2011-2012 Registration Packet for Kindergarten

8/3/2019 2011-2012 Registration Packet for Kindergarten

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The mission of the West Windsor-Plainsboro Regional School District, valuing our tradition of excellence, is to

develop all of our students as passionate, confident, lifelong learners who have competence and strength of

character to realize their aspirations and thoughtfully contribute to a diverse and changing world.

2011-2012 School Year

Dear Parents/Guardians:

Let me take this opportunity to welcome you to the West Windsor-Plainsboro Regional School District. We

are extremely proud of the accomplishments of students, teachers, and staff. When you have a moment,

please visit the district web site for detailed information about us (www.ww-p.org), and also to review the

New Jersey State Report Card to see how we compare with other districts in the state.

Our registration process is easy to follow, and will enable us to provide the best experience for your child.To begin the process, please collect the following items, which are necessary to start the registration

procedure:

Proof of Residency. A copy of your mortgage agreement, H.U.D. settlement statement, affidavit of title,lease, deed, tax bill, or contract of sale (until closure of home) with your name on it will be accepted.

Health and Immunization Records. Current records can be obtained from your previous school orpediatrician. These must be current with dates and translated into English.

Proof of Age. Birth certificate or passport in its original form or with seal; no photocopies are accepted. Previous School Records. School records should include report cards, IEPs (if applicable), and recent

state test results.

To make a registration appointment, please visit the district web site and click on Parents and the link forRegistration. You can link to the online calendar to make a registration appointment and you can

download the registration forms. If you have any questions, you can reach the district registrar by calling

716-5000, extension 5505. Please bring completed forms with you to register your child in the West

Windsor-Plainsboro Regional School District. Registration takes place at the Special Services Office, 506

Plainsboro Road, Plainsboro, NJ 08536. Your child does not need to come with you for registration. Please

check the web site for any additional registration forms that are not included in this packet.

It is my hope that you will have a wonderful experience in our district and that our mission statement will

become a reality for your child: The mission of the West Windsor-Plainsboro Regional School District,

valuing our tradition of excellence, is to develop all of our students as passionate, confident, lifelong

learners who have competence and strength of character to realize their aspirations and thoughtfully

contribute to a diverse and changing world.

Sincerely,

Victoria Kniewel, Ed.D.

Superintendent of Schools

WEST WINDSOR-PLAINSBORO REGIONAL SCHOOL DISTRIC

505 Village Road West

P.O. Box 505

West Windsor, NJ 08550-0505

Phone: (609) 716-5000

Fax: (609) 716-5022

Web Site: www.ww-p.org


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WEST WINDSOR-PLAINSBORO REGIONAL SCHOOL DISTRICT

REGISTRATION DATA SHEET

Student Name - Last Name First Name Grade Registering fo

Current Address City Zip Code

Phone Number Development Name Former Address (include zip code)

Which of the following ethnic groups best describes you? (Optional) Primary language spoken at home:

White Black/African American Hispanic

Asian American Indian/Alaskan Native Pacific Islander ________________________________

Title: Mr/Mrs/Ms/Dr ____________

First name: Last Name:

Address if different from student:

Business Phone: Cell Phone:

Title: Mr/Mrs/Ms/Dr ____________

First name: Last Name:

Address if different from student:

Business Phone: Cell Phone:

Name: ______________________________ Relation: _____________________ Date of Birth: _____________

Sibling Information: Name: ______________________________ Relation: _____________________ Date of Birth: _____________

Name: ______________________________ Relation: _____________________ Date of Birth: _____________

First Contact Name: Daytime Phone Number: Cell Phone:

Second Contact Name:

SCHOOL: _______________________________ DATE: _______________ STUDENT ID#: ________________

Emergency Contact Information: (Please list one local contact other than yourself)

Ext #

Relationship:

E-mail Address (s)

E-mail Address (s)

Ext #

Relationship to Student ______________________ Legal Guardian (Y/N) ______

Birth State

If the student was born outside the United States, what date did the student first enter a US School? ________________

Relationship to Student ______________________ Legal Guardian (Y/N) ______

Does the child have Health Insurance? (Y/N) ________ If "yes" name of Insurance Provider _______________________________

MI

Birth City

Date of Birth Gender

Page 1 of 2 As of 09/12/2011 MANDATORY


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Grades

AttendedDates Enrolled

Date

LeftSchool - Address

Public?

Yes or No

Transfer of Records Request sent. Date: _____________

I hereby affirm that the information entered is true and correct to the best of my knowledge.

Parent/Guardian Signature: _____________________________________________ Date: ___________

Required Registration Forms

Health/Immunization Records received. Date/Initial: ___________/_________

Proof of Residency received. Date/Initial: ___________/_________

Birth Certificate received. Date/Initial: ___________/_________

District Guardian form received - if applicable. (if student is not living with parents) Date/Initial: ___________/_________

Route # (s): Pick up time:

Bus Stop:

Driver (s): Effective Date:

ESL Services Eligible. Foreign Language Survey received. Date/Initial: ___________/_________

Consent to Release Personally Identifiable Information received. Date/Initial: ___________/_________

Meets "Future Resident" conditions and application has been received. Date/Initial: ___________/_________

Child has been previously referred or tested as a Special Education Student. Date/Init ial: ___________/_________

Child has been classified as a Special Education Student. Date/Initial: ___________/_________

Child Study Team Release and Questionnaire received. Date/Initial: ___________/_________

Child has received services under a 504 Plan. Previous 504 plan has been received. Date/Initial: ___________/_________

Child is currently receiving Speech and Language Services. Date/Initial: ___________/_________

Varsity Athlete? Transfer Waiver form completed if applicable. Date/Initial: ___________/_________

Has taken the High School Proficiency Assessment at a previous NJ High School. Date/Initial: ___________/_________

Please list any special Transportation requirements on the line below:

High School Forms

Previous School (s) - Most Recent First - (List Pre-School if Applicable)

For Transportation Department Use Only

FOR OFFICE USE ONLY

Related Services Forms

Location

Page 2 of 2 As of 09/12/2011 MANDATORY


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Part A Page 1 of 3NJDOE/APPEF Revised 3/10 Use of this form is required by N.J.A.C. 6A:16-Programs to Support Student Development

New Jersey Department of EducationANNUAL ATHLETIC PRE-PARTICIPATION PHYSICAL EXAMINATION FORMPart A: HEALTH HISTORY QUESTIONNAIRE-CompletedbytheparentandstudentandreviewedbyexaminingprovidePart B: PHYSICAL EVALUATION FORM-CompletedbyexamininglicensedproviderwithMD,DO,APNorPA Part A: HEALTH HISTORY QUESTIONNAIRETodays Date:_____________________ Date of Last Sports Physical: __________________________

StudentsName:__________________________________ Sex:MF(circleone) Age:____ Grade:________DateofBirth:____/___/_______ School:_____________________________ District: _______________________Sport(s):_____________________________________________________________________ HomePhone:(_____)___________ProviderName(MedicalHome):_______________________________Phone:_______________________Fax:____________

EMERGENCY CONTACT INFORMATIONNameofparent/guardian:_________________________________ Relationshiptostudent:______________________________

Phone(work):_____________________ Phone(home):______________________________ Phone(cell):______________

Additionalemergencycontact:____________________________ Relationshiptostudent:______________________________

Phone(work):_____________________ Phone(home):______________________________ Phone(cell):______________Directions: PleaseanswerthefollowingquestionsaboutthestudentsmedicalhistorybyCIRCLINGthecorrectresponse.Explainallyesresponsesonthelinesbelowthequestions.Pleaserespondtoallquestions.1.Have you ever had, or do you currently have:

a.Restrictionfromsportsforahealthrelatedproblem? Y/N/DontKnowb.Aninjuryorillnesssinceyourlastexam? Y/N/DontKnowc.Achronicorongoingillness(suchasdiabetesorasthma)? Y/N/DontKnow

(1.)Aninhalerorotherprescriptionmedicinetocontrolasthma? Y/N/DontKnowd.Anyprescribedoroverthecountermedicationsthatyoutakeonaregularbasis? Y/N/DontKnowe.Surgery,hospitalizationoranyemergencyroomvisit(s)? Y/N/DontKnowf.Anyallergiestomedications? Y / N / Dont Knowg.Anyallergiestobeestings,pollen,latexorfoods? Y/N/DontKnow

(1.)Ifyes,checktypeofreaction:

RashHivesBreathingorotheranaphylacticreaction

(2.)Takeanymedication/Epipentakenforallergysymptoms?(Listbelow.) Y/N/DontKnowh.Anyanemias,blooddisorders,sicklecelldisease/trait,bleedingtendenciesorclottingdisorders? Y/N/DontKnowi.Abloodrelativewhodiedbeforeage50? Y/N/DontKnow

Explainallyesanswershere(includerelevantdates):

List all medications here:MedicationName Dosage Frequency


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2.Have you ever had, or do you currently have, any of the following head-related conditions:a.Concussionorheadinjury(includingbellrungorading)? Y/N/DontKnowb.Memoryloss? Y/N/DontKnowc.Knockedout? Y/N/DontKnowc.Aseizure? Y/N/DontKnowd.Frequentorsevereheadaches(Withorwithoutexercise)? Y/N/DontKnowe.Fuzzyorblurryvision Y/N/DontKnowf.Sensitivitytolight/noise Y/N/DontKnow

Explainallyesanswershere(includerelevantdates):____________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________3.Have you ever had, or do you currently have, any of the following heart-related conditions:

a. Restrictionfromsportsforheartproblems? Y/N/DontKnowb. Chestpainordiscomfort? Y/N/DontKnowc. Heartmurmur? Y/N/DontKnowd. Highbloodpressure? Y/N/DontKnowe. Elevatedcholesterollevel? Y/N/DontKnowf. Heartinfection? Y/N/DontKnowg. Dizzinessorpassingoutduringorafterexercisewithoutknowncause? Y/N/DontKnowh. Hasaprovidereverorderedahearttest(EKG,echocardiogram,stresstest,Holtermonitor)? Y/N/DontKnowi. Racingorskippedheartbeats? Y/N/DontKnowj. Unexplaineddifficultybreathingorfatigueduringexercise? Y/N/DontKnowk. Anyfamilymember(bloodrelative):

(1.)Underage50withaheartcondition? Y/N/DontKnow(2.)WithMarfanSyndrome? Y/N/DontKnow(3.)Diedofaheartproblembeforeage50?Ifyes,atwhatage?_____________________ Y/N/DontKnow(4.)Diedwithnoknownreason? Y/N/DontKnow(5.)Diedwhileexercising?Ifyes,wasitduringorafter?(Circleone.) Y/N/DontKnow

Explainallyesanswershere(includerelevantdates):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________4. Have you ever had, or do you currently have, any of the following eye, ear, nose, mouth or throat conditions: a.Visionproblems? Y/N/DontKnow (1.)Wearcontacts,eyeglassesorprotectiveeyewear?(Circlewhichtype.) Y/N/DontKnow b.Hearinglossorproblems? Y/N/DontKnow

(1.)Wearhearingaidesorimplants? Y/N/DontKnow c.Nasalfracturesorfrequentnosebleeds? Y/N/DontKnow d.Wearbraces,retainerorprotectivemouthgear? Y/N/DontKnow e.Frequentstreporanyotherconditionsofthethroat(e.g.tonsillitis)? Y/N/DontKnow

Explainallyesanswershere(includerelevantdates):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________5. Have you ever had, or do you currently have, any of the following neuromuscular/orthopedic conditions:

a. Numbness,aburner,stingerorpinchednerve? Y/N/DontKnowb. Asprain? Y/N/DontKnowc. Astrain? Y/N/DontKnowd. Swellingorpaininmuscles,tendons,bonesorjoints? Y/N/DontKnow

e. Dislocatedjoint(s)? Y/N/DontKnowf. Upperorlowerbackpain? Y/N/DontKnowg. Fracture(s),stressfracture(s),orbrokenbone(s)? Y/N/DontKnowh. Doyouwearanyprotectivebracesorequipment? Y/N/DontKnow

Explainall(yes)answershere(includerelevantdates):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


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6.Have you ever had or do you currently have any of the following general or exercise related conditions : a.Difficultybreathing?

(1.)Duringexercise? Y/N/DontKnow(2.)Afterrunningonemile? Y/N/DontKnow(3.)Coughing,wheezingorshortnessofbreathinweatherchanges? Y/N/DontKnow(4.)Exercise-inducedasthma? Y/N/DontKnow

i.Controlledwithmedication?(specify__________________________) Y/N/DontKnowii.Experiencedizziness,passingoutorfainting? Y/N/DontKnow

b.Viralinfections(e.g.mono,hepatitis,coxsackievirus)? Y/N/DontKnowc.Becometiredmorequicklythanothers? Y/N/DontKnow

d.Anyofthefollowingskinconditions:

(1.)Coldsores/herpes,impetigo,MRSA,ringworm,warts? Y/N/DontKnow(2.)Sunsensitivity? Y/N/DontKnow

e.Weightgain/loss(of10poundsormore)? Y/N/DontKnow(1.)Doyouwanttoweighmoreorlessthanyoudonow? Y/N/DontKnow

f.Everhadfeelingsofdepression? Y/N/DontKnowg.Heat-relatedproblems(dehydration,dizziness,fatigue,headache)? Y/N/DontKnow

(1.)Heatexhaustion(cool,clammy,dampskin)? Y/N/DontKnow(2.)Heatstroke(hot,red,dryskin)? Y/N/DontKnow(3.)Musclecramps? Y/N/DontKnow

h.Absenceorlossofanorgan(e.g.kidney,eyeball,spleen,testicle,ovary)? Y/N/DontKnow

Explainallyesanswershere(includerelevantdates):_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

7.Females only: Ageofonsetofmenstruation:______ Howmanymenstrualperiodsinthelasttwelve(12)months? ________ Howmanyperiodsmissedinthelasttwelve(12)months? ________

8.Males only: Haveyouhadanyswellingorpaininyourtesticlesorgroin? Y/N/DontKnow

PARENT/GUARDIANSIGNATURE

Icertify that the information providedherein isaccurate to thebestofmyknowledgeasof thedateofmysignature._______________________________________ _________________Signature,Parent/GuardianorStudentAge18 DateofSignature:

THIS COMPLETED AND SIGNED HEALTH HISTORY MUST BE REVIEWED BY THEEXAMINING PROVIDER AT THE TIME OF THE MEDICAL EXAM.


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Part B Page 1 of 4

NJDOE/APPEF Revised 3/10 Use of this form is required by N.J.A.C. 6A:16-Programs to Support Student Development

ANNUAL ATHLETIC PRE-PARTICIPATION PHYSICAL EVALUATION FORMPart B: Physical Evaluation Form(Completed by the examining licensed provider MD, DO, APN or PA)-STUDENT INFORMATION-

StudentsName:__________________________________ Sport(s):_____________________________________________________Sex:MF(circleone) Age:________ Grade:_____________ DateofBirth:_________________________________________

Address:___________________________________________________________________________________________________________City/State/Zip:________________________________________________ HomePhone:_________________________________________School:_____________________________________________________ District:_____________________________________________Parent/GuardiansFullName:__________________________________________________________________________________________

- EXAMINING PHYSICIAN/PROVIDER CONTACT INFORMATION-If conducted by school physician check hereName:_______________________________ Phone:__________________________ Fax:_________________Address:______________________________ City/State/Zip:_____________________________________________

- FINDINGS OF PHYSICAL EVALUATION -Height:_________ Weight:_________ BloodPressure:______/_______Pulse:_____bpm.

Vision:R20/____L20/____Corrected:Y/N Contacts:Y/N Glasses:Y/N INDICATORS NORMAL? ABNORMAL FINDINGS/COMMENTS

GeneralAppearance YES

Head/Neck YES Eyes/Sclera/Pupils YES

Ears YES

GrossHearing YES Nose/Mouth/Throat YES

LymphGlands YES

Cardiovascular YES

HeartRate YES Rhythm YES

Murmur ABSENT Ifmurmurpresent Standingmakesit:LouderSofterNoChange

Squattingmakesit:LouderSofterNoChange

Valsalvamakesit:LouderSofterNoChange

FemoralPulses YES

Lungs:Auscultation/Percussion YES ChestContour YES Skin YES

Abdomen(liver,spleen,masses) YES AssessmentofphysicalmaturationorTannerScale

YES

TesticularExam(MalesOnly) YES

Neck/Back/Spine: YES RangeofMotion YES

Scoliosis ABSENT

UpperExtremities:(ROM,Strength,Stability)

YES

LowerExtremities:(ROM,Strength,Stability)

YES

Neurological:Balance&Coordination YES Hernia ABSENT EvidenceofMarfanSyndrome ABSENT


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Part B Page 2 of 4


Most recent immunizations and dates administered:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Medications currently prescribed, with dose and frequency:MedicationName Dosage Frequency

Additional observations:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________General Diagnosis:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________General Recommendations:_______________________________________________________________________________________________________________________________________________________________________________________________________________________

THE HISTORY PREPARED BY THE PARENT/STUDENT MUST BE REVIEWED BYTHE EXAMINING PROVIDER AT THE TIME OF THE PHYSICAL EXAMINATION.


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Part B Page 3 of 4


CLEARANCES: This section is completed by the examining healthcare provider. After examining the student and reviewing the medical history the student is:

A. Cleared forparticipationinallsportswithoutrestrictions. B. Not clearedforparticipationinany sportuntilevaluation/treatmentof:

___________________________________________________________________________________

C. Cleared for limited participationinthefollowingtypesofsportsonly.Pleaseseebelowforsportclassifications.CHECK ALL THAT APPLY

___ CONTACT/COLLISION ___ NON-CONTACT/STRENUOUS___ LIMITED CONTACT ___ NON-CONTACT/NON-STRENUOUS

Limitationsdueto:___________________________________________________________________

________________________________________________NOTES TO THE EXAMINING PROVIDERConditions requiring clearance before sports participation include, but are not limited to the following:Anaphylaxis;Atlantoaxialinstability; Bleedingdisorder;Hypertension;Congenitalheart disease;Dysrhythmia;Mitral valveprolapseHeart murmur; Cerebral palsy; Diabetes mellitus; Eating disorders; Heat illness history; One-kidney athletes; HepatomegalySplenomegaly;Malignancy;SeizureDisorder;MarfansSyndrome;Historyofrepeatedconcussion;Organtransplantrecipient;Cysticfibrosis;Sicklecelldisease;and/orOne-eyedathletesorathleteswithvisiongreaterthan20/40inoneeye.

SAMPLES OF CLASSIFICATION OF SPORTS BY CONTACTContact/Collision Limited Contact Non-Contact Strenuous Non-strenuous

Basketball Baseball Discus Bowling

Diving Cheerleading Javelin GolfFieldHockey Fencing Shotput Football HighJump Rowing IceHockey Polevault Running/CrossCountry

Lacrosse Gymnastics StrengthTraining Soccer Skiing Swimming Wrestling Softball Tennis

Volleyball Track

Effects of physiologic maneuvers on heart sounds Physical Stigmata of Marfans SyndromeStanding IncreasesmurmurofHCM Kyphosis DecreasesmurmurofAS,MR Higharchedpalate MVPclickoccursearlierinsystole Pectusexcavatum ArachnodactylySquatting IncreasesmurmurofAS,MR,AI Armspan>height1.05:1orgreater DecreasesmurmurofMCH MitralValveProlapse MVPclickdelayed AorticInsufficiency MyopiaValsalva IncreasesmurmurofHCM Lenticulardislocation DecreasesmurmurofAS,MR MVPclickoccursearlierinsystoleHCM: HypertrophicCardioMyopathyAS: AorticStenosisAI: AorticInsufficiencyMR:MitralRegugitationMVP: MitralValveProlapse


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Part B Page 4 of 4


HISTORY REVIEWED AND STUDENT EXAMINED BY: Physicians/Providers Stamp: Primary Care ProviderSchool Physician ProviderLicense Type: MD/DOAPN

PAPHYSICIANS/PROVIDERS SIGNATURE: __________________________________________________Todays Date: ______________ Date of Exam: ______________

RESERVED FOR SCHOOL DISTRICT USENOTE:N.J.A.C.6A:16-2.2requirestheschoolphysiciantoprovidewrittennotificationtotheparent/legalguardianstatinapprovalordisapprovalofthestudentsparticipationinathleticsbasedonthisphysicalevaluation.Thisevaluationan

thenotificationletterbecomepartofthestudentsschoolhealthrecord.History and Physical Reviewed By: __________________________ ________ Date: _______________Title of Reviewer (please check one): School Nurse School Physician

Medical Eligibility Notification Sent to Parent/Guardian by School Physician ______________________DateLetter of notification is attached.OR

Parent notification indicates that:Participation Approved without limitations.Participation Approved with limitations pending evaluation.Participation NOT Approved

Reason(s) for Disapproval: _________________________________________________________________________________________________________________________________________________


11/36MAR 09

MINIMAL IMMUNIZATION REQUIREMENTS FOR SCHOOL ATTENDANCE IN NEW JERSEYN.J.A.C. 8:57-4: Immunization of Pupils in School

DISEASE(S) MEETS IMMUNIZATION REQUIREMENTS COMMENTS

DTaP

(AGE 1-6 YEARS): 4 doses, with one dose givenon or after the 4th birthday, OR any 5 doses.

(AGE 7-9 YEARS): 3 doses of Td or anypreviously administered combination of DTP,DTaP, and DT to equal 3 doses.

Any child entering pre-school, pre-Kindergarten, or Kindergarten needs aminimum of four doses. Pupils after the seventh birthday should receive adulttype Td. DTP/Hib vaccine and DTaP also valid DTP doses.

Laboratory evidence of immunity is also acceptable.

Tdap GRADE 6 (or comparable age level for specialeducation programs): 1 dose

For pupils entering Grade 6 on or after 9-1-08 and born on or after 1-1-97.A child does not need a Tdap dose until FIVE years after the last DTP/DTaP or Tddose.

POLIO(AGE 1-6 YEARS): 3 doses, with one dose givenon or after the 4th birthday, OR any 4 doses.

(AGE 7 or OLDER): Any 3 doses.

Either Inactivated Polio Vaccine (IPV) or Oral Polio Vaccine (OPV) separately or incombination is acceptable.Polio vaccine is not required of pupils 18 years of age or older.


MEASLES

If born before 1-1-90, 1 dose of a live Measles-containing vaccine on or after the first birthday.If born on or after 1-1-90, 2 doses of a liveMeasles-containing vaccine on or after the firstbirthday.If entering a college or university after 9-1-95 andpreviously unvaccinated, 2 doses of a liveMeasles-containing vaccine on or after the firstbirthday.

Any child over 15 months of age entering child care, pre-school, or pre-Kindergarten needs a minimum of 1 dose of measles vaccine.Any child entering Kindergarten needs 2 doses.Previously unvaccinated students entering college after 9-1-95 need 2 doses ofmeasles-containing vaccine or any combination containing live measles virusadministered after 1968. Documentation of 2 prior doses is acceptable.

Laboratory evidence of immunity is also acceptable.Intervals between first and second measles/MMR/MR doses cannot be less than 1month.

RUBELLAand

MUMPS

1 dose of live Mumps-containing vaccine on orafter the first birthday.

1 dose of live Rubella-containing vaccine on orafter the first birthday.

Any child over 15 months of age entering child care, pre-school, or pre-Kindergarten needs 1 dose of rubella and mumps vaccine.

Any child entering Kindergarten needs 1 dose each.Each student entering college for the first time after 9-1-95 needs 1 dose of rubella

and mumps vaccine or any combination containing live rubella and mumps virusadministered after 1968.Laboratory evidence of immunity is also acceptable.

VARICELLA 1 dose on or after the first birthday.

All children 19 months of age and older enrolled into a child care/pre-school centerafter 9-1-04 or children born on or after 1-1-98 entering a school for the first timein Kindergarten or Grade 1 need 1 dose of varicella vaccine.Laboratory evidence of immunity, physicians statement or a parental statement ofprevious varicella disease is also acceptable.

HAEMOPHILUSINFLUENZAE B

(Hib)

(AGE 2-11 MONTHS)(1): 2 doses

(AGE 12-59 MONTHS)(2): 1 dose

Mandated only for children enrolled in child care, pre-school, or pre-Kindergarten.(1) Minimum of 2 doses of Hib vaccine is needed if between the ages of 2-11months.(2) Minimum of 1 dose of Hib vaccine is needed after the first birthday.

DTP/Hib and Hib/Hep B also valid Hib doses.

HEPATITIS B (K-GRADE 12): 3 doses or 2 doses (1)

(1) If a child is between 11-15 years of age and has not received 3 prior doses ofHepatitis B then the child is eligible to receive 2-dose Hepatitis B Adolescentformulation.


PNEUMO-COCCAL

(AGE 2-11 MONTHS)(1): 2 doses

(AGE 12-59 MONTHS)(2): 1 dose

Mandated only for children enrolled in child care, pre-school, or pre-Kindergarten.(1) Minimum of 2 doses of Pneumococcal vaccine is needed if between the ages of2-11 months.(2) Minimum of 1 dose of Pneumococcal vaccine is needed after the first birthday.

MENINGO-COCCAL

(Entering GRADE 6 (or comparable age level forSpecial Ed programs): 1 dose (1)

(Entering a four-year college or University,previously unvaccinated and residing in a campusdormitory): 1 dose (2)

(1) For pupils entering Grade 6 on or after 9-1-08 and born on or after 1-1-97.(2) Previously unvaccinated students entering a four-year college or university after9-1-04 and who reside in a campus dormitory, need 1 dose of meningococcalvaccine. Documentation of one prior dose is acceptable.

INFLUENZA (AGES 6-59 MONTHS): 1 dose ANNUALLYFor children enrolled in child care, pre-school or pre-Kindergarten on or after9-1-08.1 dose to be given between September 1 and December 31 of each year.

AGE APPROPRIATE VACCINATIONS (FOR LICENSED CHILD CARE CENTERS/PRE-SCHOOLS)CHILDS AGE NUMBER OF DOSES CHILD SHOULD HAVE (BY AGE):

2-3 Months 1 dose DTaP, 1 dose Polio, 1 dose Hib, 1 dose PCV74-5 Months 2 doses DTaP, 2 doses Polio, 2 doses Hib, 2 doses PCV76-7 Months 3 doses DTaP, 2 doses Polio, 2-3 doses Hib, 2-3 doses PCV7, 1 dose Influenza8-11 Months 3 doses DTaP, 2 doses Polio, 2-3 doses Hib, 2-3 doses PCV7, 1 dose Influenza12-14 Months 3 doses DTaP, 2 doses Polio, 1 dose Hib, 2-3 doses PCV7, 1 dose Influenza15-17 Months 3 doses DTaP, 2 doses Polio, 1 dose MMR, 1 dose Hib, 1 dose PCV7, 1 dose Influenza18 Months-4 Years 4 doses DTaP, 3 doses Polio, 1 dose MMR, 1 dose Hib, 1 dose Varicella, 1 dose PCV7, 1 dose Influenza

PROVISIONAL ADMISSION:Provisional admission allows a child to enter/attend school but must have a minimum of one dose of each of the required vaccines. Pupils must be actively in theprocess of completing the series. If a pupil is


12/36

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1. Record the generic abbreviation for the type of vaccine given (e.g., DTaP-Hib, PCV), notthe trade name.

2. Record the source of the vaccine given as either F (Federally-supported), S (State-supported), or P (supported by Private insurance or other Private funds).

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Patient name:

Birthdate:

Chart number:

3. Record the site where vaccine was administered as either RA (Right Arm), LA (LArm), RT (Right Thigh), LT (Left Thigh), IN (Intranasal), or O (Oral).

4. Record the publication date of each VIS as well as the date it is given to the patie

5. For combination vaccines, fill in a row for each separate antigen in the combinat

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16/36

2010

TRANSFER OF STUDENT RECORDS

Date: _____________________________

To Whom It May Concern:Re: _________________________________

Date of Birth: _________________________

Grade: ______

The student named above has recently enrolled in our district. Would you kindly forward all

school, discipline, and medical records to us at your earliest convenience? Please includeresults of standardized group and individual tests, and any other information that will assist us

in proper placement.

Sincerely,

Colleen OConeRegistrar

Previous School and Address: West Windsor-Plainsboro School:

__________________________________ ___________________________

__________________________________ (add name of school)

__________________________________

Parent Authorization for Release:

___________________________________

Signature

Please send records to the attention of Guidance Department at the appropriate school(s).

See reverse side for addresses. Thank you.

WEST WINDSOR-PLAINBORO REGIONAL SCHOOL DISTRICT


P.O. Box 505

West Windsor, NJ 08550

Phone: (609) 716-5000

Fax: (609) 716-5012


17/36

2010

West Windsor-Plainsboro District Schools

Dutch Neck Elementary School392 Village Road East, PO Box 468


Maurice Hawk Elementary School

303-305 Clarksville Road, PO Box 507


Town Center Elementary School

700 Wyndhurst Drive

Plainsboro, NJ 08536

J.V.B. Wicoff Elementary School

510 Plainsboro Road, PO Box 360Plainsboro, NJ 08536

Millstone River School

75 Grovers Mill Road, PO Box 869Plainsboro, NJ 08536

Village School601 New Village Road, PO Box 498


Community Middle School

95 Grovers Mill Road, PO Box 410

Plainsboro, NJ 08536

Grover Middle School

10 Southfield Road, PO Box 506


High School North

90 Grovers Mill Road, PO Box 50Plainsboro, NJ 08536

High School South346 Clarksville Road, PO Box 535



18/36

ThemissionoftheWestWindsorPlainsboroRegionalSchoolDistrict,valuingourtraditionofexcellence,

istodevelopallofourstudentsaspassionate,confident,lifelonglearnerswhohavecompetenceand

strengthofcharactertorealizetheiraspirationsandthoughtfullycontributetoadiverseandchangingworld.

WESTWINDSORPLAINSBORORegionalSchoolDistrict505VillageRoadWest,WestWindsor,NJ08550

609.716.5000www.wwp.org

DearParent/Guardian:

Overthepastfewyears,theWestWindsorPlainsboroRegionalSchoolDistricthasbeen

increasingitsuseoftechnology.WenowofferinformationinInfiniteCampus,ouronline

studentinformationsystem,andthroughthedistrictwebsiteandcabletelevisionstations.

We use technology to share achievements, accomplishments, and programs relating to

studentsandstaff.

WearerequiredbytheStateofNewJerseytoaskpermissionfromparents/guardiansto

poststudentinformationonthewebsiteandcabletelevisionprograms.Hence,weneed

written permission from you to effectively share news about students with parents,

students,staff,andthecommunity.In the operation of WWP web site, cable television stations, and student information

system,we strive to create anappropriatebalance between the potential risksand the

great benefits of celebrating and sharing the accomplishments of our students. State

regulationanddistrictpracticerequirethatweaskpermissiontousestudentinformation

in district publications, local media, and cable television station programs and on the

districtwebsite.Pleasecompletetheformbelowandreturntoyourchildsschool.

Sincerely,

VictoriaKniewel,EdD,SuperintendentofSchools

20112012SCHOOLYEAR:PLEASECHECKONEOFTHEFOLLOWING

CHOICESANDRETURNTOYOURCHILDSSCHOOL

Igrantpermissionformychildsphotograph/image/nametobeplacedonthedistrict

website,andinschoolpublications,PTA/PTSAmaterials,localmedia,andcable

televisionstationprograms.

Idonotgrantpermissionformychildsphotograph/image/nametobeplacedonthe

districtwebsite,andinschoolpublications,PTA/PTSAmaterials,localmedia,andcable

televisionstationprograms.

StudentName___________________________________________________________________School/Grade______________________

Parent/GuardianName_____________________________________________Email________________________________________

Parent/GuardianSignature__________________________________________________________________Date__________________


19/36

The mission of the West Windsor-Plainsboro Regional School District, valuing our tradition of excellence, is to

develop all of our students as passionate, confident, lifelong learners who have competence and strength of

character to realize their aspirations and thoughtfully contribute to a diverse and changing world.2010

Parents/Guardians of New Students:

The Health Office staff welcomes you to the West Windsor-Plainsboro Regional School

District.

We require all new students to supply the school nurse with health information. Enclosed

are all the necessary forms that must be completed: health history questionnaire,immunization requirement form, and private physical form. An emergency information

card will be given to your child at school.

New students are required to undergo a physical examination, but a new examination is not

necessary if a student has received a physical examination within 365 days of the day the

student begins school. All the forms are enclosed in this registration packet.

During the school year, new students will be screened for height, weight, blood pressure,

vision, and hearing. A Mantoux tuberculin test will be given, if necessary.

If there are any questions or concerns regarding your childs health, please feel free to

contact the nurses office at your childs school.

Wicoff Elementary School (609)716-5450 (x5452) Moira Healey

Town Center Elementary School (609)716-8330 (x6509) Alice GuestDutch Neck Elementary School (609)716-5400 (x5403) Gerri BarberMaurice Hawk Elementary School (609)716-5425 (x5428) Cindy Jenkins

Millstone River School (609)716-5500 (x5512) Edna TiberiVillage School (609)716-5200 (x5205) Valerie Leiggi

Community Middle School (609)716-5300 (x5306) Mary Doyle

Grover Middle School (609)716-5250 (x5266) Michelle Crilly

High School North (609)716-5100 (x5107) AnnMarie GominiakPatricia Walsh

High School South (609)716-5050 (x7306) Kris Grabell



P.O. Box 505


Phone: (609) 716-5000

Fax: (609) 716-5012


20/36

2010

HEALTH OFFICE INFORMATION AND PROCEDURES

The nurses of the West Windsor-Plainsboro Regional School District would like you to be aware

of procedures that are to be followed in helping to safeguard your childs health.

ACCIDENTSThe school attempts to provide an environment in which the student will be safe from

accidents. If any accident or sudden illness occurs, first aid will be administered and the

students parents notified. No care beyond first aid will be given by the school physician or

nurse.

GUIDELINES FOR KEEPING A CHILD HOMEDO NOT SEND A STUDENT TO SCHOOL WHO IS COMPLAINING OF FEELING ILL,

OR WHO HAS HAD A FEVER THE NIGHT BEFORE SCHOOL. Children must be fever-

free (WITHOUT TYLENOL) for 24 hours before they return to school. Children who feelunwell before school invariably feel ill in class and must be sent home. It is unfair to the

other children in the class, as well as the teacher, to be exposed to a student with a possible

contagious illness.

TEL-SAFE

When a student will be out of school, notify Tel-Safe. For a prolonged illness of three ormore days, a note is required for admittance into class. Please dial 716-5000 and then the ext.below:

Dutch Neck 5410 Community Middle School 5310Maurice Hawk 5430 Grover Middle School 5260

Village 5210 High School, South Campus 5063

Wicoff 5460 High School, North Campus 5110

Millstone River 5510 Town Center 6510

MEDICATION

Administration of medication during school hours is not encouraged. However, if aphysician determines that failure to take medication would jeopardize the health or school

attendance of a student, the medication will be given by the school nurse only. No

medications other then those deemed necessary for life threatening illness/conditions (asdefined in the WW-P Boards Medication Policy), shall be administered on field trips.

The following procedures must be followed if any medication (including inhalers) is to be

administered during school hours.

WEST WINDSOR-PLAINSBORO REGIONAL SCHOOL DISTRIC505 Village Road, West

P.O. Box 505


Phone: (609) 716-5000

Fax: (609) 716-5012


21/36

2010

A prescription form, found in the nurses office, is required to be completed andsigned by the students physician and signed by the parent.

The form and container with the pharmacists label designating patients name,instructions, name of drug and name of physician must be given to the nurse by

the parent.

When specific guidelines are followed, certain students may self-administer medication.

Grades K-5 No student will be permitted to self-administer medication without the

assistance of the nurse other than those deemed necessary for life threateningillness/conditions (as defined in the WW-P Boards Medication Policy)

Grades 4-5 A student will be permitted to use inhalers for asthma without nursesassistance on field trips only. A student will be permitted to self administer insulin on

field trips and in school if directed by physician.

Grades 6-12 A student may self-administer medication for life threatening

illnesses/conditions (as defined in the WW-P Boards Medication Policy) *Specific

guidelines are in place for overnight field trips.

PHYSICAL EDUCATION

If a student cannot take physical education classes due to illness or injury, a note stating the

reason for the excuse must be sent by the parents to the nurse. If a prolonged physicaleducation absence is necessary, a note from a physician is required.

IMMUNIZATIONSIn order to attend school, state law states that each students immunization requirements must

be fulfilled. These requirements are stated on the school calendar and in the school

registration packets.

Further information regarding school health services is provided in registration packets and

school calendar. If you have any questions regarding the above information, please call the

school nurse. The main thrust of our efforts is the well being of your child in a healthy schoolenvironment. Only through parent-school cooperation can this be accomplished.

Screenings: All students are screened for vision, hearing, blood pressure, height, weight, andpediculosis. Screenings occur throughout the year. Referrals are sent home to the parents if

there is a problem.


22/36

2

Prescription Form for Administration of Medication in School

Students Name D.O.B. Grade

Diagnosis

Name of Medication Dosage

Time and Circumstances of Administration

Possible side effects:

Length of time the prescription is valid (May not exceed the school year)

When specific guidelines are followed, a student may self-administer medication. Self-administration

of a prescribed medication is permitted only in exceptional circumstances when a life threatening

condition exists. For purposes of the Board policy life threatening illness is defined as, an illnessor condition that requires an immediate response to specific symptoms or sequelae that if left

untreated may lead to potential loss of life such as, but not limited to, the use of an inhaler to treat an

asthmatic attack or the use of an adrenaline injection to treat a potential anaphylactic reaction.

When self-administration of medication is applicable for a life threatening condition and in accordance with

West Windsor-Plainsboro School District policy guidelines are as follows:Grades K-3 No student will be allowed to self-administer medication without the assistance of a nurse.

Grades 4-5 A student will be allowed to use inhalers without nurse assistance on field trips only.

Grades 6-12 A student may self-administer medication for life threatening illnesses.

is capable and has been instructed in the proper method of

Students name

self administration of as directed.Medication

When an auto-injector is prescribed, please provide the following information:Is there a documented history of anaphylaxis? Yes No

If yes, please provide the signs/symptoms of this childs anaphylactic episode(s)

_________ __________________

SIGNATURE OF PHYSICIAN/DENTIST DATE PHONE

PHYSICIAN/DENTIST NAME (PRINT/TYPE/STAMP)

____HSS ____HSN ____Grover MS ____Community MS

____Millstone River ____Village ____ Hawk ____DN

____Wicoff ____ Town Center

Please check one


23/36

2010


Parent Permission for Administration of Medication in School

Students Name D.O.B. Grade

Administration of medication during school hours is not encouraged. However, if a

physician determines that failure to take medication would jeopardize the health or school

attendance of a student, the medication will be given by the school nurse. In so doing,

the West Windsor-Plainsboro Board of Education and its employees shall incur no

liability for any benefits or consequences occurring from the administration of the

medicine.

I hereby request that the school nurse administer asName of Medication

Directed by my physician. I will supply the medication in its original container and

personally deliver it to the school nurse.

Medication Information /Adjustments

If this medication is to be given on a regular basis, please indicate what needs to be done

if the student is on a class trip or on early closing days. Teaching staff can not

administer.

Check One:

_____Student will not be taking the medication when going on a class trip.

_____Administer the medication when the student returns from the class trip.

_____Parent will administer the medication when accompanying student on the trip.

Circle One: Administer/Do Not Administer the medication on early closing days.

When applicable and in accordance with the West Windsor-Plainsboro School Districts policy, I give

permission for my son/daughter to self-administer the above medication. I also understand that the self-

administration privilege shall be revoked if it is deemed that my son/daughter has failed to comply with

school policy and tenets of the agreement to self-medicate.

I relieve the West Windsor-Plainsboro Board of Education and its employees of any liability for the

benefits or consequences arising from the administration or student self-administration of this medication.

Signature of Parent/Guardian Date

Parent/Guardian Name (Print/Type/Stamp)


24/36

Provisional Admittance

According to the N.J. State Sanitary Code, Chapter 14, provisional admittance to schoo

is based on medical verification indicating that at least one dose of each of th

following vaccines has been administered and that full compliance is in process. Th

vaccines are Diptheria-Pertussis-Tetanus (DPT), Oral Polio Vaccine (OPV), Measle

Mumps and Rubella (MMR), Hepatitis B and Varicella (Chicken Pox). Please see th

enclosed Immunization Requirement form for further explanation of require

immunizations. Upon enrollment into school;i. Each school district shall require parents to provide examination documentation of each student within 30 days upon enrollin

into school.

ii. When a student is transferring to another school, each school district shall ensure that student documentation of entr

examination is forwarded to the transfer school district pursuant to N.J.A.C. 6A:16-2.4(d).iii. Students transferring into a New Jersey school from out-of-State or out-of-country may be allowed a 30-day period in order t

obtain entry examination documentation.

STUDENTS NAME GRADE_____ MALE____FEMALE____

TRANSFERRED FROM:

SCHOOL: ________________________________________________________

ADDRESS:________________________________________________________

I request that my child be provisionally admitted to school pending completion of deficiencies accordin

to New Jersey State requirements. Upon evaluation of my childs record by the school nurse, deficien

immunizations/physical exam will be met or in the process of compliance by _____________________.

_____________ _____________________________ ____________________DATE SIGNATURE PARENT/GUARDIAN PHONE

For Office Use Only

Imm. ______________

Physical __________

Tb. Date __________



25/36

Dear Parents/Guardians:

The West Windsor-Plainsboro School Transportation Office would like to take this opportunity to

welcome you and your child to our District. The Transportation Department provides transportation to

day care centers located in each of the elementary school attendance area. All transportation to these day

care centersmust be five days per week. If you choose to have your child attend a day care center for

less than five days per week, you will be responsible for transportation any day that your child is not at the

day care center.

All students that will attend a day care center must submit an alternate transportation form; if this

form is not submitted, your child will be transported to your home address. Alternate forms will not be

taken over the telephone. You will find the Alternate Transportation Form in the registration packet, which

is online at ww-p.org. The following list is a summary of Day Care choices according to assigned AM and

PM kindergarten attendance.

Dutch Neck Elementary School: Assigned AM Kindergarten

Beth Chaim Preschool Childrens House Goddard School-Windsor KinderCare Learning Center New Horizon Montessori School West Windsor Day School Windsor Happy School Princeton Presbyterian Preschool The Learning Experience

Dutch Neck Elementary School: Assigned PM Kindergarten

Beth Chaim Preschool Childrens House KinderCare Learning Center New Horizon Montessori School The Learning Experience Windsor Happy School

Maurice Hawk Elementary School: Assigned AM Kindergarten

Beth Chaim Preschool Childrens House Dupress Day Care Goddard School-Princeton Bright Horizons of Carnegie Center KinderCare Learning Center Lakeview Child Center at WW New Horizon Montessori School The Learning Experience West Windsor Day School Windsor Happy School

Maurice Hawk Elementary School: Assigned PM Kindergarten

Beth Chaim Preschool Childrens House Bright Horizons of Carnegie Center KinderCare Learning Center Lakeview Child Center at WW New Horizon Montessori School West Windsor Day School Windsor Happy School Princeton Presbyterian Preschool The Learning Experience

Town Center Elementary School: Assigned AM Kindergarten

Bright Horizons/BMS Harmony Child Care Center Knowledge Beginnings Montessori Corner @Princeton Meadows

Town Center Elementary School: Assigned PM Kindergarten

Bright Horizons/BMS Knowledge Beginnings Montessori Corner @Princeton Meadows

Wicoff Elementary School: Assigned AM Kindergarten

Bright Horizons/BMS Harmony Child Care Center Knowledge Beginnings Montessori Corner @Princeton Meadows

Wicoff Elementary School: Assigned PM Kindergarten

Bright Horizons/BMS Knowledge Beginnings Montessori Corner @Princeton Meadows

WEST WINDSOR-PLAINSBORO REGIONAL SCHOOL DISTRIC


P.O. Box 505


Phone: (609) 716-5000

Fax: (609) 716-5075


26/36

2010

WEST WINDSOR-PLAINSBORO REGIONAL SCHOOL DISTRICTTransportation Department

P. O. Box 536, Princeton-Hightstown Road


(609) 716-5570

FAX 609-716-5575

TRANSPORTATION PROCEDURES

1. Students will be allowed to ride one bus to school from home or child care andanother bus to home or child care facility after school. This must be for five days a

week each way.

2. Parents requesting a transportation change for childcare arrangements must completethe Alternate Transportation Form five school days in advance of the effective

change date. No forms will be processed between the dates of August 25 and

September 15 due to the start of school.

ALL CHILD-CARE ARRANGEMENTS MUST BE FIVE (5) DAYS A WEEK.

3. Parents requesting a transportation change due to a change in address must submit tothe District Registrar a new proof of residency. The Registrar will contact the

Transportation Department regarding the change of address.

4. Students may not switch buses to go home with another student for school projects,music lessons, playing or other personal matters.

5. Visiting out-of-district children may not ride district buses. The parents who arehosting the children must provide transportation.

6. Students may not use a different stop unless written parental notification is given tothe Transportation Department.

7.

Students should be at their bus locations ten minutes before the scheduled pick-uptimes. Parents are responsible for transporting children who have missed their bus.

8. Parents are not permitted to ride or board school buses to or from school. Youngersiblings are not permitted to ride the school buses to or from school or accompany

parents or coaches on field/athletic trips.

9. Telephone requests for changes will only be accepted in emergencies.


27/36


Transportation Department

3 Wallace Rd, P.O. Box 536


Phone: 609 716-5570 FAX: 609-716-5575

Alternate Transportation Request Form

This form must be fill out completely and forwarded to your childs school of attendance. The school will forward a copy to the

Transportation Department. Once the form has been received and approved by transportation a revised bus pass will the

forwarded to the school with the effective date of the change. All alternates must be 5 days per week, no exceptions and processing

normally take 3 days except for the first 2 weeks of school. If changes are made to this Alternate a new form must be submitted.

We will not take changes over the phone.

Date: __________________________________

Student Name:________________________________________________________Grade_______________________

Home Address: ___________________________________________________________________________________

Home Phone #:________________________________________________Work/Cell Phone#:____________________

School your child attends: ___________________________________________________________________________

ALTERNATE LOCATION REQUESTED- PLEASE FILL IN COMPLETE INFORMATION

MUST BE 5 DAYS PER WEEK

Will your child ride bus to school from home? Yes _________ No______________

If no, please completely fill out the area below: Incomplete information will delay the processing of the alternate

Name of daycare or sitter: _________________________________________________________________________

Complete address of daycare or sitter: ________________________________________________________________

Contact number for daycare or sitter: _________________________________________________________________

---------------------------------------------------------------------------------------------------------------------------------------------------

Will your child ride bus from school to home? Yes ___________ No ____________

If no, please completely fill out the area below: Incomplete information will delay the processing of the alternate

Name of day care or sitter: _____________________________________________________________________

Complete address of daycare or sitter: ____________________________________________________________

Contact number for daycare or sitter: _____________________________________________________________

If you request and are granted a change in session for your kindergarten student to accommodate your daycare arrangements and your

arrangements change during the school year, parents will be responsible for transporting their child.

If West Windsor Plainsboro Schools are closed for any reason there will not be transportation to or from the daycare location.

Effective Date of Change (date must be at least 3 days later) Parent/Guardian Signature (form must be signed)

_______________________________ ______________________________________

WW-P Alternate Trans Form Revised 11/17/2010


28/36

2010

CHILD STUDY TEAM REQUEST FOR RECORDS

Has your child ever been referred to and/or tested by a Child Study Team?

Yes __________ No __________

Has your child ever been classified as a Special Education Student?

Yes __________ No __________

If either answer is yes, complete the information below.

To Whom It May Concern: School _______________________________

I hereby give permission to release any medical, psychological, educational, and/or social

information to the West Windsor-Plainsboro Child Study Team concerning my child.

__________________________________ __________________________________

Students Name Date of Birth

____________________________________________________________________________

Address

__________________________________ __________________________________Parent/Guardian Signature Date

This information will be treated with the utmost confidentiality and will be used only by

professional people for the purpose of arriving at the best educational plan for your child.

West Windsor-Plainsboro Regional School District505 Village Road West

P.O. Box 505


Phone: (609) 716-5000

Fax: (609) 716-5012


29/36

2010

PARENTS STATEMENT OF RESIDENCY

I am the ____________________ of __________________________________________________________.

(Mother or Father) (Childs Name)

I currently live and reside at _________________________________________________________________

(Street Address) (Apt. No.)

________________________. This postal address is in West Windsor/Plainsboro Township.

(Town) (Zip) (Circle one)

My child resides with me at that address. I submit the following proof of my residence:

___________Copy of Executed Deed ____________Copy of Executed Lease

___________ Signed Settlement Statement ____________ Affidavit of Title

___________Other ____________H.U.D. Settlement

(See Cover Page for additional information)

I do / do not maintain any other residence.

(Circle one)

If you do, give address of other residence and state why you are residing here instead.

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________

In the event an investigation should disclose that my child is not entitled by law to attend the West Windsor-Plainsboro

School District free of charge, I understand that the child will be dis-enrolled, and that I will be held responsible for the

costs of tuition to the district for any periods of unlawful attendance. Such tuition will be based upon the per pupil costs

of education for the portion of the year in which the child was unlawfully enrolled.

I certify that the foregoing statements made by me are true. I am aware that if any of these statements are false, I will besubject to legal action.

DATE:_________________ PARENTS SIGNATURE:__________________________

West Windsor-Plainsboro Regional School District


P.O. Box 505


Phone: (609) 716-5000

Fax: (609) 716-5012


30/36

2011

NATIVE LANGUAGE SURVEY

Todays Date _____________________________________

Students name__________________________________ Grade _____ Home School ___________Fathers name __________________________________ Home Phone # _____________________

Mothers name ___________________________________ Work Phone # _____________________

Address _______________________________________ Cell Phone # _______________________

________________________________________

Childs Date of Birth _____________________________ Gender: M_____ F_____

1. What languageother than English is spoken at home? (see attached list)

parents?___________________________________ child?_____________________________

2. What country do you and/or your child come from? _____________________________________

3. Was the child born in the United States? Yes______ No______

4. Does the child speak English? Fluent______ Limited______ None______

5. Do the childs parents speak English? Fluent______ Limited______ None______

6. Has the child attended an English-speaking Nursery School? Yes______ No______

7. Has the child attended an English-speaking school in the United States before coming to WestWindsor-Plainsboro?

Yes______ No______ If yes, how many years? __________

8. Was the child in an ESL and/or Bilingual program before?

ESL______ Bilingual______ Both______ Neither______

9. How many years was the child in an ESL or Bilingual program? ______________

FROM what date _______________ TO what date______________________

10. Did the child formally test out of an ESL or Bilingual program? No_____ Yes ______ Date____

11. Name oflast school attended _____________________________________________________

District _________________________________ State/Country _______________________

West Windsor-Plainsboro Regional School Distric505 Village Road West

P.O. Box 505


Phone: (609) 716-5000

Fax: (609) 716-5012


31/36

English Name ofLanguage

LanguageCode

Abkhazian abk

Achinese ace

Acoli ach

Adangme ada

Adygei ady

Adyghe ady

Afar aar

Afrihili afh

Afrikaans afr

Afro-Asiatic languages afa

Ainu ain

Akan aka

Akkadian akk

Albanian alb/sqi

Alemannic gsw

Aleut ale

Algonquian languages alg

Alsatian gsw

Altaic languages tut

Amharic amh

Angika anp

Apache languages apa

Arabic ara

Aragonese arg

Arapaho arp

Arawak arw

Armenian arm/hye

Aromanian rup

Artificial languages art

Arumanian rup

Assamese asm

Asturian ast

Asturleonese ast

Athapascan languages ath

Australian languages aus

Austronesian languages map

Avaric ava

Avestan ave

Awadhi awa

Aymara aym

Azerbaijani aze

Bable ast

Balinese ban

Baltic languages bat

Baluchi bal

Bambara bam

Bamileke languages bai

Banda languages bad

Bantu languages bnt

Basa bas

Bashkir bak

Basque baq/eus

Batak languages btk

Bedawiyet bej

Beja bej

Belarusian bel

Bemba bem

Bengali ben

Berber languages ber

Bhojpuri bho

Bihari languages bih

Bikol bik

Bilin byn

Bini bin

Bislama bis

Blin byn

Bliss zbl

Blissymbolics zbl

Blissymbols zbl

Bokml, Norwegian nob

Bosnian bos

Braj bra

Breton bre

Buginese bug

Bulgarian bul

Buriat bua

Burmese bur/mya

Caddo cad

Castilian spa

Catalan cat

Caucasian languages cau

Cebuano ceb

Celtic languages cel

Central American Indian

languages

cai

Central Khmer khm

Chagatai chg

Chamic languages cmc

Chamorro cha

Chechen che

Cherokee chr

Chewa nya

Cheyenne chy

Chibcha chb

Chichewa nya

Chinese chi/zho

Chinook jargon chn

Chipewyan chp

Choctaw cho

Chuang zha

Church Slavic chu

Church Slavonic chu

Chuukese chk

Chuvash chv

Classical Nepal Bhasa nwc

Classical Newari nwc

Classical Syriac syc

Cook Islands Maori rar

Coptic cop

Cornish cor

Corsican cos

Cree cre

Creek mus

Creoles and pidgins crp

Creoles and pidgins,

English based

cpe


French-based

cpf


Portuguese-based

cpp

Crimean Tatar crh

Crimean Turkish crh

Croatian hrv

Cushitic languages cus

Czech cze/ces

Dakota dak

Danish dan

Dargwa dar

Delaware del

Dene Suline chp

Dhivehi div

Dimili zza

Dimli zza

Dinka din

Divehi div

Dogri doi

Dogrib dgr

Dravidian languages dra

Duala dua

Dutch dut/nld

Dutch, Middle (ca.1050-

1350)

dum

Dyula dyu

Dzongkha dzo

Eastern Frisian frs

Edo bin

Efik efi

Egyptian (Ancient) egy

Ekajuk eka

Elamite elx

English eng

English, Middle (1100- enm


32/36

1500)

English, Old (ca.450-1100) ang

Erzya myv

Esperanto epo

Estonian est

Ewe ewe

Ewondo ewo

Fang fan

Fanti fat

Faroese fao

Fijian fij

Filipino fil

Finnish fin

Finno-Ugrian languages fiu

Flemish dut/nld

Fon fon

French fre/fra

French, Middle (ca.1400-

1600)

frm

French, Old (842-ca.1400) fro

Friulian fur

Fulah ful

Ga gaa

Gaelic gla

Galibi Carib car

Galician glg

Ganda lug

Gayo gay

Gbaya gba

Geez gez

Georgian geo/kat

German ger/deu

German, Low nds

German, Middle High

(ca.1050-1500)

gmh

German, Old High (ca.750-

1050)

goh

Germanic languages gem

Gikuyu kik

Gilbertese gil

Gondi gon

Gorontalo gor

Gothic got

Grebo grb

Greek, Ancient (to 1453) grc

Greek, Modern (1453-) gre/ell

Greenlandic kal

Guarani grn

Gujarati guj

Gwich'in gwi

Haida hai

Haitian hat

Haitian Creole hat

Hausa hau

Hawaiian haw

Hebrew heb

Herero her

Hiligaynon hil

Himachali languages him

Hindi hin

Hiri Motu hmo

Hittite hit

Hmong hmn

Hungarian hun

Hupa hup

Iban iba

Icelandic ice/isl

Ido ido

Igbo ibo

Ijo languages ijo

Iloko ilo

Imperial Aramaic (700-300

BCE)

arc

Inari Sami smn

Indic languages inc

Indo-European languages ine

Indonesian ind

Ingush inh

Interlingua (International

Auxiliary Language

Association)

ina

Interlingue ile

Inuktitut iku

Inupiaq ipk

Iranian languages ira

Irish gle

Irish, Middle (900-1200) mga

Irish, Old (to 900) sga

Iroquoian languages iro

Italian ita

Japanese jpn

Javanese jav

Jingpho kac

Judeo-Arabic jrb

Judeo-Persian jpr

Kabardian kbd

Kabyle kab

Kachin kac

Kalaallisut kal

Kalmyk xal

Kamba kam

Kannada kan

Kanuri kau

Kapampangan pam

Kara-Kalpak kaa

Karachay-Balkar krc

Karelian krl

Karen languages kar

Kashmiri kas

Kashubian csb

Kawi kaw

Kazakh kaz

Khasi kha

Khoisan languages khi

Khotanese kho

Kikuyu kik

Kimbundu kmb

Kinyarwanda kin

Kirdki zza

Kirghiz kir

Kirmanjki zza

Klingon tlh

Komi kom

Kongo kon

Konkani kok

Korean kor

Kosraean kos

Kpelle kpe

Kru languages kro

Kuanyama kua

Kumyk kum

Kurdish kur

Kurukh kru

Kutenai kut

Kwanyama kua

Kyrgyz kir

Ladino lad

Lahnda lah

Lamba lam

Land Dayak languages day

Lao lao

Latin lat

Latvian lav

Leonese ast

Letzeburgesch ltz

Lezghian lez

Limburgan lim

Limburger lim

Limburgish lim

Lingala lin

Lithuanian lit

Lojban jbo


33/36

Low German nds

Low Saxon nds

Lower Sorbian dsb

Lozi loz

Luba-Katanga lub

Luba-Lulua lua

Luiseno lui

Lule Sami smj

Lunda lun

Luo (Kenya and Tanzania) luo

Lushai lus

Luxembourgish ltz

Macedo-Romanian rup

Macedonian mac/mkd

Madurese mad

Magahi mag

Maithili mai

Makasar mak

Malagasy mlg

Malay may/msa

Malayalam mal

Maldivian div

Maltese mlt

Manchu mnc

Mandar mdr

Mandingo man

Manipuri mni

Manobo languages mno

Manx glv

Maori mao/mri

Mapuche arn

Mapudungun arn

Marathi mar

Mari chm

Marshallese mah

Marwari mwr

Masai mas

Mayan languages myn

Mende men

Mi'kmaq mic

Micmac mic

Minangkabau min

Mirandese mwl

Mohawk moh

Moksha mdf

Moldavian rum/ron

Moldovan rum/ron

Mon-Khmer languages mkh

Mong hmn

Mongo lol

Mongolian mon

Mossi mos

Multiple languages mul

Munda languages mun

N'Ko nqo

Nahuatl languages nah

Nauru nau

Navaho nav

Navajo nav

Ndebele, North nde

Ndebele, South nbl

Ndonga ndo

Neapolitan nap

Nepal Bhasa new

Nepali nep

Newari new

Nias nia

Niger-Kordofanian

languages

nic

Nilo-Saharan languages ssa

Niuean niu

No linguistic content zxx

Nogai nog

Norse, Old non

North American Indian

languages

nai

North Ndebele nde

Northern Frisian frr

Northern Sami sme

Northern Sotho nso

Norwegian nor

Norwegian Bokml nob

Documents

2011-2012 Registration Packet for Kindergarten