E. C. GLASS HIGH SCHOOL 2111 MEMORIAL AVENUE, LYNCHBURG, VA 24501

Transcription

1 E. C. GLASS HIGH SCHOOL 2111 MEMORIAL AVENUE, LYNCHBURG, VA COUNSELING DEPARTMENT MAIN OFFICE Janet Reynolds Director Dr. Tracy Richardson, Principal / FAX: / FAX: NEW STUDENT ORIENTATION GUIDE 1. Please complete the multi-purpose enrollment packet. 2. Not having any of the information listed below will/may delay your enrollment. Please provide: 2 Proofs of Residency MANDATORY (Utility bill, car registration or rental agreement with guardian s name and address) Driver s License cannot be accepted All students must live with a Legal Guardian. Any student living with a relative other than a parent must have court papers (Custody) prior to enrollment. If Guardian and Student are living with someone else, A letter from the homeowner/leasee must be Notarized stating you and your child is living with them. (According to state standards you will be classified as homeless until you have a permanent residence.) If a student is 18 yrs old and living with someone other than a parent, the other person must have a Notarized Note stating you are living there and 2 Proofs of Residence with their name on it. 3. TUITION: Family living outside LCS school s district. A Non Resident Student form must be filled out. Tuition Students must be approved by the Finance Department in the School Administration Building. 4. DOCUMENTS REQUIRED: Original Birth Certificate Social Security Card Transcript and/or withdrawal grades Immunization Records, if not provided by previous school 5. PROVIDED UPON REQUEST Free Lunch Form Bus Schedule Parking Registration Form (Main Office) School Accident Insurance Form 6. ALL STUDENTS MUST PURCHASE A SCHOOL AGENDA. (Cost $10.00) 7. Develop a schedule of classes with the Director/Counselor If your last name begins with A - C D - H I - M N R S - Z Secretary Registrar Resource Assistant Test Coordinator/Assessment Specialist Your Counselor is: Mrs. Lonnie Hoade Mrs. Karen Carlson Mr. Robert Cook Mrs. Janet Reynolds, Director Mrs. Felicia Calloway Mrs. Karen Allison Mrs. Jean Long Mrs. Corlett Keefer Mrs. Kellie Reams

2 Application for Entrance and Emergency Medical Form For Office use only Student # School Grade Teacher/HR Bus No. Student Information Last Name First Middle Sex Race (see back of form) Social Security Number Birth Date Home Phone Birth Certificate Number City, State, Country of Birth Grade at Last School Attended Last School Attended Address Has student ever attended Lynchburg City Schools? _Yes _No If yes, which school? Year Grade Name of Pre-School(s) Attended How many days per week did child attend preschool? Child attended for Full Day Half Day Is this child currently residing in a foster home? Yes No Has this child ever been found guilty or delinquent in a court of law? Yes No (Per Code of VA ) Please describe Parents/guardians with whom the child lives (person/s who have primary physical custody of child) Parent/Guardian Name Relationship Residence Address ZIP Home Phone Unlisted? Employer Work Phone Address Cell Phone Parent/Guardian Name Relationship Employer Work Phone Address Cell Phone Primary language spoken in the home _English _Spanish _French _Other (please specify) Parents/guardians with whom the child DOES NOT live (for example, father and stepmother) Parent/Guardian Name Relationship Use this person as a contact in case of emergency? Yes No Address ZIP Home Phone Employer Work Phone Address Cell Phone Pager Parent/Guardian Name Relationship Use this person as a contact in case of emergency? Yes No Address ZIP Home Phone Employer Work Phone Additional Emergency Contacts In the event that there is an emergency and the parents/guardians above can t be reached, whom should we contact? 1. Name Phone Relationship Cell Phone 2. Name Phone Relationship Cell Phone Medical Information Physician s Name Phone List all allergies, including drug and food allergies List any serious chronic medical condition the child may have, such as heart problems, asthma, diabetes, seizures, etc. List all medications the child is currently taking on a regular basis Medical Release I realize that I, as the Parent/Guardian, am responsible for notifying the school of any changes of the above information including change of address, new phone number, medical problems, etc. I hereby authorize the school and/or hospital to provide medical care for my child according to their best judgment, and agree to pay expenses so incurred, including ambulance transportation if necessary. Date EmergencyMedicalForm Rev /25/2012 J. McKinney Parent/Guardian s Signature

3 ETHNICITY AND RACE IDENTIFICATION Page 2 of 2 Description and Instructions The federal government has issued new standards for reporting individual race and ethnicity data beginning in the school year. To comply with those standards, please complete the information below for the student listed on the front of this form. If you choose not to provide this information, we are required to provide an answer on your behalf. The two questions below are designed to identify your ethnicity and race. Please be sure to answer both questions. Question 1. Are you Hispanic or Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin.) Yes No Question 2. Select the racial category or categories with which you most closely identify by placing a check by the appropriate category. Check as many as apply, but you must choose at least one. Racial Category (Check as many as apply, but at least one.) American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Definition of Category A person having origins in any of the original peoples of North and South America (including Central America) A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent A person having origins in any of the black racial groups of Africa A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands A person having origins in any of the original peoples of Europe, the Middle East, or North Africa

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5 TUITION & FALSE STATEMENTS Any time during the school year you move outside the city limits, tuition to Lynchburg City Schools is effective immediately for the remainder of the year. You may contact the Lynchburg City Schools Finance Office at to receive tuition cost information and a tuition application. When moving within the city, please notify the school s Counseling Office of your new address. A new Emergency Medical form must be filled out and proof of residence must accompany the Emergenccy Medical form! Code of Virginia> Misdemeanor to make false statements as to school division or attendance zone residency; penalty. Any person who knowingly makes a false statement concerning the residency of a child, as determined by , in a particular school division or school attendance zone, for the purposes of (i) avoiding the tuition charges authorized by (ii) enrollment in a school outside the attendance zone in which the student resides, shall be guilty of a Class 4 misdemeanor. Parent Signature: Date: ********************************************************* Interested in playing Sports for E. C. Glass Yes No If you are interested in participating in athletics, there are many Virginia High School League rules that regulate participation. If you have not moved into our attendance zone, you are not eligible unless specific exceptions apply If you are a tuition student, you may not be eligible. If your custodial parent has changed, you must bring court documentation (after the hearing) to the Athletic Director to prove eligibility. If your response is yes, you must meet with the ATHLETIC DIRECTOR, Mr. Berry, to determine your child s eligibility to participate in athletics. You may schedule the meeting by calling the ATHLETIC OFFICE at Signature Date ************************************************************ FREE AND REDUCED LUNCH FORM (Must Complete One (1) Application EVERY year as a family and list all children) Free or reduced lunch daily Free SAT or ACT test fees fee waiver 4 free college application fees IF you use fee waiver for testing Free PSAT testing (11 th grade) Scholarship Opportunities 1. Reduced fees for 2 nd Chance (after school makeup classes 2. Reduced fee on graduated scale for Behind-The-Wheel 3. Reduced fees for AP testing 4. Reduced Dual Enrollment tuition

6 SPECIAL EDUCATION INFORMATION (Information Must Be Acknowledged and Signed By Parent/Guardian) Date: Student s Name: Grade: FORMER SCHOOL: I am receiving Special Services. I am not receiving Special Services. I did receive Special Services in grade But exited and no longer receiving Special Services. [Parent s Signature] [Student s Signature] IEP TRANSFER PACKET 504 Transfer Packet Date Sent: By:

7 E. C. GLASS HIGH SCHOOL 2111 Memorial Avenue Lynchburg, VA (434) Fax: (434) Counseling Office Phone: (434) Fax: (434) Dear Parent(s): As per the Code of Virginia, we screen all children, with sixty (60) administrative workings Days of initial enrollment in Lynchburg City Schools, in the following areas: 1. Speech, voice and language (Pre-K, K, 1 st, 2 nd, 3 rd ) 2. Fine and gross motor functions (Pre-K, K, 1 st, 2 nd, 3 rd ) 3. Vision and hearing (Grades Pre-K, K-12) In addition, screening in vision and hearing will be administered for all students in grades 3, 7 and 10 yearly. Information related to the results of the screening is considered confidential. We will maintain your son/daughter s scholastic record as outlined in the document. Management of Student s Scholastic Record in the Public Schools of Virginia We welcome you to the Lynchburg City Schools. Should you have questions related to our screening procedures, please do not hesitate to contact me. Sincerely Dr. Tracy Richardson, Principal

8 DISCIPLINE AFFIDAVIT In accordance with the Code of Virginia, Section I Affirm that has not been expelled from school attendance at a private school or in a public school division of the Commonwealth or in another state for an offense in violation of school board policies relating to weapons, alcohol or drugs, or for the willful infliction of injury to another person. Any person making a materially false statement or affirmation shall be guilty upon conviction of a Class 3 misdemeanor. I will receive a copy of the student handbook. I understand that I am responsible for reading it and knowing the contents. This registration document shall be maintained as a part of the student s scholastic records. (Signature of Parent/Guardian) (Date) (Signature of Student) (Date)

9 Student Acceptable Use of School Division Technology Policy Agreement Student Section: Student Name Grade (please print include middle initial) I agree to abide by all guidelines listed in School Board Policy 6-48: Acceptable Use of School Division Technology Resources Policy. I realize the purpose of the school division s technology is educational. I realize the use of technology is a privilege, not a right. I accept that inappropriate behavior may lead to penalties, including revoking my account, disciplinary action, and/or legal action. I realize that school personnel (school administrators, teachers, network administrators) can access all of my current and past network materials and my student accounts. I agree not to access or transfer inappropriate, pornographic, or illegal materials through the school division's network or storage media I agree not to allow other individuals use of my account(s), nor will I give anyone my password(s). I agree to abide by the school division s software licenses and guidelines. I agree to abide by the school division s guidelines for the use of social media. I will not access on-line gaming sites and/or save gaming software files on school division equipment. I will not launch programs from personal storage devices. The Acceptable Use Policy has been read to me or I have read the Acceptable Use Policy. I agree to abide by the guidelines established, and understand that violation of the guidelines may result in termination of my access to school division technology. I also realize I may be subject to additional disciplinary action, including suspension from school and/or possible criminal charges. Student Signature Date Parent Section: (A parent or guardian must also read and sign.) As the parent or guardian of this student, I have read the Acceptable Use Policy. I understand that school division technology is designed for educational purposes and that the school division has taken precautions to eliminate inappropriate materials. I understand, however, that it is impossible to restrict access to all controversial materials, and I will not hold the school division responsible for materials acquired through school division technology. I understand that my child will participate in Internet Safety instruction and will use the school division s technology resources including the Internet under the guidelines established. Parent Signature Date Each staff member is responsible for adhering to school board policy relating to the use of school division technology resources. Each staff member has read the Acceptable Use Policy and has agreed to abide by the provisions included and to promote this policy with students. All staff members will ensure acceptable use of the Internet and proper network etiquette using the approved Lynchburg City Schools Internet Safety curriculum. Each staff member will make reasonable effort to ensure that student access to the network including the Internet is appropriate. Each staff member has a signed form on file indicating his/her acceptance of the provisions of school board policy. Revised 6/20/2012

10 CUSTODIAL RESIDENT FORM To accompany Petition or Custody Papers Please furnish the following information: Name of Student: Name of Legal Guardian: Address of Legal Guardian student will be living with for the 2015 school year. I certify that my son/daughter Will be living with me at the above address for the 2015 Lynchburg City Schools Academic Year. [Signature] [Date] Next Court Date: Please return this signed form and a copy of Court Order to: Dr. Tracy Richardson, Principal Mrs. Jean Long, Registrar E. C. Glass High School 2111 Memorial Avenue Lynchburg, VA 24501

11 TRANSPORTATION DEPARTMENT 3525 John Capron Road Lynchburg, Virginia (434) Fax: (434) Transportation Request Form (Please Print) Please check the reason for submitting this form: 1. The student is new to Lynchburg City Schools. 2. The student is moving or has moved to within the school s attendance zone. 3. The student is transferring from another school in the division. 4. Transportation service is needed to or from an alternate location within the school s zone, such as a baby sitter, relative, day care center, etc** 5. Requesting a change in the student s stop location.**(see School Board policy below)* Date: Desired Start Date: School: Student s Name: Grade: Stu ID#: Home Address: Current: Bus # (A.M./P.M.): Stop Location (A.M./P.M.): **If requesting a change from the stop(s) listed above (4 or 5 checked). A.M. Pick-up Location (address): P.M. Drop-off Location (address): Special Instructions: Parent/Guardian: Contact Information: Phone: (H) (W) (Cell) Please allow up to 5 school days for your request to be processed. The Transportation Department will notify you when the request has been processed. *Bus stops shall be located in accordance with the following criteria: 1. Bus stops shall be designed to pick up groups of students whenever possible. 2. Bus stops will be located at points of maximum safety. 3. Traffic and traffic patterns shall be considerations in the designation of a bus stop. 4. Students in grades K-5 shall not be expected to walk more than one-half mile to school or to a bus stop. Students in grades 6-12 shall not be expected to walk more than one and one-half miles to school or to a bus stop. Due to certain hazardous situations, transportation may be provided for some students who live closer to school than the limitations stated above.