provide the student with an overview of competencies in State Board of
Cosmetology requirements and in the study of the cosmetology law and rules and regulations. The student will briefly review entrepreneurship
competency.
Course Title: Cosmetology Nails 2 (.5 credit)
Course Description: This course is designed to provide competencies in manicuring and pedicuring and in applying artificial nails and nail wraps.
This instruction includes selection of supplies and equipment, sanitation procedures and performing designated procedures.
Course Title: Cosmetology Facials 3 (1 credit)
Course Description: This course is designed to provide instruction in competencies in facials and related massage, hair removal, artificial lash
application and instruction in the selection of supplies and equipment, sanitation procedures and performing designated procedures.
Intermediate & Advanced Cosmetology Levels: (1 credit)
These courses are designed to provide instruction in the following areas: Cosmetology 4 – Hair Shampooing and Scalp Treatments, Cosmetology 5 –
Hair Shaping, Cosmetology 6 – Hairstyling, Cosmetology 7 - Principals of Hair Design, Cosmetology 8- Hair Reconstruction (permanent waving,
curl reconstruction, hair relaxing) Cosmetology 9- Hair Coloring and Bleaching.
Content: The content includes but is not limited to: Communication, leadership, human relations and employability Skills; Safe and
efficient work practices; Florida cosmetology law and rules; acquisition of technical knowledge, skills and related chemistry;
bacteriology, anatomy and physiology; art of make-up and development of skill in performing the manipulative and electrical
techniques required in the practice of cosmetology and related occupations. This program also focuses on broad, transferable skills
and stresses understanding and demonstration of the following elements of the cosmetology industry; planning, management,
technical and production skills, underlying technological principles, labor, community, health, safety, and environmental issues.

Objectives: Upon completion of the course requirements, the determined graduate will be able to:
1. Project a positive attitude and a sense of personal integrity and self-confidence.
2. Practice effective communication skills, visual poise, and proper grooming.
3. Respect the need to deliver worthy service for value received in an employer-employee relationship.
4. Perform basic manipulative skills in the areas of hair, nail and skin care.
5. Perform the basic analytical skills to determine proper applications for the client’s overall image.
6. Apply learned theory, technical information, and related matter to assure sound judgments, decisions, and procedures.

Program Structure: This program consists of a core (basic curriculum). Students must complete the core, or demonstrate the
mastery of skills standards contained in the core, before advancing in the program. Students wishing to complete the full cosmetology
specialty programs shall complete the core requirements that outline the basic curriculum which shall be used in cosmetology schools
in the state of Florida. This curriculum includes definitions, level of acceptable competency, knowledge of Florida law, and sanitation
and sterilization practices. Additional curricula and course requirements are set by Florida’s State Board of Cosmetology and the
Florida Department of Education.

Instructional Activities: Instruction includes a combination of classroom theory and practical experiences through practice on
manikins and patrons in the classroom laboratory. Instruction and learning activities are provided in a laboratory setting using hands-
on experiences with chemicals, implements, and equipment appropriate to the programs content and in accordance with safety and
sanitation practices in the trade.

Textbook: Milady’s Standard Cosmetology textbook is provided for classroom use.

Behavioral and Performance Expectations: Students should be to class every day, on time, and ready to work. Class participation
is expected. Student must put forth maximum effort and assignments are to be completed in the given allotted time frames. Students
are expected to follow the cosmetology classroom and safety rules as well as Miami-Dade County Public Schools Code of Conduct for
Secondary students. M-DCPS Code of Conduct can be viewed at: http:ehandbooks.dadeschools.net/policies/90/index.htm

Page 1of 5, Parent or Guardian’s Initials: _______


Grading: Letter grades will be recorded in the M-DCPS electronic grade book at least once per week and are based on student
performance in the areas of academics, effort and conduct. Assignments that are submitted after their initial due date drop one letter
grade for each day the assignment is late.
Academic grades are determined by the completion of and performance on written and manipulative (theory and practical)
assignments. Students are required to complete theory and practical assignments in the given allotted time frame.
Theory assignments are evaluated after each unit of study. To remain in good standing within the cosmetology program and with the
Florida Board of Cosmetology, students are to maintain a theory grade average of 75%, “C” or higher.
Practical assignments must meet industry standards and/or instructor’s approval. Practical projects are evaluated according to
textbook procedures and framework performance standards. Scores will be converted to a scale of 0 to 100. The minimum passing
score as determined by the Florida Board of Cosmetology is set at 75% on that scale. Practical lab work (and the grade you earn) can
only be done in the lab so choose the days you will be absent from school carefully.
Your habits and the quality of your class assignments will determine your effort grade.
Your maturity level, performance and attitude regarding school, work, human relations and classroom policies are among the factors
that will determine your conduct grade.
M-DCPS Grade scale is as follows: 90 – 100 = A (4), 80 – 89 = B (3), 70 – 79 = C (2), 60 – 69 = D (1), 0 – 59 = F (0).
Additionally, a student may earn a “Z” or “zero” grade where little to no attempt has been made.
Graded categories and weights: Classwork / Labs (40 %), Tests (20%), Project / Home Learning (15%), Responsibility / Duty (10%),
Bell Ringers / Journaling (10%), Extra Credit (5%).
Required Office Supplies (replace as needed):
One three ring binder (1” size)
Five (5) tab dividers labeled Safety, Bell Ringer, Theory, Practical, Vocabulary)
Pack of ten (10) Plastic Sheet Protectors
White, loose leaf, lined writing paper (no spiral notebooks)
Composition Notebook
Blue ink pens, Yellow hi-lighter, Black Sharpee marker
Dry-erase correction tape (no liquid white-out)
One USB storage device (4 GB or higher). Storage device may be shared with other classes/subjects (create one cosmetology folder).
Policies and Procedures
Attendance:
Cosmetology/Specialty programs in Florida consist of several hundred hours of instruction; therefore, regular attendance to class is
critical to meet Florida’s Cosmetology State Board requirements. Cosmetology students must uphold class attendance throughout the
duration of their vocational/career program. High absenteeism/lateness jeopardizes the student’s opportunity to re-enroll in future
cosmetology courses as they will be referred to student services for redirection into another area of study. Students having ten (10) or
more unexcused absences may result in having credit for the course denied.

Absenteeism/Admits:
It is the student’s responsibility to acquire (before or after school) and submit admits for all excused absences within 3 days of
returning to class. Admits can be obtained before or after school in the attendance office. Admits must be submitted to the instructor
upon re-entering the classroom. Students who accumulate excessive absences will not be recommended to re-enter or continue in a
future cosmetology course.

Make-up Work Policy:


If your absence is excused, you may ask for make-up work (theory). You have the same number of days to make it up and turn it in as
the number of days you were absent. If the missed assignments are not made up during that time, they will remain recorded as a zero
grade. It is the students’ responsibility to first check their M-DCPS student portal for missed assignments before approaching the
instructor for make-up work. It is the student’s responsibility to inquire about and obtain any missing class notes from a classmate.
Any assignments not made up will be counted as a zero. If your absence is reported as unexcused, you may not make up missed work.
Clock Hours:
When a cosmetology student is not physically present in the classroom (absent, tardy, bathroom breaks, school activities, etc.), time
towards meeting the state requirements for cosmetology and/or specialty courses will be deducted as follows:
1 to 15 minutes out of the classroom (less .25)
16 to 30 minutes out of the classroom (less .50)
31 to 45 minutes out of the classroom (less .75)
46 to 60 minutes out of the classroom (less 1 hour), etc.
Students should take care of personal matters outside of class time (before or after school) to avoid time deductions. If a student must
leave the classroom for any reason, they must first obtain the instructor’s permission, obtain a pass, sign out, log the time they are
leaving and their destination. Students are required to log their classroom reentry time upon return. Daily sign in/out sheets are kept
and maintained by the instructor.
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Tardy
The classroom door is locked at the ringing of the bell. Student is to be in their assigned seat before the late bell rings. Tardy
students will be allowed to enter the classroom if they hold a pass. If student is caught in a hall sweep, any assignment(s) collected
prior to late arrival will be marked late and will drop one letter grade. Students with excessive tardies will be referred (written
referral/SCAM) to administration and will not be recommended to continue in a future cosmetology course.
Hallway
Hallways and classroom walkways are to be kept clear. Students are not congregate in the hallways or around any classroom door.
While transitioning in the hallways, be courteous to others by keeping to the right. Enter the classroom quickly and quietly.
Hall Passes
Follow a 15/15 minute rule: No passes will be allotted the first or last 15 minutes of class so do not ask to be excused during these
times. Students are to tend to personal matters outside instructional time (before or after school). If a student would like to meet with
a counselor, please make an appointment with student services before or after school.
Bathroom Passes
Bathroom passes will not be issued the first or the last fifteen (15) minutes of class time. Only one student at a time may be excused
from the classroom to use the restroom (five minutes allowed) and are to follow the cosmetology sign-out procedures. Students are to
make it a habit to utilize those facilities before and after instructional times.
Food / Drink
Eating and Drinking are not permissible in the cosmetology classroom. All food and beverage items must be stowed in your book bag
or disposed of PRIOR to entering the cosmetology lab/classroom.
Electronic Devices
Electronic devices must be silenced (vibrate mode) and stored out of sight (in your book bag) before entering the classroom.
Electronic devices seen out during instructional time will be collected and secured by Ms. Northcut until the end of class. It is the
student’s responsibility to speak with teacher at the end of class to retrieve the collected device after the class has been dismissed. If
student continues to violate this rule, device will be collected, referral written and/or the electronic device will be turned in to an
administrator until a parent or guardian are able to retrieve.
Classroom Computers
Classroom computers have been provided to enhance your learning and educational experience. They may not be used for gaming or
social media. Students are not to utilize the teacher’s computer, printer or desk area.
Uniform Policy
Cosmetology students (first year) are to be in MHS school uniform every day. Returning cosmetology students (intermediate &
advanced levels) may elect to wear solid black medical scrubs (top & bottom) on practical days (Wednesday/Thursday/Friday)
whenever their class meets (A/B calendar). Wearing closed toed shoes and an official school student ID is mandatory. The student’s
school ID is to be worn on a lanyard visibly around the student’s neck. As a part of job training, the student will receive several grades
throughout the school year for demonstrating daily responsibly in wearing the correct/complete uniform (uniform check). Class entry
may be denied if student is out of uniform and/or not wearing lanyard w/ID.

Practical Sessions
Practical sessions are used to develop manual dexterity; therefore, it is necessary for you to concentrate on what you are doing.
Talking must be kept to a minimum. A practice session is not a break time, social time, or “do whatever you want” time. Every
student has a specific practical job to perform that is assigned by the instructor. A practice session will be utilized to do just that…
practice, practice, practice.
Clinic / Production
On clinical days, immediately disinfect and set up your station to work. Timing and punctuality are crucial when working in this profession so form
good habits now during your training. Your employer and your customers will greatly appreciate and respect you for this. Students cannot refuse a
client/model, or the services assigned to them even if that student has already met the states minimum requirement for that service. Any student who
is defiant and refuses a client/model and/or service(s) will be referred to an administrator/CSI. There is no maximum number for doing any service.
Changes in client/model assignment can only be done by the instructor. Never leave your client/model unattended.
Receiving Services
Periodically there will be personal service days. Students who are up to date with all class work and have satisfactorily performed their clean up
duties (see below) may have personal services done (chemical applications must be paid for). All requests must be approved by the instructor.
Students who are not “up-to-date” must utilize this time as a remedial time to get caught up.
Clean up Duties and Responsibilities
Students are responsible for keeping their personal areas of the classroom clean, organized, sanitized, and disinfected when applicable.
This includes the complete training area (station, chairs, tabletops, floor, mirror, and equipment). In addition to maintaining this
personal space, students will be assigned additional lab responsibilities (duty work) in accordance with standard salon practices.
Students who are unable to satisfactorily perform classroom cleanup/sanitation practices will be denied request for services on
personal service days. Violation(s) will be recorded, and detention(s) will be issued. Students who continue to unsatisfactorily
perform such duties will be referred to an administrator and will not be recommended to continue in the program as this is an integral
part of working in the cosmetology/salon industry.
Page 3 of 5, Parent or Guardian’s Initials: _______
Instructor: Ms. Northcut
Course: Cosmetology

Behavioral Expectations and Classroom Rules


Behavioral Expectations
Cosmetology students in training are to report to class on time and uphold regular attendance. Students are to project a positive attitude and greet
others politely and pleasantly. Students are to be well groomed, be responsible for their work and their actions, abide by the rules and regulations set
forth by the school and individual classroom, seek changes in an orderly and approved manner and not argue with or disrespect their instructor.
Students are to represent Miami Senior High daily by applying themselves and doing their personal best.
The cosmetology industry is a customer-based business that requires the personal service worker to conduct themselves in a mature and professional
manner. Cosmetology students are expected to uphold a high work ethic and conduct themselves in a safe and responsible manner. The following
behaviors will not be tolerated in the cosmetology classroom:
 Disrespect towards teacher, school staff, classmates, and guests.
 Profanity/racial slurs/derogatory statements/bullying/inappropriate language or conversations.
 Excessively loud talking.
 Immature behaviors (horse playing, snatching, grabbing, throwing objects, play fighting, running, jumping, etc).
 Inappropriate dress / Out of uniform.
 Constant borrowing of materials.
 Refusal to do assignment (theoretical or practical).
Cosmetology Class Rules & Procedures
1. Respect others and their property.
2. Be to class on time, in uniform, prepared with materials and in your assigned seat before the tardy bell rings.
3. Prior to entering the classroom, silence and store (inside book bag) all electrical devices and ear buds/headphones.

4. Remain in your seat or at your assigned station unless excused or dismissed by instructor. Additionally, do not “line-up” at the
door and wait for the bell to ring (the bell does not excuse you, the instructor does). Push your chair in before leaving.
5. Do not sit on furniture that is not intended for sitting such as tabletops, desk tops, computer tables, arms of chairs, etc.
6. Keep feet/shoes off furniture and walls.
7. Complete assignments yourself and to the best of your ability.
8. When you have a question or need assistance, raise hand and wait for instructor to recognize you.
9. Refrain from talking over others. Do not talk when instructor is speaking, during school announcements or during testing times.
10. If needed to be excused, first obtain instructors permission and pass then sign out (sign back in upon returning to the classroom).
11. Refrain from eating, drinking, chewing gum, heads on desks or sleeping in class.
12. Immediately clean up after yourself by following sanitation/disinfection procedures learned during your training. Prior to
dismissal, tidy the work area around you (straighten chairs, return books/supplies, pick up trash/dispose in trash receptacle, etc).
13. Do not waste products (one application of product is sufficient in most situations).
14. Ask permission when borrowing materials and return to rightful owner before the end of class (no constant borrowing).
15. Immediately notify instructor of any broken furniture, equipment or if you detect an unsafe situation.
16. Use classroom computers for classroom projects. Gaming & social media usage is prohibited. Use a USB/travel/jump drive to
save your class projects and working documents. DO NOT save working documents/projects to your e-mail address. SAVE
cosmetology documents on a jump drive. This will be the only allowance during times of presentation. Class time WILL NOT BE
ALLOCATED to access your personal e-mail to search for stored projects.
17. Do not spray perfume inside the classroom.
18. Set up an appointment with Ms. Northcut if you wish to discuss a personal matter (grades, upcoming event causing loss of class
time, etc). Refrain from blurting out personal issues during class as this causes a disruption to others and the learning environment.
Consequences
1st offense = Verbal warning. 2nd offense = Logged conference with student / Detention / Parental notification (if detention is not
served, student will have two detentions). 3rd offense = Written referral / Conference (parent, teacher, counselor). 4th offense =
Removal from classroom (CSI) / Written referral / Conference (parent, teacher, administrator). * If student continues to violate
classroom rules, student will be referred to an administrator for redirection into another program. * MHS Detention hall is held after
school on Thursdays and on Saturdays.
Page 4 of 5, Parent or Guardian’s Initials: _______

Cosmetology students in training are expected to demonstrate the following

Positive Work-Related Behaviors


1. COMPLY WITH ATTENDANCE – maintains attendance record that is acceptable based on district
guidelines, and provides acceptable for absence or release time.

2. PRACTICE PUNCTUALITY - arrives on time for class and/or work and from breaks; is on time for
appointments.

3. INTERACT WITH TEACHERS AND SUPERVISORS – converses and interacts with teachers or
supervisors in a respectful manner.

4. COOPERATE AS A TEAM MEMBER – performs as a member of a team; works smoothly with and
cooperates with others.

5. SEEK ASSISTANCE APPROPRIATELY – seeks help, when needed, in a non-disruptive, patient, and
cooperative manner.

6. WORK UNSUPERVISED – follows directions; consistently remains on task without supervision.

7. COMPLETE TASKS ACCURATELY AND IN A TIMELY MANNER – works at a pace and speed
required to correctly complete the assigned work.

8. USE GOOD JUDGMENT – makes decisions that are logical, correct, and mature for a given situation in a
work setting; shows evidence of the use of common sense.

9. ACCEPTS CHANGES – adapts readily to changes in situations without becoming upset, showing
emotional outbursts or decreasing work production.

10. ACCEPTS CONSTRUCTIVE CRITICISM – accepts criticism that identifies behaviors or manners of
task performance which should be changed to enhance success; attempts and desires to improve on required task.

11. DISPLAYS INITIATIVE – is ready to work and begins tasks promptly, without being told.

12. DISPLAYS INTEGRITY – demonstrates fair and honest behavior.

13. DISPLAYS FRUSTRATION TOLERANCE – maintains emotional stability and work pace when faced
with challenging, difficult, or pressured situations.

14. DISPLAYS GOOD PERSONAL HABITS & MANNERS – avoids interrupting or disrupting others and
does not use profane language.

15. DISPLAYS PERSONAL APPEARANCE REQUIRED BY SITUATION – practices good hygiene and
wears appropriate clothing.

16. DISPLAYS SAFE USE AND PROPER CARE OF MATERIALS AND EQUIPMENT – demonstrates
ability to safely use, maintain, and care for workstation, tools, and materials.
Page 5 of 5, Parent or Guardian’s Initials: _______

Student Name: _________________________ ID # ________________ Code:_____ / _____

Parental Consent Form & Student Agreement


Your child is scheduled in a cosmetology class. In the cosmetology classroom students will be exposed to various chemicals
depending on the services we are doing on any particular day (examples: acetone and non-acetone nail polish removers, acrylic liquid
(monomers) and powders (polymers), hair color, etc. Parent/Guardian may want to provide their child with a standard black
cosmetologist smock in order to protect child’s clothing/uniform. A standard black cosmetologist smock can be purchased at any
professional beauty supply (ex: Sally Beauty Supply).
Please list any allergies your child has or any other concern regarding his or her participation in the cosmetology class:

____________________________________________________________________________________________________________

Please list your child’s FIRST emergency contact:


Mr. / Mrs. / Ms.: ________________________________________________________ Relationship: ________________________

Cell Ph. #: _______________________ Home Ph. #: _________________________ Work Ph. #: __________________________

E-mail address: ________________________________________________________

Please list your child’s SECOND emergency contact:


Mr. / Mrs. / Ms.: ________________________________________________________ Relationship: ________________________

Cell Ph. #: _______________________ Home Ph. #: _________________________ Work Ph. #: __________________________

E-mail address: ________________________________________________________

By signing below, I, the parent/guardian of ___________________________________, acknowledge that I have read and understood
the content in the cosmetology course syllabus provided to my child and allow he/she to participate in the program.

_______________________________ _______________________________ ________________________________


Parent’s Name (print) Parent’s Signature Date

*****Student Agreement & Pledge…


I have been instructed and am fully aware of the rules and regulations regarding behavior, proper attitude, dress code and performance
during class and am aware of the consequences if I am found in violation. I understand that I must be prepared for class every day. I
understand that I must maintain a monthly minimum attendance requirement of eighty-five percent (85%) to remain in the
cosmetology program. I understand that I risk losing the privilege to re-enroll in cosmetology in the future if I fail to maintain this
average. I understand that it is my responsibility to inquire about, and make-up all missed assignments when my absence is excused.
I understand that I can receive clinical services if I meet the following requirements:
a.) I obtain permission from my instructor.
b.) My assignments, bookwork and tests are turned in and are up to date.
c.) I satisfactorily perform my salon duty work or other responsibility assigned to me.
e.) I pay for chemical services.
I understand that taking any product or tool from the classroom is grounds for referral and possible removal from the cosmetology
program.
I promise to report all cases of accidents immediately to my instructor to ensure my safety as well as all others. Furthermore, I
understand that by violating any class rule or safety regulation may result in the loss of privilege to use chemicals or equipment
applicable to my vocational program.
By signing below, I acknowledge that I have read and understand the cosmetology course syllabus. I understand the classroom rules,
procedures and behavioral expectations and understand that by following them I will contribute positively to a favorable classroom
learning environment. I agree to follow the rules and procedures to participate in the course and if I fail to do so I will be subjected to
the consequences.

________________________________ _______________________________ _________________________________


Student’s Name (print) Student’s Signature Date
_________________________________ _______________________________ _________________________________
Student’s Home Phone Number Student’s Cell Phone Number Student’s E-Mail Address
Code: _____ / _____
Miami Senior High School Instructor: Ms. Northcut
12450 SW 1st St. Room: 2104
Miami, Fl. 33135 Phone: (305) 642-2811
Phone: (305) 649-9800 E-mail: northcut@dadeschools.net

Cosmetology Contract
Thank you for your interest in the cosmetology program at Miami Senior High School. Before you decide on taking this
course there are some things you should know about this class and that there are rules and guidelines to think about.
Firstly, this course is not for students to come in and do their own hair, nails and make-up or to relax but rather to learn
how to provide quality service to others (fellow students/models/clients, etc.). The purpose of this course is to provide the
student with knowledge and training needed to prepare in obtaining one of the following:
Cosmetology License = 1200 hours: 15 hair removal, 65 chemical waving/relaxing, 45 hair color, 300 hair arranging, 50
shampoos, 45 hair treatments, 75 hair shaping’s, 15 facials, 20 manicures, 10 pedicures, 10 nail extensions, Theory,
Sanitation/Disinfection, Florida Law. In order to apply to the Department of Business and Professional Regulation to sit
and take the Florida State Board of Cosmetology licensing exam, student must take a four-hour Board approved HIV
course (approximate cost $20.00) and receive a passing score of 75 % or higher on test. A total passing score of 75% or
higher is required on the Florida State Board of Cosmetology exam to become a licensed cosmetologist.
Nail Specialty Registration = 180 hours: 20 manicures, 10 pedicures, 15 Acrylics, 15 Sculpture, 10 Fiberglass, 10 Nail
refills, 5 Acrylic Removal, 20 Nail Art, 5 Gel 10 Tips.
Facial Specialty Registration = 220 hours: 40 facials, 5 set up, 20 hair removal, 10 make up applications, 10 lash and
brow tinting, 10 eyelash applications, 5 manual extractions.
Full Specialist Registration = 400 hours: The student has met both nail and skin care requirements.
If a high school student does not complete all requirements set by the Florida Board of Cosmetology and The Florida
Department of Business and Professional Regulation, the student may request a cosmetology transcript from their
instructor and continue working towards completing program requirements at an adult learning facility.

In any outside/private beauty school, the cost of this program can be anywhere from $30,000.00 to $50,000.00. The
cosmetology program is offered at Miami High for free however we ask that you purchase your own materials because
without them you will not be able to learn to work.

APPROXIMATE COST:
Cosmetology kit $250.00 (once approved, funds to order hair training kits are typically due in the month of December).
CND Acrylic Nail kit $100.00 (acrylic nail kits (purchased locally by the family) are to be brought to class at the beginning of
the 2nd nine-weeks in January).

If you and your parent/guardian accept these responsibilities and are still willing to take this course, we ask that
you please sign below.

I, _____________________________ understand that the cosmetology course is not intended for me to do my own hair,
nails and make-up or to simply relax but rather to learn how to provide quality service to others (fellow
students/models/clients, etc.). I will cooperate with my instructor and act as a model for my fellow classmates when
either needed or assigned as well as put forth my best effort to fulfill the state course requirements.

_______________________________ __________________
Student Signature Date

As parent/guardian of, _____________________________ I hereby agree and give my full cooperation. I


understand the need and cost for my child’s cosmetology equipment, and I am willing to accept it and pay for it.
____________________________ __________________
Parent/Guardian Signature Date

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