REQUEST FOR STUDENT RECORDS

Transcription

1 REQUEST FOR STUDENT RECORDS PARENT/GUARDIAN: Please Complete TOP portion ONLY. PLEASE PRINT : To: (Previous School) (Address) (Phone) (FAX) Please send records for of Birth Present Grade Parent Signature REGISTRAR USE ONLY Please include the following records: Official transcript (please MAIL) Unofficial transcript (please FAX) Key to your grading system Withdrawal form & withdrawal grades Current report card Attendance Immunizations Pending Discipline Other Birth Certificate Social Security Card PEIMS Number (Texas Schools) TAKS Scores (Texas Schools) Standardized Test Scores Special Education Records ESL Records 504 Information, if applicable Klein High Registrar ۰ Phone ۰ FAX: Klein High School ۰ Stuebner Airline, Klein, TX 77379

2 STATEMENT OF ADDRESS I understand the Board of Trustees policy on Attendance Area which requires that a student attend the school in whose attendance area he/she resides. I certify that my son/daughter resides at which I believe lies within the Klein Collins High School attendance area. I understand that he/she will be required to transfer to the school in whose attendance area he/she resides if it is determined that he/she does not reside in the aforementioned attendance area. Signature of Parent or Court-Appointed Guardian Address City Zip Code Telephone Number = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = Address verified by: Utility bill_ Real estate document Other (Specify) School Administrator

3 LAWS RELATING TO ATTENDANCE In addition to the penalty provided by Sec Texas Penal Code, a person who knowingly falsifies information on a form required for enrollment of a student in a school district is liable to the district if the student is not eligible for enrollment in the district but is enrolled on the basis of the false information. The person is liable, for the period during which the ineligible student is enrolled, for the greater of: (1) the maximum tuition fee the district may charge under Sec TEC; or (2) the amount the district has budgeted for each student as maintenance and operation expense. A school district may include on an enrollment form notice of the penalties provided by Section Texas Penal Code, and the liability provided by Subsection (G) of this section for falsifying information on the form SUMMARY OF TPC Sec TAMPERING WITH GOVERNMENTAL RECORDS (B) A person commits an offense if he: (1) knowingly makes a false entry in, or false alteration of a government record; (2) makes, presents, or uses any record, document, or thing with knowledge of its falsity and with intent that it be taken as a genuine governmental record; (3) intentionally destroys, conceals, removes, or otherwise impairs the verity, legibility, or availability of governmental records. (C) It is an exception to the application of Subsection (A) (3) of this section that the governmental record is destroyed pursuant to legal authorization. (D) An offense under this section is a Class A misdemeanor unless the actor's intent is to defraud or harm another, in which event the offense is a felony of the third degree. In limited other circumstances defined in the statute, the offense may be a Class B or C misdemeanor. I SWEAR THE INFORMATION GIVEN BY ME IN THIS DOCUMENT IS TRUE. I ALSO UNDERSTAND THAT I COULD BE PROSECUTED FOR GIVING FALSE INFORMATION. DATE SIGNATURE

4 Warning Presenting a false document or record while registering a student in the Klein ISD is an offense under the Texas Penal Code and subjects the enrolling party to liability for tuition costs. In addition, if a student is enrolled pending the receipt of the official proof of identity, law enforcement authorities will be contacted after 30 days have elapsed and asked to determine if the child(ren) have been reported as missing. Student Name _ Parent Signature

5 Form G-1 KLEIN INDEPENDENT SCHOOL DISTRICT HOME LANGUAGE SURVEY-19TAC Chapter 89, Subchapter BB TO BE COMPLETED BY PARENT OR GUARDIAN (OR STUDENT IF GRADES 9-12): The state of Texas requires that the following information be completed for each student that enrolls for the first time in Texas public schools. This survey shall be kept in each student s permanent record folder. NAME OF STUDENT STUDENT ID# ADDRESS TELEPHONE # CAMPUS 1. What language is spoken in your home most of the time? 2. What language does your child (do you) speak most of the time? Signature of Parent/Guardian Signature of Student if Grades Cuestionario del idioma que se habla en el hogar DEBE DE COMPLETARSE POR EL PADRE/MADRE/ O REPRESENTANTE LEGAL: (O POR EL ESTUDIANTE SI ESTA EN LOS GRADOS 9-12): El estado de Texas requiere que la siguiente información se complete para cada estudiante que se matricula por primera vez en una escuela pública de Texas. Este cuestionario se archivará en el expediente del estudiante. NOMBRE DEL ESTUDIANTE #ID DIRECCION TELÉFONO_ ESCUELA 1. Qué idioma se habla en su hogar la mayoría del tiempo? 2. Qué idioma habla su hijo/a (usted) la mayoría del tiempo? Firma del Padre/Madre/ o Representante Legal Firma del estudiante si está en los grados 9-12 Fecha Fecha Klein ISD April 2010 SPANISH

6 Texas Education Agency Texas Public School Student/Staff Ethnicity and Race Data Questionnaire The United States Department of Education (USDE) requires all state and local education institutions to collect data on ethnicity and race for students and staff. This information is used for state and federal accountability reporting as well as for reporting to the Office of Civil Rights (OCR) and the Equal Employment Opportunity Commission (EEOC). School district staff and parents or guardians of students enrolling in school are requested to provide this information. If you decline to provide this information, please be aware that the USDE requires school districts to use observer identification as a last resort for collecting the data for federal reporting. Please answer both parts of the following questions on the student s or staff member s ethnicity and race. United States Federal Register (71 FR 44866) Part 1. Ethnicity: Is the person Hispanic/Latino? (Choose only one) Hispanic/Latino - A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Not Hispanic/Latino Part 2. Race: What is the person s race? (Choose one or more) American Indian or Alaska Native - A person having origins in any of the original peoples of North and South America (including Central America), and who maintains a tribal affiliation or community attachment. Asian - A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Black or African American - A person having origins in any of the black racial groups of Africa. Native Hawaiian or Other Pacific Islander - A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. White - A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. Student/Staff Name (please print) Student/Staff Identification Number (Parent/Guardian)/(Staff) Signature This space reserved for Local school observer upon completion and entering data in student software system, file this form in student s permanent folder. Ethnicity choose only one: Race choose one or more: American Indian or Alaska Native Hispanic / Latino Asian Black or African American Not Hispanic/Latino Native Hawaiian or Other Pacific Islander White Observer signature: Campus and : Texas Education Agency March 2010

7 PRINTED Legal Name of Student _ Student's of Birth Grade School, _ Dear Parent and Student: Please sign and return this form to the school by Friday, September 5, NOTE: If any boxes are left unchecked or if this form is not returned to the school, it will be assumed that permission is granted. You must specifically check and sign this form to deny access. Please call the school principal if you have any questions. Thank you for your cooperation. 1. The KISD Student Handbook is available on the KISD website at or you may request a hard copy. I will access the student handbook online. I am requesting a hard copy of the student handbook. This will certify that I understand and consent to my parental/student responsibilities as outlined in the school district's Student Handbook, the Student Code of Conduct, and the Student Acceptable Use Guidelines for Technology Resources. Signature of Parent/Guardian Signature of Student 2. The Family Educational Rights and Privacy Act of 1974 (FERPA) and the Texas Public Information Act govern the Klein ISD's release of directory information about students. Please see the FERPA Notice of Parent and Student Rights which is printed on the pages i and ii of the Student Handbook. Also, copies of the FERPA regulations and the Texas Public Information Act are available for review in each school principal's office. The Klein ISD does not have an option. Unless the parent objects, this information must be released to anyone who follows procedures for requesting it through the school district's central office. (This does not apply to directories published by grade levels, clubs, organizations, or individual schools.) An objection must be made in writing to the school principal within ten school days after the issuance of this notice. Please check this box if you object to the release of the above information. 3. Federal law requires the KISO to provide a military recruiter or an institution of higher education, on request, with the name, address, and telephone number of a secondary student unless the parent has advised the district that the parent does not want the student's information disclosed without the parent's prior written consent Please check this box If you object to the release of your secondary student's name, address, and telephone number to a military recruiter or institution of higher education. 4. The Klein ISD uses a variety of resources to publicize district events and school news. Additionally, occasionally there is news media coverage of district campuses, activities, or events. Should you object to a photograph or other electronic image of your child or his/her work on the school district website, newspaper, marketing brochures, publications, yearbooks, newsletters, KISD promotional videos, or other media coverage prepared for use both inside and/or outside the school district, please check the box below. **Failure to check the box below Indicates agreement for your child's picture or electronic image to be used in the manner stated in the above paragraph. Please check this box if you object to the use of a photograph or other electronic Image with your child's name, school and grade Identification as described in the paragraph above. Signature of Parent/Guardian