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RME Step 2 document for on-line enrollment
Citation preview
Robert Martin Elementary School
On-‐Line Enrollment Step 2 Document 2011/2012
Volume 3, Issue 1
July 2011
Robert M. Martin Elementary 2342 N. 159th Street East Wichita, KS 67228 316.218.4720 www.usd385.org
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Mark Your Calendars… July 5th Online Enrollment information sent to Parents/Guardians of all students
August 1st School Office Opens Hours: 8:00am - 12:00pm and 1:00pm to 4:00pm
August 8th New students enroll Hours: 8:00am - 12:00pm and 1:00pm - 4:00pm
August 9th Returning students enroll Hours: 12:30pm - 7:00pm
August 11th K-5th Grade room assignments mailed home
August 10th-12th New teachers report to school
August 15th-17th All teachers report to school
August 16th “Meet Your Teacher Night” at Martin Ele-mentary 6:00pm - 7:00pm
August 18th First day of school for 1st - 5th grade stu-dents
August 22rd First day of school for kindergarten students
Enrollment Information
Enrollment ‐ USD 385 is enrolling students online for the 2011‐2012 school year. Any form that needs to be completed, signed, and returned to the office may be done on Tues‐day, August 9th. Payments for regis‐tration and technology fees may also be made at the school on Tuesday, August 9th. If you need assistance with the new online enrollment process, please call the school office for available dates and times that our computer lab will be open to help complete online enrollment for your student. The office will open on August 1st, at 8:00am.
On‐line payment opportunity ‐ Fee payments and meal account deposits may be made online at the end of the online enrollment process or on the top of the district homepage, www.usd385.org. You will find a link entitled “Payment for Meals & Fees” in the upper right hand corner.
Classroom Placements ‐ Your child’s classroom placement will be mailed home on August 11th. Class lists will also be posted at the school dur‐ing “Meet Your Teacher Night” on Tuesday, August 16th from 6:00 ‐ 7:00 p.m.
Dr. Crystal D. Hummel, principal
ARRIVAL, DISMISSAL, & PARKING
ARRIVAL
K-AM, All Day K, and 1st-5th Grade Students Enter Class 8:25 a.m.
K-AM, All Day K, and 1st-5th Grade Students Class Begins 8:35 a.m.
K-PM Students Enter Class 12:25 p.m.
K-PM Students Begin Class 12:35 p.m.
Much consideration has been given to the safety of our children. To prevent any “close calls” or accidents, we need all people who drop off children in the morning to support and follow certain procedures.
1) Car riders may only be dropped off after 8:25 a.m. at the South entrance. Students are not to arrive before 8:25 a.m. since there is no supervision available until this time.
2) Afternoon kindergarten students should not arrive at school any earlier than 12:25 p.m.
Late Arrivals
If your child arrives after 8:35 a.m., please stop by the office, sign your child in and receive a “pink slip.” The “pink slip” is to be given to your child’s teacher by the student, so he/she will know the office has been notified of any arrivals.
DISMISSAL
K-AM Dismiss 11:35 a.m.
K-PM, All Day K, 1st-5th Grades Dismiss 3:35 p.m.
School is not officially dismissed until 11:35 a.m. for Kindergarten Half-Day morning class, and 3:35 p.m. for All Day Kin-dergarten, Kindergarten Half-Day afternoon class, and 1st-5th grade students. Walkers and bike riders will also be dis-missed at 3:35 p.m. We request that parents/guardians do not arrive early and linger around the classroom doorways. This can interfere with optimum instruction. A student must be signed out through the office if the student is leaving be-fore the official dismissal time.
Automobile Procedures
1) Car riders will be picked up on the South side of the building.
2) All cars must have an identification sign provided to Martin parents/guardians on their dashboard so supervisors may easily read the last name on the sign. Place the sign on the PASSENGER side of the vehicle.
3) Parents are asked to remain in their car while waiting in line to receive their child.
4) Drivers are asked to remain in a single file in the lane next to the sidewalk all the way to the end of the drive. Drivers are not allowed to pull out of line. Remaining in a single file will ensure that no student is crossing in front of moving vehicles.
5) Students will be called from the music room when the supervisor reads the sign located on the passenger side of the car.
6) Students will be released from the music room in family groups to enter the right side of the vehicle for safety.
7) Drivers are asked to stay in their automobiles and allow staff to guide students to the entry doors. If you need to get out of your automobile, please park in the South parking area in order to keep the drive open for safe passage.
8) Students may only cross the divider to the parking lot when accompanied by a parent or guardian.
9) Any student not picked up by 3:45 p.m. is walked to the office. Parents/guardians arriving after 3:45 p.m. are asked to come into the office to pick up their child.
2011-2012 Robert M. Martin Elementary Fees
Student Name:
Grade:
Required Fees $65.00 - Half Day Kindergarten Textbook Fee
$75.00 - All Day Kindergarten, 1st thru 5th Grade Textbook Fee
$25.00 - All Day Kindergarten, 1st thru 5th Grade Technology Fee
$12.50 - Half Day Kindergarten Technology Fee
Elective Fees $100.00/1 student - Transportation Fee (for all students who live less than 2.5 miles from their school and choose to ride the bus)
$150.00/family - Transportation Fee (for all students in one family who live at the same address)
$275.00 – Monthly Fee for All Day Kindergarten
Food Service Fees $1.50 – Breakfast $2.05 – Lunch $0.40 – Snack Milk (kindergarten only)
Required Fee Payment Options • Check or money order payable to Martin Elementary School • Pay online at www.usd385.org
Elective Fee Payment Options • Check or money order payable to USD #385 • Pay online at www.usd385.org
Food Service Payment Options • Check or money order payable to USD #385 Food Service • Pay online at www.usd385.org
Attention New Students: The following forms will need to be printed off from the District web site and returned to the school office before enrollment is complete. _____ Request for Transcript (new students only) _____ Student Requiring Special Meals (if applicable)
_____ Placement Information (new students only) _____ Free & Reduced Application (if applicable)
_____ Proof of Residence (new students only) _____ Health Examination (new students only)
_____ Birth Certificate (new students only) _____ KCI (new students only)
_____ Home Language (new students only) _____ Immunization Statement (new students only)
Applications for free and reduced fee assistance are available online.
The A-Line————
If you have any questions about Andover Public Schools
Transportation or The A-Line, please contact the
Transportation Department at (316) 218-4621 or
cloptonj@usd385.org.
Andover Public Schools will make available fee
-based transportation for all students in the
district who live less than 2.5 miles from their
school and choose to ride the bus.
Eligibility for this program is based on the
student’s home address, not from the location
the student boards the bus.
Students must be registered and fees must be
paid before transportation can begin.
Registration must be made by parents — not by
students or babysitters.
The program fee is $100 per year per student.
Pro-rating will be available to new students
only.
There is a maximum fee of $150 per year for
all students in one family who live at the same
address.
Students in the program must go to the
nearest established bus stop for pick up.
There are no discounts for students in sports
or other activities that make it necessary for
the student to use the bus only once a day—
the cost remains the same whether the
student(s) ride one way or both ways.
Students who qualify for free or reduced
lunches may use this program for free.
Because the district receives state aid for
transporting students who live 2.5 miles or more
from their school, the district will continue to
provide free bus transportation for all of those
students.
To use the A-Line, please complete the form
included on the back of this sheet and return it
with payment by August 1 to Julie Clopton, Director
of Transportation, at 222 W. King, Andover, KS
67002.
Transportation service for those who live less than 2.5 miles from their school
Fee
$100 per student per year
Maximum fee of $150 per year for
all students in one family who live
at the same address.
Application for Busing in the A-Line Program (for students who live less than 2.5 miles from their school)
Please complete one form per family per location, listing each child in the household who will be riding the bus.
1. Student’s Last Name:__________________________________ First Name: ______________________________
School: __________________________________ Grade: _________
2. Student’s Last Name:__________________________________ First Name: ______________________________
School: __________________________________ Grade: _________
3. Student’s Last Name:__________________________________ First Name: ______________________________
School: __________________________________ Grade: _________
4. Student’s Last Name:__________________________________ First Name: ______________________________
School: __________________________________ Grade: _________
Parent/Guardian Name: ____________________________________________________________________
Cell Phone: ________________ Work Phone: _________________ Evening Phone: __________________
If you qualify for free or reduced lunches, this service is free.
Please make checks payable to Andover USD 385. Enclosed: $______ for #_____ students in family.
If you paid online, please print a copy of your receipt and send it in with this form.
Alternate Pick Up and Drop Off Request
If a student is to be picked up or dropped off at an address other than the home, fill out the information below. Please
note: the location must be in the boundaries of the school the student is attending—student transfers due to babysitter
location may be allowed — contact Administration at (316) 218-4660.
Pick up location: ____________________________________ _________ _______________________ Name of resident Phone # ___________________________________________________ Pick up days: M T W TH F Address Drop off location: ____________________________________ _________ _______________________ Name of resident Phone # ___________________________________________________ Pick up days: M T W TH F Address Home Address: _________________________________________________________________ ***************************************Office Use Only Below***************************************
Date: ____________ Method of Payment: _______________ Amount Received: $_______
ANDOVER PUBLIC SCHOOLS USD 385
DEPARTMENT OF HEALTH SERVICES
MEDICATION ADMINISTRATION RELEASE FORM
I hereby certify that _________________________ has previously had at least one dose of the prescribed medication listed and did not have an adverse reaction from it. I request that this medication(s) to be administered at school as prescribed by the physician. I understand that any school employee who administers this prescription to my child in accordance with written instructions from the physician or dentist (and USD #385 Board of Education Policy) shall not be liable for damages as a result of an adverse drug reaction suffered by the pupil, because of administering such a drug or because of a mislabeled or altered product. I hereby authorize USD #385 Department of Health Services personnel to exchange information regarding dispensing and monitoring of this medication with ___________________________, the attending physician or dentist, or with the pharmacy as identified on the label of the prescribed medication container.
__________________________________________ _________________ Signature of Parent/Legal Guardian Date ___________________________ Telephone Number
NOTE: The medication must be brought to school in the original container appropriately labeled by the pharmacy, or physician, stating the name of the medication, the dosage and times to be administered.
Building: ________________________________ Teacher/Grade____________________________
Student's Name______________________________________ Birth Date:________________
Medication:_____________________________ Diagnosis:____________________________
Route:_______________________________ Dosage:______________________________
Special Instructions for Administration:_________________________________________________
________________________________________________________________________________
Requested Starting Date of treatment: _________________ Duration (End Date):_______________
Time to administer at school: ____________________
_____________________________________________ ________________________________
Physician's Signature Date
________________________________ ________________________________
Telephone Number Fax Number
Please print and return this form to the school office by August 9.
Please print and return this form to the school office by August 9.
2011-2012 PTO
Welcome! Martin Elementary PTO promotes communication between the school, teachers, students, and families. If
you are a Martin parent, then you are a PTO member. The Martin PTO is very active and we do great things!
VOLUNTEER OPPORTUNITIES – Volunteer Name: _________________________________________ Please check all areas that interest you. Only one form needs to be completed per household.
Helping Hands (first week of school):
Helping Hands (first week of school):
Volunteer:
Volunteer:
Fall Fundraiser/Jog-A-Thon:
Spirit Committee:
We look forward to meeting new volunteers with new ideas. The staff and PTO members of Martin Elementary are grateful for
those that have volunteered in the past. We hope that you will continue with this support. We cannot do it without you!
Student Name(s):_________________________________________ Grade: ______
_________________________________________ ______
_________________________________________ ______
_________________________________________ ______
Address: ________________________________________________________________________________________________
Phone:_________________________________________________ Email:__________________________________
Parent/Guardian Name(s): ___________________________________________________________________________________
DIRECTORY Martin Elementary PTO publishes a student directory each year for the personal use of Martin Elementary families and staff. It
promotes communication and contact between families, friends and teachers. It is prohibited to distribute the directory for any
commercial purpose. Directories will be sold for $1 in the Fall.
If your child has more than one household, please note both addresses on this form.
If you do not wish to publish your email address simply check this box: □
Participation is optional; if you do not want your child listed in the directory, please check the appropriate box below.
Feel free to contact the school office or Julie Schillings at jschil@cox.net with any questions.
Yes, I give permission to include my child’s/children’s contact information in the School Directory.
No, do not include my child’s/children’s contact information in the School Directory.
_______________________________________________________________ __________________
Parent/Guardian Signature Date
MARTIN MONDAY UPDATE (MMU) The “Martin Monday Update” is a weekly email that shares what’s going on during the following week (picture day, field trips,
projects due, girl scouts, etc.). Your email address will be kept confidential and will NOT be shared with any outside parties.
Please notify Tricia Gracey at graceys@sbcglobal.net if you need e-mail changes made at any time during the school year.
___ Yes, sign me up! ___ No Thanks Use this e-mail instead of the e-mail above: __________________________
Kdgtn Dismissal (11:35) AM Bus Duty Kdgtn Assessment
Kdgtn Arrival (12:35) PM Bus Duty Lunch Aide
School Pictures Book Fairs Music Programs
Dental/Vision Screening Sign In/Out Tables Yearbook Photographer
Planning/Prizes/Supplies Tracking Donation Forms Planning JAT Assemblies
Bulletin Boards Teacher Appreciation (Goods & Supplies)
S:\School\PTO\Volunteers and Confidentiality Form.doc Revised 2.25.10
Robert M. Martin Elementary
Volunteers and Confidentiality Guidelines Volunteers: We deeply appreciate your support and presence at our school. Our
partnership is critical to the success of our students. Please know how much your
assistance is appreciated. While at school, we ask that you adhere to the following
expectations. All volunteers are asked to read the information below and complete
this form prior to providing volunteer services to our school.
CONFIDENTIALITY NOTICE:
Information you witness or hear while observing may be confidential or privileged and is
not to be shared or discussed with ANY individuals other than staff members.
Furthermore, student names and behaviors should not be discussed with anyone other
than the staff member(s) in charge of the area you are providing assistance in.
Our family handbook reinforces these expectations:
BUILDING CODE OF ETHICS (FOR VOLUNTEERS)
1. Respect the confidentiality of the teacher and the students, and refrain from
discussing confidential issues outside the school setting.
2. Respect the teaching/learning process by arranging to discuss your child’s
progress at times other than when you are volunteering.
3. Maintain open and honest communication with school staff. Bring any
concerns you have to the teacher (or staff member).
4. Maintain a strong relationship of trust, integrity, and respect with adults and
children.
5. Be dependable. Follow through on tasks by attending at the dates or times
arranged. Inform the school of any absences as soon as possible.
By signing, I hereby agree to these terms and conditions.
Print Name: _____________________________________________________________
Signature: ______________________________________________________________
Date Signed: ____________________________________________________________
Please return this completed form to the school office.
The following pages
only apply to
students new to
Andover Public Schools.
S:\School\Enrollment\2011-2012\11-12 enrollment paperwork\New Student Placement Form 11-12.docx
Robert M. Martin Elementary
New Student Placement Information Form
2011-2012 School Year
Student Name: _______________________________________ Male or Female
(Please circle)
2011-2012 Grade: ___________
To better help us place your student, please provide the following information:
1. Was your child ever retained? If so, which grade(s)?
2. Please circle the number below that best reflects your child’s performance in language arts
(reading, writing, spelling).
1 = Consistently needs enrichment
2 = Average performance
3 = Occasionally has problems
4 = Consistently has problems
3. Please circle the number below that best reflects your child’s performance in math.
1 = Consistently needs enrichment
2 = Average performance
3 = Occasionally has problems
4 = Consistently has problems
4. Was your child involved in any special programs and if so, what were they? (Example:
Reading and Math Support Programs, Speech, Language, Learning Disabilities, other special
programs of any nature)
5. Please describe your child’s personality. (Is he/she excitable, creative, very active, quiet,
etc?
Please use the back of this form to add any additional information about your child that would help with
your child’s placement.
________________________________________ ________________________
Parent/Guardian Signature Date
S:\School\Forms\Request for Transcript.docx 8/29/08
Robert M. Martin Elementary 2342 N. 159
th St. East; Wichita, KS 67228
Dr. Crystal D. Hummel, Principal
316-218-4720 Office
316-733-7963 Fax
REQUEST FOR TRANSCRIPT
Date
Student Grade
Registrar:
Please send us at your earliest convenience, all official records, transcript of grades, cumulative
records, test results, health records, athletic eligibility, and any other data directly related to this
student. Please include the following special education records if these apply to the student: 1)
Individualized Educational Plan (IEP), 2) placement Statement, 3) latest evaluation or re-
evaluation report, and 4) psychologist’s report.
Former School:
Send Records To: Robert M. Martin Elementary
2342 N. 159th
St. East
Wichita, KS 67228
Attn: Registrar
Parental permission is no longer required when records are requested by authorized school
personnel. (Family Education Rights and Privacy Act, Final Rule on Education Records, Federal
Register, June 17, 1976, Vol. 41, No. 118, page 24673.)
06-07
ANDOVER PUBLIC SCHOOLS USD 385 HEALTH EXAMINATION REPORT
Pupil’s Name_____________________________________ SS#__________________ Birth Date_____________ Grade___________ Last First To Parents: For maximum health your child should have a periodic health examination. If your child is entering Kindergarten (or is new to Kansas Schools and is under 9 years of age) please obtain an examination of your child by your family doctor. Gender: M______F_______ Height_____ Weight_____ BP_____ T_____ P_____ R_____ Central Nervous System________________________________________ Epilepsy?__________ Emotional Disturbance?______________ Cardio-Vascular System________________________________________ Heart Disease?____________________ Limitation?__________ EENT (Eye, Ear, Nose & Throat)_________________________________ Myringotomy?____________________ Glasses?____________ Endocrine System_____________________________________________ Diabetes Mellitus?_____________________________________ Gastrointestinal System________________________________________ Nutritional Status______________________________________ Genitourinary System__________________________________________ Musculo-Skeletal System_______________________________________ Scoliosis?____________________ Arthritis?________________ Respiratory System____________________________________________ Asthma?_____________________ Allergies?_______________ Social Development (family, peer, school if appropriate)______________ Recommendations:____________________________________________ Physician’s Signature__________________________________________
Immunization – Please attach green Kansas Certificate of Immunization (KCI) with all dates for DPT, Polio, MMR, Varicella, and Hepatitis B
recorded - with Physician Signature and Date. Optional other vaccines or tests:____________________ Are routine medications prescribed? Yes No NOTE: If medication is to be given at school, please provide written physician/parental request. Physical Education: Regular_______________________________________ Limited (explain)_______________________________ None (explain)_________________________________ Date__________________________________________ MAY USE BACK OF CARD FOR ADDITIONAL SPACE
USD 385 DEPARTMENT OF HEALTH SERVICES
ANDOVER, KANSAS
IMMUNIZATION STATEMENT Please sign and return with enrollment forms.
Name of Student: _________________________________________ Date of Birth: _____________________________________________
I have been notified that Kansas Law (K.S.A. 72-5208, 72-5209, 72-5210, 72-5211 and 72-5211a) requires every pupil enrolling in any school for the first time, prior to admission, to present proof from a physician or local health department that the pupil has received such tests and inoculations as are deemed necessary.
In USD 385, proof of each inoculation received must be presented prior to admission. Also, mandatory booster inoculations in all required series must be received (within 30 days for students admitted after September 1). If transferring into USD #385, it is the parents obligation to make sure proof of inoculations are received within 30 days. Required inoculations include the following:
DTP, DTaP and/or DT/Td Additions for Early Childhood OPV or IPV Hib MMR PCV7 (pneumococcal) Hepatitis B Hepatitis A Varicella
Parents will be notified of any additional requirements. Parent/Guardian Signature Indicating Receipt of Notice:
_______________________________________Date:_________________ Student is transferring from: _____________________________________ Name of School City St.
Date Student Entered USD #385: _______________________________
KANSAS CERTIFICATE OF IMMUNIZATIONS (KCI)This record is part of the student's permanent record and shall be transferred from one school to another as defined in Section 72-5209 (d) of the Kansas School Immunization Law (amended 1994.)
Student Name:
Parent or Guardian Name:
Address:
Birthdate (MM/DD/YYYY): SEX: [ ] MALE [ ] FEMALE
Phone:
Race: Ethnicity: County:
RECORD THE MONTH, DAY, AND YEAR THAT EACH DOSE OF VACCINE WAS RECEIVEDVACCINE
7th6th5th4th3rd2nd1st
If additional doses are added,
please initial the dose and sign
below:
Polio Required for school entry.
HEP B (Hepatitis B) Required for school entry through Grade 11 for
2011-2012 school year. Recommended for all children.
Varicella (Chickenpox) Required for school entry. 2 doses grades K-2 & 7.
One dose grades 3-6 and 8-11 for 2011-2012 school year.
MMR (Measles, Mumps, and Rubella combined) Required for school entry.
HIB (Haemophilus Influenzae Type B) Required < 5 years of age for preschool
or child care operated by a school.
PCV (Pneumococcal Conjugate) Required < 5 years of age for preschool or
child care operated by a school.
HEP A (Hepatitis A) Required < 5 years of age for preschool or child care
operated by a school.
Physician Signature:
MCV4 (Meningococcal) Recommended at 11 years of age. Not required for
school entry.
DTaP/DT/Td/Tdap (Diphtheria, Tetanus, Pertussis) Required for
school entry. Single Tdap required for grades 7-9.
HPV (Human Papillomavirus) Recommended for females and provisionally
recommended for males at 11 years of age. Not required for school entry.
Rotavirus Recommended < 8 mo. Not required for school entry.
Hx of Disease: Date of Illness:
State Type
Influenza (Flu) Recommended annually for ages 6mo and older. Not
required for school entry.
I certify I reviewed this student's vaccination record and transcribed it accurate
Agency Name:
1. "Annual written statement signed by a licensed physician (Medical Doctor/M.D. or Doctor of Osteopathy/D.O.) stating the physical
condition of the child to be such that the tests or inoculations would seriously endanger the life or health of the child." Medical
exemption shall be validated annually by physician completion of KCI Form B and attachment to the KCI.
2. "Written statement signed by one parent or guardian that the child is an adherent of a religious denomination whose
religious teachings are opposed to such tests or inoculations."
DateParent/Legal Guardian's Signature
I give my consent for information contained on this form to be released to the Kansas Immunization
Program for the purpose of assessment and reporting.
KANSAS IMMUNIZATION PROGRAM
1000 SW Jackson, Suite 075, Topeka, KS 66612-1274
PHONE 785-296-5591 FAX 785-296-6510
WEB SITE www.kdheks.gov/immunizeRev. 02/01/2011
Date
q
Authorized Representative:
Address:
The record presented was
Kansas Immunization Record
Other Immunization Record (Specify)
DOCUMENTATIONKCI MAY ONLY BE SIGNED BY A PHYSICIAN (MD/DO), HEALTH DEPT, OR SCHOOL.
LEGAL ALTERNATIVES TO VACCINATION REQUIREMENTS "KSA 72-5209"
KANSAS IMMUNIZATION REQUIREMENTS: Based on age of child as of September 1 of current school year.
As per Kansas Statute 72-5209, all children upon entry to school must be appropriately vaccinated. In each column below, vaccines are required for all ages listed in that column.
Ages 0-4
Recommended Schedule
Birth
2 Months
4 Months
6 Months
12-15 Months
HEP B
DTaP/DT
POLIO
HIB
PCV
ROTAVIRUS
DTaP/DT
POLIO
HEP B
HIB
PCV
ROTAVIRUS
DTaP/DT
MMR
VAR
HIB
PCV
HEP A
DTaP/DT
POLIO
HEP B
HIB
PCV
ROTAVIRUS
Ages 5-6 Ages 7 and Older
DTaP: 5 Doses
a)
b)
c)
d)
POLIO: 4 Doses
� - The ACIP Schedules may be accessed at: http://www.cdc.gov/vaccines/recs/schedules
Vaccine doses given up to 4 days before the minimum interval or age may be considered valid.
With the exception of Hepatitis B vaccine, immunizations given before 6 weeks of age are not considered valid.
Half doses or reduced doses of vaccine are not considered valid.
PARENTS AND/OR GUARDIANS ARE NOT AUTHORIZED TO COMPLETE KCI FORMS.
A ROSTER WITH THE NAMES OF ALL EXEMPT STUDENTS SHOULD BE MAINTAINED. PARENTS OR GUARDIANS OF EXEMPT CHILDREN SHOULD BE INFORMED THAT
THEIR CHILDREN SHALL BE EXCLUDED FROM SCHOOL IN THE EVENT OF AN OUTBREAK OR SUSPECTED CASE OF A VACCINE-PREVENTABLE DISEASE.
KCI FORM B - MEDICAL EXEMPTION is located at http://www.kdheks.gov/immunize/imm_manual_pdf/KCI_formB.pdf
BLANK VERSION OF KCI FORM is available at http://www.kdheks.gov/immunize/download/KCI_Form.pdf
Recommendations are based
on the ACIP recommended
schedule.�
a)
b)
MMR: 2 Doses
a)
b)
c)
d)
VARICELLA: 2 Doses Grade K-2 for 2011-2012 school year
a)
b)
c)
HEPATITIS B: 3 Doses Grades K-11 for 2011-2012 school year
a)
b)
c)
d)
HEPATITIS B: 3 Doses required through Grade 11 for 2011-2012 school year
a)
b)
c)
d)
VARICELLA: 2 Doses Grade 7 for 2011-2012 school year
1 Dose Grades 3-6 and 8-11 for 2011-2012 school year
a)
b)
MMR: 2 Doses
a)
3 Doses
a)
4 Doses
POLIO - All IPV or OPV Schedule
a)
b)
c)
d)
e)
Tdap/Td: 3 doses if DTaP series not completed previously
POLIO - IPV/OPV Combination Schedule
4 Doses
a)
a)
b)
4 week minimum interval between first 3 doses; 6 month interval between dose 3 and
dose 4.
4 doses acceptable if dose 4 given on or after the 4th birthday.
If dose 4 administered before 4th birthday, 5th dose must be given at 4-6 years of
age.
6 dose limit regardless of schedule.
4 week minimum interval between first 3 doses; 6 month interval required between
dose 3 and dose 4.
One dose required after 4th birthday regardless of the number of previous doses.
First dose on or after the 1st birthday.
4 week minimum interval between doses.
First dose on or after the 1st birthday.
4 week minimum interval between doses.
None required if prior varicella disease verified by physician.
Two doses are recommended for all children.
4 week minimum interval between dose 1 and dose 2.
8 week minimum interval between dose 2 and dose 3.
16 week minimum interval between dose 1 and dose 3.
Dose 3 must be given after 24 weeks of age.
4 week minimum interval between dose 1 and dose 2.
One of the 3 doses should be Tdap.
6 month interval between dose 2 and dose 3.
Single dose of Tdap required for grades 7-9.
Tdap required for grades 10-12 if more than 10 years since previous DTaP.
4 week minimum interval between doses, regardless of age given.
4 week minimum interval between each dose, with 1 dose given on or after the 4th
birthday.
4 week minimum interval between doses, regardless of age given.
First dose on or after the 1st birthday.
4 week minimum interval between doses.
First dose on or after the 1st birthday.
4 week minimum interval between doses.
None required if prior varicella disease verified by physician.
Two doses are recommended for all children.
4 week minimum interval between dose 1 and dose 2.
8 week minimum interval between dose 2 and dose 3.
16 week minimum interval between dose 1 and dose 3.
Dose 3 must be given after 24 weeks of age.
Recommended