SUN Community Schools SUMMER CAMP GUIDE

Size: px
Start display at page:

Download "SUN Community Schools SUMMER CAMP GUIDE"

Transcription

1 SUN Community Schools SUMMER CAMP GUIDE Providing school based and school linked services in Portland since 1978 Summer 2015 REGISTRATION BEGINS APRIL 20TH, 2015 Commissioner Amanda Fritz Register on-line at Commissioner Jim Francesconi Director Mike Abbaté Go to PortlandParks.org, click on the Register Now tab. Director Zari Santner

2 Portland Parks & Recreation Alice Ott SUN Community School SE Ramona St., Telephone: Site Manager - Jennifer Garcia Hours - June 22 - August 14, 2015 M-F 9am - 4pm No camps on Friday, July 3rd Bus Lines: #10 - Harold-136th & #71-122nd Ave Parking: On SW side of school Disabled Access: Entrances: Accessible Parking: Accessible Restrooms: Accessible Federal Lunch Program Join us for a FREE nutritious meal! M-F age: 1-18 June 22- August 14 Breakfast: 9am-9:30am Lunch: 12:30pm-1pm No meals on Friday, July 3rd AM Youth Camps (Breakfast Included) SUN Camp - Illuminate age: 6-10 Week 1: All Ball! M-F 9am-12:30pm Week 2: Stars & Stripes M-Th 9am-12:30pm Week 3: Artful Antics M-F 9am-12:30pm Week 4: Challenge Week M-F 9am-12:30pm Week 5: Mad Science M-F 9am-12:30pm Week 6: Active Adventures M-F 9am-12:30pm Week 7: Outdoor Odyssey M-F 9am-12:30pm Week 8: Pirate Voyage M-F 9am-12:30pm AM Youth Sports Camps SUN Camp - Illuminate age: 6-10 Week 1: Basketball M-F 9am-12:30pm Week 2: Soccer M-Th 9am-12:30pm Week 3: Court Sports M-F 9am-12:30pm Week 4: Field Games M-F 9am-12:30pm Week 5: Dodgeball & Kickball M-F 9am-12:30pm Week 6: Basketball M-F 9am-12:30pm Week 7: Soccer M-F 9am-12:30pm Week 8: Capture the Flag M-F 9am-12:30pm 6 Sun Community Schools

3 Portland Parks & Recreation PM Youth Camps (Lunch Included) SUN Camp - Illuminate age: 6-10 Week 1: All Ball! M-F 12:30pm-4pm Week 2: Stars & Stripes M-Th 12:30pm-4pm Week 3: Artful Antics M-F 12:30pm-4pm Week 4: Challenge Week M-F 12:30pm-4pm Week 5: Mad Science M-F 12:30pm-4pm Week 6: Active Adventures M-F 12:30pm-4pm Week 7: Outdoor Odyssey M-F 12:30pm-4pm Week 8: Pirate Voyage M-F 12:30pm-4pm PM Middle School Sports Camps SUN Camp - Illuminate age: Week 1: Basketball M-F 12:30pm-4pm Week 2: Soccer M-Th 12:30pm-4pm Week 3: Court Sports M-F 12:30pm-4pm Week 4: Field Games M-F 12:30pm-4pm Week 5: Dodgeball & Kickball M-F 12:30pm-4pm Week 6: Basketball M-F 12:30pm-4pm Week 7: Soccer M-F 12:30pm-4pm Week 8: Capture the Flag M-F 12:30pm-4pm PM Youth Skate Camps SUN Camp - Illuminate age: 7-10 Too good to miss! Week 1: Skateboarding - Jump On Board M-F 12:30pm-4pm Week 5: Skateboarding - Jump On Board M-F 12:30pm-4pm Teens GirlStrength age: Empower yourself! Develop strong skills while building self-confidence & increase awareness of your surrounding environment. Explore a variety of strategies & self-defense techniques to help defend against sexual assault. This program is sponsored by the Portland Police Bureau.Bring a snack and water. Week M-F 1pm-4pm PPB Auditorium 7/6-7/10 $15 SUN Community Schools, a great place to work and play! Register On-Line at 7

4 Portland Parks & Recreation Register Now One of Five Ways ONLINE at PortlandParks.org Click on the Register Now top tab. Read the prepared information for our new online registration system, then click the GO NOW buttons. Search for classes by age, category, location, keyword, or narrow your search by specific activity or course number. PHONE Complete this registration form and call any PP&R site using the phone numbers on the map pages. You may also phone in your registration to the PP&R Customer Service Hotline at , Monday through Friday, 8:30am-5:15pm. Only Visa or MasterCard accepted with phone-in registration. MAIL Mail in your completed registration form to the program center address. Include full payment using your Visa, MasterCard or check payable to the City of Portland. Mail-in registration is also received at the PP&R Customer Service Center, 1120 SW Fifth Ave, Suite 1302, Portland, OR FAX Complete the registration form and fax it to the program center fax number with full payment using your Visa or MasterCard. Faxes are accepted 24 hours a day, seven days a week, but are processed during regular business hours. IN PERSON Any PP&R facility is able to process your registration, including the Customer Service Center located on the first floor of the Portland Building at 1120 SW 5th Ave. All Community Centers are open for walk-in registration during business hours. CHECK ONE: New Customer Taken class with PP&R before My account information has changed Main Contact Name Birthdate M F CIRCLE ONE: African Immigrant American Indian/Alaska Native Black/African American Hispanic/Latino Native Hawaiian/Pacific Islander White Slavic/Eastern European Immigrant Asian Multi-Racial Other Home Address City/St/Zip Home Phone ( ) Work Phone ( ) Cell Phone ( ) Address Emergency Contact Name & Phone Number Portland Parks & Recreation welcomes individuals with disabilities and special needs into programs. Please describe any accommodations needed for successful inclusion: PARTICIPANT INFORMATION Name (last, first) Birthdate M/F Class Title Course # Class Location Start Date Cost NON-RESIDENTS: Please be sure to enter the non-resident (NR) class fee in the Cost column. If an NR fee is not listed in the catalog, please add a 40% surcharge to each class fee. TOTAL PAYMENT INFORMATION CHECK Check number (make check payable to the City of Portland) CREDIT CARD Information Account # Expires Cardholder s Name Signature Please print VISA MasterCard Register On-Line at 29

5 SCHOLARSHIP APPLICATION for Classes & Programs FACILITY NAME: PROGRAM/ACTIVITY: Portland Parks & Recreation recognizes that some residents of the City of Portland require financial assistance to attend certain recreational activities. A limited number of scholarships are available for those who qualify. The information requested below is confidential and necessary to help determine the degree of need for each applicant. ALL information must be filled in or the application will be returned unaccepted. If you are applying for multiple scholarships, a separate application is required for each participant and for each activity. Please allow a minimum of 2 working days to process your scholarship. Call or come in to the recreational facility to confirm approval of your scholarship. Proof of income is required with ALL scholarship applications. Please see reverse for more information and valid forms of income verification. Participant s Name: Age: Address: City State: Zip Code: Daytime Phone: Evening Phone: This scholarship will be used for: Activity: Barcode: Knowing that the normal fee for this program is $, what do you think you can pay? $ NOTE: PP&R Scholarship Policy does not allow us to cover the program fee completely. Please enter an amount that is possible for you to pay. State the financial need which makes it impossible for you to pay entire fee: FOR YOUTH REGISTRATIONS ONLY: Father s Name: Mother s Name: Employer: Employer: Participant / Parent / Guardian Signature Date FOR OFFICE USE ONLY: Notes: Date Received: Date Approved: Regular Program Fee: $ Term: Dates Phoned: Less Scholarship Amt: $ Program Manager Signature: Total Participant Fee: $ Dates Phoned:

6 APLICACION DE BECA para Clases Y Programas Nombre de Centro: Actividad o Programa: El Departamento de Parques y Recreación de Portland reconoce que algunos de los residentes de la ciudad de Portland requieren ayuda financiera para atender a ciertas actividades recreacionales. Un número limitado de becas esta disponible para los que califiquen. La información solicitada es confidencial y es necesario para determinar la necesidad de cada solicitante. Se necesita rellenar la aplicación por completo para determinar la necesidad de cada solicitante. Si esta solicitando más de una beca se requiere una aplicación para cada participante y para cada actividad. Por favor deje por lo menos dos días para procesar su aplicación. Llame o venga al centro de recreación para confirmar si su beca fue aprobada. Prueba de ingresos son requeridos para todas las aplicaciones. Atrás ahí información de formas validas para verificar el ingreso. Nombre de Participante: Edad: Dirección: Cuidad: Estado: Código Postal: Numero de Teléfono de día: Número de Teléfono de la tarde: Esta beca será utilizada para : Actividad: Numero de clase: Sabiendo que el precio normal de la clase es $ cuánto cree usted que podrá pagar? $ Nuestro programa no nos permite cubrir el costo por completo de la actividad. Por favor ponga la cantidad que usted pueda pagar. Indique la necesidad financiera especial que tiene por la cual es imposible pagar el precio total: PARA REGISTRACION DE JOVENES SOLAMENTE: Nombre de Padre: Emplador: Nombre de Madre: Emplador: Participante / Padre / Firma de Guardián Fecha PARA USO DE OFICINA SOLAMENTE: Notes: Date Received: Date Approved: Regular Program Fee:$ Term: Dates Phoned: Less Scholarship Amt:$ Program Manager Signature: Total Participant Fee: $ Dates Phoned:

Save the Date! May 17-18, 2015. (Holiday Inn Austin Midtown) 6000 Middle Fiskville Road Austin, TX 78752

Save the Date! May 17-18, 2015. (Holiday Inn Austin Midtown) 6000 Middle Fiskville Road Austin, TX 78752 Save the Date! May 17-18, 2015 (Holiday Inn Austin Midtown) 6000 Middle Fiskville Road Austin, TX 78752 Promotores/CHW/Instructor Registration Fee: $35.00* Includes conference materials, CEUs, and meals

More information

Application for Admission 2014-2015 School Year

Application for Admission 2014-2015 School Year Application for Admission 2014-2015 School Year Mail or deliver applications to: Admissions Office Cristo Rey Columbus High School 840 West State Street Columbus, Ohio 43222 Phone: (614) 223-9261 x 227

More information

Application for Admission 2016-2017 School Year

Application for Admission 2016-2017 School Year Application for Admission 2016-2017 School Year Mail or deliver applications to: Admissions Office Cristo Rey Columbus High School 400 East Town Street Columbus, Ohio 43215 Phone: (614) 223-9261 x 12008

More information

Memorial Health Care System Catholic Health Initiatives Financial Assistance Application Form

Memorial Health Care System Catholic Health Initiatives Financial Assistance Application Form B Please note - Memorial Hospital may access external validation resources to assist in determining whether a full application for assistance is required. Financial Assistance Application 1) Patient Name

More information

Benedictine College Financial Aid

Benedictine College Financial Aid 2015 2016 Institutional Verification Document V4 Dependent Your 2015 2016 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before

More information

PERSONAL INFORMATION / INFORMACIÓN GENERAL Last Name / Apellido Middle Name / Segundo Nombre Name / Nombre

PERSONAL INFORMATION / INFORMACIÓN GENERAL Last Name / Apellido Middle Name / Segundo Nombre Name / Nombre COMPUTER CLASS REGISTRATION FORM (Please Print Clearly Lea con cuidado) To register for the Computer Technology Program, please complete the following form. All fields in this form must be filled out in

More information

Financial Aid Information

Financial Aid Information Financial Aid Financial aid refers to any grant, scholarship, loan or paid employment offered to help a student meet his/ her college expenses. These monies can be meritbased and/or need-based. Merit-based

More information

Questions or Feedbacl<? i Schoolwires Privacy Policy (Updated)! Tenns of Use

Questions or Feedbacl<? i Schoolwires Privacy Policy (Updated)! Tenns of Use 7f23/2015 aspiraillinois.schoolwires.net/siteldefaullaspx?pagetype=3&domainld=8&modulelnstanceld=177&viewld=047e6be3-6d87-4130-8424-d8e4e9ed6c2a&renderloc=o&flexdatald=40&pageld=9 ~?RA... c. 7~1LLNOS L

More information

Daytime Telephone Number (Número Telefónico) Date of Application (Fecha) County (Condado)

Daytime Telephone Number (Número Telefónico) Date of Application (Fecha) County (Condado) Borough of Matawan - Dept. of Vital Statistics $10.00 p/copy 201 Broad Street, Matawan, NJ 07747 Phone 732-566-3898 x625 Fax 732-566-0036 APPLICATION FOR A NON-GENEALOGICAL CERTIFICATION OR CERTIFIED COPY

More information

Adaptive and Inclusive Recreation (AIR)

Adaptive and Inclusive Recreation (AIR) Spring 2016 Adaptive and Inclusive Recreation (AIR) Drop-in Swimming... see page 4 NEW Teen Hip Hop Class... see page 5 Teen Explorer Camp... see page 5 Commissioner Amanda Fritz Director Mike Abbaté REGISTRATION

More information

BALANCE DUE 10/25/2007 $500.00 STATEMENT DATE BALANCE DUE $500.00 PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT

BALANCE DUE 10/25/2007 $500.00 STATEMENT DATE BALANCE DUE $500.00 PLEASE DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT R E M I T T O : IF PAYING BY MASTERCARD, DISCOVER, VISA, OR AMERICAN EXPRESS, FILL OUT BELOW: XYZ Orthopaedics STATEMENT DATE BALANCE DUE 10/25/2007 $500.00 BALANCE DUE $500.00 ACCOUNT NUMBER 1111122222

More information

Family Support Network

Family Support Network Special Services for Special Families Web: www.familysupportnetworkca.org February 2016 Over the weekend of May 13, 14 and 15th Family Support Network and the Orange County community will be hosting its

More information

PATIENT INFORMATION. Today s Date. I do not currently carry insurance (initial) Patient s Last Name: Patient s First Name: MEDICAL INSURANCE

PATIENT INFORMATION. Today s Date. I do not currently carry insurance (initial) Patient s Last Name: Patient s First Name: MEDICAL INSURANCE PATIENT INFORMATION Please present a Photo ID and ALL insurance cards to receptionist. If items are not presented, full payment will be due at time of service. Please know ALL Co-Pays are due at time of

More information

PWB Management Corporation 3092 Hull Avenue, Bronx, NY 10467 Tel:(718) 519-6900 Fax: (718) 519-6904

PWB Management Corporation 3092 Hull Avenue, Bronx, NY 10467 Tel:(718) 519-6900 Fax: (718) 519-6904 PWB Management Corporation 3092 Hull Avenue, Bronx, NY 10467 Tel:(718) 519-6900 Fax: (718) 519-6904 Dear Applicant, Enclosed is our apartment application which must be totally completed prior to submission.

More information

ATLANTA INTERNATIONAL PHYSICAL THERAPY, INC.

ATLANTA INTERNATIONAL PHYSICAL THERAPY, INC. .Specwtlfczlkuj Ut Pedlfltric. physical, occ.upflt«>ithl, Speech Therapy sen/tees PATIENT INFORMATION Patient Name (Nombre del paciente] Date of Birth (Fecha de nacimiento] Address (Direccion] City [Cuidad]

More information

Please note that the print size cannot be smaller than the text in the document.

Please note that the print size cannot be smaller than the text in the document. Clarification for Civil Rights Non-Discrimination Statement There have been several questions about using the short version of the USDA nondiscrimination statement on NSLP and SBP menus. It is acceptable

More information

Customer Name Address City, State Zip <INSERT DATE>

Customer Name Address City, State Zip <INSERT DATE> Customer Name Address City, State Zip Announcement to Customers: The transition is complete Dear < insert name>, has successfully completed transitioning your water utility account. Once

More information

IDAHO CHILD CARE PROGRAM (ICCP)

IDAHO CHILD CARE PROGRAM (ICCP) IDAHO CHILD CARE PROGRAM (ICCP) Dear Customer, In order to process your application for Child Care Assistance in the most efficient and timely manner possible, we will need to verify certain items. We

More information

CHILD CARE 2016 SUMMER CREDENTIAL COURSES NEW YORK

CHILD CARE 2016 SUMMER CREDENTIAL COURSES NEW YORK CHILD CARE 2016 SUMMER CREDENTIAL COURSES NEW YORK 100% online Convenient, evening classes Caring instructors with field experience Scholarships available We are proud to offer you the fully accredited

More information

2014-2015 Independent

2014-2015 Independent 2014-2015 Independent V4-V5 Independent VERIFICATION of High School Completion and Identity Statement of Educational Purpose V4-V5 Your 2014 2015 Free Application for Federal Student Aid (FAFSA) was selected

More information

OFFICE OF COMMON INTEREST COMMUNITY OMBUDSMAN CIC#: DEPARTMENT OF JUSTICE

OFFICE OF COMMON INTEREST COMMUNITY OMBUDSMAN CIC#: DEPARTMENT OF JUSTICE RETURN THIS FORM TO: FOR OFFICIAL USE: (Devuelva Este Formulario a): (Para Uso Oficial) OFFICE OF COMMON INTEREST COMMUNITY OMBUDSMAN CIC#: DEPARTMENT OF JUSTICE (Caso No) STATE OF DELAWARE Investigator:

More information

105-01 Compliance with the National Voter Registration Act of 1993

105-01 Compliance with the National Voter Registration Act of 1993 Connecticut WIC Program Manual Federal Fiscal Year 2016 Section: Voter Registration 105-01 Compliance with the National Voter Registration Act of 1993 Connecticut WIC Program Manual WIC 105-01 SECTION:

More information

LOS ANGELES UNIFIED SCHOOL DISTRICT Policy Bulletin

LOS ANGELES UNIFIED SCHOOL DISTRICT Policy Bulletin Policy Bulletin TITLE: NUMBER: ISSUER: Procedures for Requests for Educationally Related Records of Students with or Suspected of Having Disabilities DATE: February 9, 2015 Sharyn Howell, Executive Director

More information

SUBCHAPTER A. AUTOMOBILE INSURANCE DIVISION 3. MISCELLANEOUS INTERPRETATIONS 28 TAC 5.204

SUBCHAPTER A. AUTOMOBILE INSURANCE DIVISION 3. MISCELLANEOUS INTERPRETATIONS 28 TAC 5.204 Part I. Texas Department of Insurance Page 1 of 11 SUBCHAPTER A. AUTOMOBILE INSURANCE DIVISION 3. MISCELLANEOUS INTERPRETATIONS 28 TAC 5.204 1. INTRODUCTION. The Texas Department of Insurance proposes

More information

Plumbers and Irrigators INSTRUCTIONS -- PLEASE READ CAREFULLY

Plumbers and Irrigators INSTRUCTIONS -- PLEASE READ CAREFULLY Phone:(401)462-8580 Fax: (401)462-8528 www.dlt.ri.gov/profregs Plumbers and Irrigators INSTRUCTIONS -- PLEASE READ CAREFULLY Applications that are incomplete or missing required documents will not be processed

More information

LOS ANGELES UNIFIED SCHOOL DISTRICT BULLETIN

LOS ANGELES UNIFIED SCHOOL DISTRICT BULLETIN TITLE: NUMBER: ISSUER: Parental Exception Waivers: Procedures and Guidelines for Requesting Alternative Programs for English Learners, K-12 Dr. Judy Elliot, Chief Academic Officer Instructional Services

More information

SUMMER PROGRAM APPLICATION

SUMMER PROGRAM APPLICATION www.iefl.org SUMMER PROGRAM APPLICATION LATINO STUDENT LEADERSHIP CONFERENCE July 29 August 3, 2012 ASTROCAMP IDYLLWILD, CALIFORNIA MAY BE DUPLICATED INLAND EMPIRE Dear Student: If you are an eighth- or

More information

Electrician Application -- INSTRUCTIONS -- PLEASE READ CAREFULLY

Electrician Application -- INSTRUCTIONS -- PLEASE READ CAREFULLY Phone:(401)462-8580 Fax: (401)462-8528 www.dlt.ri.gov/profregs Electrician Application -- INSTRUCTIONS -- PLEASE READ CAREFULLY Applications that are incomplete or missing required documents will not be

More information

Summer Reading and Class Assignments 2014-2015 Rising Seniors

Summer Reading and Class Assignments 2014-2015 Rising Seniors Student Name: Summer Reading and Class Assignments 2014-2015 Rising Seniors JIMMY CARTER EARLY COLLEGE HIGH SCHOOL LA JOYA INDEPENDENT SCHOOL DISTRICT To the Class of 2015: Jimmy Carter Early College High

More information

Ecuador Official visa Application

Ecuador Official visa Application Ecuador Official visa Application Please enter your contact information Name: Email: Tel: Mobile: The latest date you need your passport returned in time for your travel: Ecuador official visa checklist

More information

Information Regarding / Información acerca de Unlicensed Money Transmitter / Your Personal Information /

Information Regarding / Información acerca de Unlicensed Money Transmitter / Your Personal Information / STATE OF CALIFORNIA BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF FINANCIAL INSTITUTIONS WILLIAM S. HARAF, Commissioner of Financial Institutions www.dfi.ca.gov COMPLAINT REGARDING AN UNLICENSED

More information

COLLEGE PLANNING SERVICES ISM. College Planning Division. 17722 Irvine Boulevard Tustin, California 92780 (800) 488-1474 Ext. 702

COLLEGE PLANNING SERVICES ISM. College Planning Division. 17722 Irvine Boulevard Tustin, California 92780 (800) 488-1474 Ext. 702 ISM COLLEGE PLANNING SERVICES College Planning Division 17722 Irvine Boulevard Tustin, California 92780 (800) 488-1474 Ext. 702 Making your child s college education a reality Copyright Interstate Specialty

More information

DAILY TIGER ANNOUNCEMENTS. Finals Schedule. 4th Period Final 8:00-9:30. Break 9:30-9:45. TEAM/Study Hall/book return 9:45-10:23

DAILY TIGER ANNOUNCEMENTS. Finals Schedule. 4th Period Final 8:00-9:30. Break 9:30-9:45. TEAM/Study Hall/book return 9:45-10:23 DAILY TIGER ANNOUNCEMENTS Junction City High School 1135 W. 6th Ave * Junction City * OR * 97448 Main office: 541-998-2343 * Attendance: 541-998-8617 Counseling Center: 541-998-5955 * Athletics: 541-998-3521

More information

Applying for a Social Security Card is easy AND it is FREE!

Applying for a Social Security Card is easy AND it is FREE! SOCIAL SECURITY ADMINISTRATION Application for a Social Security Card Applying for a Social Security Card is easy AND it is FREE! If you DO NOT follow these instructions, we CANNOT process your application!

More information

Special Programs. Extended Day/Week Tutorial Program Guidelines

Special Programs. Extended Day/Week Tutorial Program Guidelines 2013 2014 Special Programs Extended Day/Week Tutorial Program Guidelines In Brownsville ISD, every opportunity is extended to help our lowest achieving students become academically successful. In support

More information

Summer Employment Application 2014

Summer Employment Application 2014 Summer Employment Application 2014 Thank you for your interest in the North Shore Youth Career Center s Summer Youth Program 2014. The next step in the process is to complete this application and include

More information

Application for World Wide Views on Climate and Energy Phoenix, AZ

Application for World Wide Views on Climate and Energy Phoenix, AZ Application for World Wide Views on Climate and Energy Phoenix, AZ Thank you for applying to be part of the Arizona deliberations for World Wide Views on Climate and Energy. To learn more about the global

More information

SUBCHAPTER A. AUTOMOBILE INSURANCE DIVISION 3. MISCELLANEOUS INTERPRETATIONS 28 TAC 5.204

SUBCHAPTER A. AUTOMOBILE INSURANCE DIVISION 3. MISCELLANEOUS INTERPRETATIONS 28 TAC 5.204 Part I. Texas Department of Insurance Page 1 of 10 SUBCHAPTER A. AUTOMOBILE INSURANCE DIVISION 3. MISCELLANEOUS INTERPRETATIONS 28 TAC 5.204 1. INTRODUCTION. The commissioner of insurance adopts amendments

More information

CA Dream Application References

CA Dream Application References CA Dream Application References 2014 California High School Counselor Workshop Guide Page 171 California Nonresident Tuition Exemption For Eligible California High School Graduates (The law passed by

More information

PATIENT'S INFORMATION REGISTRATION SHEET / INFORMACION DEL PACIENTE

PATIENT'S INFORMATION REGISTRATION SHEET / INFORMACION DEL PACIENTE DAN S. COHEN, M.D PATIENT'S INFORMATION REGISTRATION SHEET / INFORMACION DEL PACIENTE PLEASE PRINT CLEARLY / POR FAVOR ESCRIBA LEGIBLEMENTE TODAY S DATE / FECHA DE HOY: PATIENT'S NAME/NOMBRE DEL PACIENTE:

More information

WHEN: JUNE 20, 2015, 1:00 P.M. WHERE: Walt Disney Concert Hall 111 South Grand Avenue, Los Angeles, CA

WHEN: JUNE 20, 2015, 1:00 P.M. WHERE: Walt Disney Concert Hall 111 South Grand Avenue, Los Angeles, CA Presentations and signings from four world-famous cartoonists! WHEN: JUNE 20, 2015, 1:00 P.M. WHERE: Walt Disney Concert Hall 111 South Grand Avenue, Los Angeles, CA TICKETS: DrawnTogetherLA.org In partnership

More information

APS ELEMENTARY SCHOOL PLANNING SURVEY

APS ELEMENTARY SCHOOL PLANNING SURVEY ARLINGTON PUBLIC SCHOOLS PLANNING AND EVALUATION OFFICE APS ELEMENTARY SCHOOL PLANNING SURVEY SURVEY PROCESS & DATA SUMMARY PLANNING AND EV ALUATION O FFICE 1426 NORTH Q UINCY STREET A RLINGTON, VA 22207

More information

Enrollment Forms Packet (EFP)

Enrollment Forms Packet (EFP) Enrollment Forms Packet (EFP) Please review the information below. Based on your student(s) grade and applicable circumstances, you are required to submit documentation in order to complete this step in

More information

Summer Employment Application 2015

Summer Employment Application 2015 Summer Employment Application 2015 Thank you for your interest in the orth Shore Youth Career Center s Summer Youth Program 2015. If you are a youth age 14 to 21, the next step in the process is to complete

More information

Pipefitters, Refrigeration Techanicians, Sheet Metal and Fire Protection Sprinkler Fitter Application INSTRUCTIONS -- PLEASE READ CAREFULLY

Pipefitters, Refrigeration Techanicians, Sheet Metal and Fire Protection Sprinkler Fitter Application INSTRUCTIONS -- PLEASE READ CAREFULLY Phone:(401)462-8580 Fax: (401)462-8528 www.dlt.ri.gov/profregs Pipefitters, Refrigeration Techanicians, Sheet Metal and Fire Protection Sprinkler Fitter Application INSTRUCTIONS -- PLEASE READ CAREFULLY

More information

BROWARD METROPOLITAN PLANNING ORGANIZATION TITLE VI DISCRIMINATION COMPLAINT PROCEDURES

BROWARD METROPOLITAN PLANNING ORGANIZATION TITLE VI DISCRIMINATION COMPLAINT PROCEDURES BROWARD METROPOLITAN PLANNING ORGANIZATION TITLE VI DISCRIMINATION COMPLAINT PROCEDURES The Broward Metropolitan Planning Organization (Broward MPO) values diversity and both welcomes and actively seeks

More information

FAMILIES 2014 SOTX INFORMATION GUIDE

FAMILIES 2014 SOTX INFORMATION GUIDE FAMILIES Families with children who have intellectual disabilities are like other families; however, having a child with special needs often thrusts them into situations that may make their everyday lives

More information

Advanced Dyer Observers Space Science Camp Application (please list only one camper per form)

Advanced Dyer Observers Space Science Camp Application (please list only one camper per form) June 20-24, 2016! Advanced Dyer Observers Space Science Camp Application (please list only one camper per form) Student s name Grade (Fall 2016) 7th 8th School student attends Birthday Gender Adult t-shirt

More information

LOS ANGELES UNIFIED SCHOOL DISTRICT POLICY BULLETIN

LOS ANGELES UNIFIED SCHOOL DISTRICT POLICY BULLETIN TITLE: NUMBER: ISSUER: Guidelines for the Use of Audiovisual Materials Not Owned, Broadcast, or Recommended by the District BUL-5210 Judy Elliott, Chief Academic Officer ROUTING Local District Superintendents

More information

High School Common Application 2013-2014

High School Common Application 2013-2014 High School Common Application 2013-2014 KIPP Houston High School 10711 KIPP Way Drive Houston, TX 77099 Lara Wheatley, School Leader lwheatley@kipphouston.org (832) 328-1082 KIPP Sunnyside High School

More information

LOS ANGELES UNIFIED SCHOOL DISTRICT BULLETIN

LOS ANGELES UNIFIED SCHOOL DISTRICT BULLETIN TITLE: NUMBER: ISSUER: Parental Exception Waivers: Procedures and Guidelines for Requesting Alternative Programs for English Learners, K-12 BUL-4153.1 Jaime R. Aquino, Ph.D. Deputy Superintendent of Instruction

More information

REY PERALES MEMORIAL SCHOLARSHIP

REY PERALES MEMORIAL SCHOLARSHIP REY PERALES MEMORIAL SCHOLARSHIP On August 6th, 2007, the National Plasterers Council lost a great friend and respected colleague in REYMONDO Rey PERALES. REYMUNDO "Rey" PERALES was born October 14, 1951

More information

Monterey County Behavioral Health Policy and Procedure

Monterey County Behavioral Health Policy and Procedure Monterey County Behavioral Health Policy and Procedure 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Policy Number 144 Policy Title Disclosure of Unlicensed Status for License

More information

Summer 2015 Youth STEM REGISTRATION PACKET

Summer 2015 Youth STEM REGISTRATION PACKET Summer 2015 Youth STEM REGISTRATION PACKET Oakton Community College Alliance for Lifelong Learning and Center for Promoting STEM 1 Table of Contents OAKTON YOUTH STEM OVERVIEW...3 PROGRAM STRUCTURE...3

More information

Non-Refundable Processing Application Fee

Non-Refundable Processing Application Fee State of Rhode Island and Providence Plantations RI Department of Labor and Training Division of Workforce Regulation and Safety, Professional Regulations Unit 1511 Pontiac Avenue - Building 70 - P.O.

More information

Financial Aid Information

Financial Aid Information Financial Aid Financial aid refers to any grant, scholarship, loan or paid employment offered to help a student meet his/ her college expenses. These monies can be meritbased and/or need-based. Merit-based

More information

THE FOUR AMBASSADORS ASSOCIATION, INC.

THE FOUR AMBASSADORS ASSOCIATION, INC. THE FOUR AMBASSADORS ASSOCIATION, INC. INSTRUCTIONS 1. Please complete the application in full. Be sure to fill in your name exactly as it should appear on the approval form. In order to expedite the approval

More information

We will include a small token of our appreciation for your participation in this study with the survey.

We will include a small token of our appreciation for your participation in this study with the survey. NHES-1L(CS) I am pleased to inform you that the has selected your household to participate in the 2012 National Household Education Survey, which we are conducting on behalf of the U.S. Department of Education.

More information

APPLICATION CHECKLIST. If making a copy of the application, please print out each paper in the corresponding color

APPLICATION CHECKLIST. If making a copy of the application, please print out each paper in the corresponding color APPLICATION CHECKLIST A complete application includes: Student Information, Parent/Guardian Information, and Student Academic Information Waivers and Commitment Form (parent and student please sign!)(salmon)*

More information

C o u n t y o f F a i r f a x, V i r g i n i a IMPORTANT

C o u n t y o f F a i r f a x, V i r g i n i a IMPORTANT C o u n t y o f F a i r f a x, V i r g i n i a To protect and enrich the quality of life for the people, neighborhoods and diverse communities of Fairfax County IMPORTANT Please use this as a checklist

More information

This registration form is also accessible online at: https://www.csuohio.edu/business/gyes-2015

This registration form is also accessible online at: https://www.csuohio.edu/business/gyes-2015 STUDENT REGISTRATION FORM Camp Session Dates: June 22, 2015- June 26, 2015 This registration form is also accessible online at: https://www.csuohio.edu/business/gyes-2015 Last Name: First Name: M.I.: Preferred

More information

THE ARC OF THE CENTRAL CHESAPEAKE REGION RESPITE CARE PROGRAM PROGRAMA PARA CUIDADO Y RESPIRO ANNUAL REGISTRATION FORM FORMA DE REGISTRACIÓN ANUAL

THE ARC OF THE CENTRAL CHESAPEAKE REGION RESPITE CARE PROGRAM PROGRAMA PARA CUIDADO Y RESPIRO ANNUAL REGISTRATION FORM FORMA DE REGISTRACIÓN ANUAL THE ARC OF THE CENTRAL CHESAPEAKE REGION RESPITE CARE PROGRAM PROGRAMA PARA CUIDADO Y RESPIRO ANNUAL REGISTRATION FORM FORMA DE REGISTRACIÓN ANUAL Name/Nombre: Date/Fecha: / / Date of Birth/Fecha de Nacimiento:

More information

LOS ANGELES UNIFIED SCHOOL DISTRICT REFERENCE GUIDE

LOS ANGELES UNIFIED SCHOOL DISTRICT REFERENCE GUIDE TITLE: Environmental Health Advisory Procedures ROUTING All Schools and Offices NUMBER: ISSUER: Robert Laughton, Director Office of Environmental Health and Safety DATE: March 30, 2015 Thelma Meléndez,

More information

Sponsorship Package * Paquete de Patrocinios

Sponsorship Package * Paquete de Patrocinios Sponsorship Package * Paquete de Patrocinios Saturday September 19, 2015 From 9:00 AM to 5:00 PM Dear Community Partner, Homies Unidos Inc. is excited to begin planning for our first Central American Youth

More information

How To Apply For A Job At American Works, Inc.

How To Apply For A Job At American Works, Inc. Advanced AMW, Metal INC. Works, Inc. APPLICATION FOR EMPLOYMENT PERSONAL INFORMATION Name: Last First Middle Date: Social Security #: Phone #: Referred By: All Names Used In The Past: Present Address:

More information

North Shore Youth Career Center Summer Application Instructions

North Shore Youth Career Center Summer Application Instructions orth Shore Youth Career Center Summer Application Instructions Application All submitted summer application forms must be completed in full. They must include all required back up documentation. (All applicants

More information

2016 FLORISSANT SUMMER PLAYGROUND INFORMATION AND POLICIES

2016 FLORISSANT SUMMER PLAYGROUND INFORMATION AND POLICIES 2016 FLORISSANT SUMMER PLAYGROUND INFORMATION AND POLICIES CAMP LOCATIONS CAMP DATES/TIMES June 6 July 15, 2016 James J. Eagan Center (300) 9:00am 3:00pm Koch Park (320) No camp July 4th All Prices Subject

More information

Equal Opportunity Education? Assessing Information Resources for Hispanic Students at Turlock High School

Equal Opportunity Education? Assessing Information Resources for Hispanic Students at Turlock High School Equal Opportunity Education? Assessing Information Resources for Hispanic Students at Turlock High School Gabriela De La Mora It has been fifty years since the landmark decision in Brown v. Board of Education,

More information

UNITED FINANCIAL EMPOWERMENT $ CENTER NOW CLAIM IT! GET YOUR TAXES DONE FOR FREE *!

UNITED FINANCIAL EMPOWERMENT $ CENTER NOW CLAIM IT! GET YOUR TAXES DONE FOR FREE *! File a Tax Return to Claim the Tax Benefits You Earned with the Earned Income Credit and Child Tax Credit NOW CLAIM IT! If you worked in 2012 and earned less than $50,000... GET YOUR TAXES DONE FOR FREE

More information

To: adrian.cifuentes@aiesec.net

To: adrian.cifuentes@aiesec.net To apply for any internship you should send: - CV Europass format. -One letter answering this question: Why do you want to participate in this program? To: adrian.cifuentes@aiesec.net Summer Camp - 9 weeks

More information

Colquitt County Schools Enrollment Packet. Request Forms Middle School

Colquitt County Schools Enrollment Packet. Request Forms Middle School Enrollment Packet Request Forms Middle School Statement of Objection to Use of Social Security Number for Student Identification Request I do not wish to provide the Social Security Number of my child/children.

More information

Reference Guide to complete an AFIP form 4550 General resolution No. 3579 of the Administración Federal de Ingresos Públicos (AFIP)

Reference Guide to complete an AFIP form 4550 General resolution No. 3579 of the Administración Federal de Ingresos Públicos (AFIP) Reference Guide to complete an AFIP form 4550 General resolution No. 3579 of the Administración Federal de Ingresos Públicos (AFIP) UPS de Argentina Brokerage Department December 2014 Access AFIP s website

More information

Foster and Adoptive Parent Inquiry Booklet

Foster and Adoptive Parent Inquiry Booklet Foster and Adoptive Parent Inquiry Booklet believing and investing in the future of a child courage compassion fortitude commitment open your heart and your home the rewards are limitless REV. 6-10 The

More information

Quest, Inc. Title VI Complaint Procedures and Forms

Quest, Inc. Title VI Complaint Procedures and Forms Quest, Inc. Title VI Complaint Procedures and Forms 1.0 Title VI Procedures and Compliance FTA Circular 4702.1B, Chapter III, Paragraph 6: All recipients shall develop procedures for investigating and

More information

CHALLENGE TO INSTRUCTIONAL AND LIBRARY MATERIAL

CHALLENGE TO INSTRUCTIONAL AND LIBRARY MATERIAL CHALLENGE TO INSTRUCTIONAL AND LIBRARY MATERIAL The final decision for instructional and library materials rests with the School Board. The following procedures will be used for challenges to Instructional

More information

The Tiger Chronicles Volume 1 Issue 9

The Tiger Chronicles Volume 1 Issue 9 The Tiger Chronicles Volume 1 Issue 9 HARMONY SCIENCE ACADEMY JANUARY 28, 2014 Upcoming Events: Jan. 26 Jan. 30 National School Choice Week Feb. 7 STEM Festival Feb. 2 Feb. 6 STEM Week We are delighted

More information

General Parenting Workshops pp. 2&3. Co-Parenting Workshops p. 3. Community Workshops & Professional Development p. 4. Other Services p.

General Parenting Workshops pp. 2&3. Co-Parenting Workshops p. 3. Community Workshops & Professional Development p. 4. Other Services p. Service Guide January - March 2016 General Parenting Workshops pp. 2&3 Strategies for learning positive parenting skills. Co-Parenting Workshops p. 3 Techniques for positive parenting while sharing custody

More information

2015-2016 APPLICATION St. Charles School District Early Childhood Preschool Program

2015-2016 APPLICATION St. Charles School District Early Childhood Preschool Program 2015-2016 APPLICATION St. Charles School District Early Childhood Preschool Program Serving preschool children who are at least three years of age before August 1, 2015 Offering preschool classes at all

More information

Good afternoon! Upcoming Events and Dates: Friday, March 20 th CAPS Conferences for students.

Good afternoon! Upcoming Events and Dates: Friday, March 20 th CAPS Conferences for students. Good afternoon! This web site will allow you to keep up with what s going on at Palmetto. Each week Palmetto Middle School is going to post a weekly update on this page. This site will keep you informed

More information

Summer Camp at Inter-American Magnet School June 22nd through August 24th, 2015

Summer Camp at Inter-American Magnet School June 22nd through August 24th, 2015 Summer Camp at Inter-American Magnet School June 22nd through August 24th, 2015 Join us this summer as we travel to Spanish speaking countries across the world! We will feature activities that highlight

More information

Application for Employment

Application for Employment PLEASE GIVE APPLICATION TO: Club Office F&B Office Maintenance/Property Services Golf Shop Tennis Shop Horticulture Housekeeping Security Post Office Box 704 Linville, NC 28646 828.898.5151 phone 828.898.9742

More information

Central Community School

Central Community School Central Community School Working together to strengthen our community through our Community Schools After School Programs SPRING 2015 PROGRAMS: APRIL JUNE 2015 REGISTRATION DATES: March 4 TH to April 15

More information

After School Club starting on Monday, January 5 th 2015

After School Club starting on Monday, January 5 th 2015 Allegro Music and Dance School 1123 Industrial Rd. #300, San Carlos, CA 94070 www.fcallegro.com, allegro@fcallegro.com, 650-593-3900 Allegro Music & Dance School opens After School Club starting on Monday,

More information

Venezuela Business visa Application

Venezuela Business visa Application Venezuela Business visa Application IMPORTANT: Please enter your contact information Name: Email: Tel: Mobile: The latest date you need your passport returned in time for your travel: Venezuela business

More information

CITY OF LAREDO Application for Certification of Compliance for Utility Connection ($ 50.00 Application Fee Ordinance No.

CITY OF LAREDO Application for Certification of Compliance for Utility Connection ($ 50.00 Application Fee Ordinance No. CITY OF LAREDO Application for Certification of Compliance for Utility Connection ($ 50.00 Application Fee Ordinance No. 2012-O-158) Date of application: Applicant Address Telephone Cellular E-Mail Address

More information

James B. Rolle Elementary 21 st CCLC Before and After School Program

James B. Rolle Elementary 21 st CCLC Before and After School Program James B. Rolle Elementary 21 st CCLC Before and After School Program August 26, 2014 Morning Session: 7:15 AM 8:15 AM Afternoon Session: 3:30 PM 4:45 PM James B. Rolle 21 ST CCLC Before and After School

More information

Section 1. Background

Section 1. Background Harvest of the Month Guidelines: Modifying, Translating, and Developing Complementary Materials Criteria, Logo Usage, and Acknowledgement Statements Section 1. Background (page 1) Section 2. Modifications

More information

Venezuela Official visa Application

Venezuela Official visa Application Venezuela Official visa Application Please enter your contact information Name: Email: Tel: Mobile: The latest date you need your passport returned in time for your travel: Venezuela official visa checklist

More information

AUXILIARY APPLICATION

AUXILIARY APPLICATION PLEASE PRINT GREGORY-PORTLAND INDEPENDENT SCHOOL DISTRICT Office Use ONLY HUMAN RESOURCES Date Received: 608 COLLEGE STREET PORTLAND, TX 78374 (361) 777-1091, Ext. 1020 Date Approved: AUXILIARY APPLICATION

More information

The following State forms have been included in your claims kit packet:

The following State forms have been included in your claims kit packet: RE: Workers Compensation Claims Kit Dear Policyholder: Welcome to Tower Group Companies Workers Compensation Insurance Program. Although we hope that your company never experiences an injury to an employee,

More information

OVERVIEW OF THE AUTOMATED INFORMATION AND NOTIFICATION SYSTEM

OVERVIEW OF THE AUTOMATED INFORMATION AND NOTIFICATION SYSTEM Automated Information And Notification System (AINS) Users Guide 1 OVERVIEW OF THE AUTOMATED INFORMATION AND NOTIFICATION SYSTEM The Health Check Automated Information and Notification System (AINS) is

More information

Condor High School. Principal s Message- Kathy Greaves

Condor High School. Principal s Message- Kathy Greaves Condor High School Vision Statement: Condor High School inspires student to become responsible, successful, and adaptable members of the community. Mission Statement: Condor High School provides and individualized

More information

Received by NSD/FARA Registration Unit 06/25/2012 3:30:37 PM

Received by NSD/FARA Registration Unit 06/25/2012 3:30:37 PM Received by NSD/FARA Registration Unit 06/25/2012 3:30:37 PM OMB NO. 1124-0006; Expires February 28, 2014 Exhibit A to Registration Statement Pursuant to the Foreign Agents Registration Act of 1938, as

More information

WSFCCA MEMBERSHIP and ACCIDENTAL/MEDICAL APPLICATION 2013-2014

WSFCCA MEMBERSHIP and ACCIDENTAL/MEDICAL APPLICATION 2013-2014 WSFCCA MEMBERSHIP and ACCIDENTAL/MEDICAL APPLICATION 2013-2014 Christine Price, President 425-774- 9439 Lorri Hope, Treasurer & Membership 509-627- 1692 Email: wsfcca@aol.com www.wsfcca.com Washington

More information

REMINDERS. Parent/Teacher Conferences-Thursday, February 12th Parent/Teacher Conferences-Monday, February 16th

REMINDERS. Parent/Teacher Conferences-Thursday, February 12th Parent/Teacher Conferences-Monday, February 16th 2015 REMINDERS No school-monday, February 16th No school-friday, February 27th Parent/Teacher Conferences-Thursday, February 12th Parent/Teacher Conferences-Monday, February 16th Book Fair-Thursday, February

More information

Para ser considerado para obtener un espacio para vender y ser incluido a nuestro sistema de datos, por favor envíenos la siguiente información:

Para ser considerado para obtener un espacio para vender y ser incluido a nuestro sistema de datos, por favor envíenos la siguiente información: Vendor Information Latin Food & Music Family Festival: Saturday, October 3, 2015 To be considered for vendor space and be added to our database, please send all of the following: Information about your

More information

Ranking de Universidades de Grupo of Eight (Go8)

Ranking de Universidades de Grupo of Eight (Go8) En consecuencia con el objetivo del programa Becas Chile el cual busca a través de la excelencia de las instituciones y programas académicos de destino cerciorar que los becarios estudien en las mejores

More information

REVIEWER(S): Clement Anson, Tim Dodge. Ortega Industrial Contractors

REVIEWER(S): Clement Anson, Tim Dodge. Ortega Industrial Contractors GAINESVILLE REGIONAL UTILITIES Water & Wastewater Engineering SUBMITTAL REVIEW COMMENTS DATE: 11/17/14 PROJECT: GRU Dewatering SUBMITTAL NO.: 04230-001 PROJECT NUMBER: 461318.02.20.10 SUBMITTAL TITLE:

More information

NEBO SCHOOL DISTRICT Programs and Information WINTER 2007

NEBO SCHOOL DISTRICT Programs and Information WINTER 2007 The following communities offer Community School Classes through Nebo School District. You may obtain additional information regarding classes being offered in any of these communities by calling your

More information

New words to remember

New words to remember Finanza Toolbox Materials Checking Accounts When you open a checking account you put money in the bank. Then you buy a book of checks from the bank. Using checks keeps you from having to carry cash with

More information