Upload
others
View
6
Download
0
Embed Size (px)
Citation preview
Dardanelle Intermediate School
Procedural Manual/Lizard Log
2015 -2016
DARDANELLE INTERMEDIATE SCHOOL
900 North 4th
Street
Dardanelle, AR 72834
http://dardanelle.k12.ar.us
479-229-3707 (Phone)
479-229-4686 (Fax)
TERRY LAUGHINGHOUSE, PRINCIPAL
DEBBIE MURPHY, ASSISTANT PRINCIPAL
KEY PERSONNEL AT OUR SCHOOL:
Becca Manatt, Secretary
Pat Akers, Registrar
Brenda Reid, Clerk (lunch money)
Annette Sigle, School Nurse
Jean Furr, Counselor/ Parent Facilitator/504 Coordinator
Terry McElligott, Student Intervention Team Coordinator
Amy Wade, Library Media Specialist
TABLE OF CONTENTS
Accessing Student Records ________________________________________________________________________________ 7
Attendance ______________________________________________________________________________________________ 8
Car Riders _______________________________________________________________________________________________ 9
Cell Phones/Electronic Devices ____________________________________________________________________________ 12
Communicating Misbehavior ______________________________________________________________________________ 11
Concerns_______________________________________________________________________________________________ 11
Dardanelle Elementary School Core Beliefs __________________________________________________________________ 3
Dardanelle Elementary School Mission Statement _____________________________________________________________ 3
Dardanelle Elementary School Parental Involvement Plan______________________________________________________ 7
Dardanelle Elementary School Procedural Manual _____________________________________________________________ 2
Dardanelle Elementary School Rules _______________________________________________________________________ 10
Dardanelle Elementary School – School/Student / Parent Compact _______________________________________________ 5
Dates to Remember _______________________________________________________________________________________ 1
Extracurricular Activities _________________________________________________________________________________ 13
Free/Reduced Price School Meals Family Application _________________________________________________________ 10
Handling Bus Incidents ___________________________________________________________________________________ 11
Hours of Operation _______________________________________________________________________________________ 7
Inappropriate Clothing/Grooming __________________________________________________________________________ 12
Library Materials ________________________________________________________________________________________ 13
Lizard Log _______________________________________________________________________________________________ 2
Lunch Charges __________________________________________________________________________________________ 10
Parent Center ____________________________________________________________________________________________ 7
Physical Education ______________________________________________________________________________________ 12
Pinnacle Parent Viewer ____________________________________________________________________________________ 7
Reporting Absentees ______________________________________________________________________________________ 8
Reporting Bullying _______________________________________________________________________________________ 12
Rules/Procedures _______________________________________________________________________________________ 11
School Meals ____________________________________________________________________________________________ 9
Severe Weather __________________________________________________________________________________________ 1
Snacks _________________________________________________________________________________________________ 10
Student Checkout Procedure _______________________________________________________________________________ 8
Tardies _________________________________________________________________________________________________ 8
Telephone ______________________________________________________________________________________________ 12
Textbooks ______________________________________________________________________________________________ 12
Transportation ___________________________________________________________________________________________ 9
Visitors _________________________________________________________________________________________________ 9
Volunteers_______________________________________________________________________________________________ 9
Welcome ________________________________________________________________________________________________ 2
Dardanelle Intermediate School 2014-2015
Dates To Remember Labor Day (No Class) September 1 Parent Involvement Meeting First Semester -TBA Progress Report September 16 End of First Quarter October 17 Parent/Teacher Conferences October 27 Professional Development (No Class) October 31st Progress Reports November 25 Thanksgiving (No Class) November 26, 27, 28 End of Second Quarter (semester) December 19 Christmas Break (No Class) December 22 – January 5 Professional Development (No Classes) January 5 Classes Resume January 6 Martin Luther King (No Classes) January 19 Progress Report February 3 Parent/Teacher Conferences February 12 Professional Development (No Classes) February 14 President’s Day (No Classes) February 17 Parent Involvement Night Second Semester-TBA End of Third Quarter March 14 Spring Break (No Classes) March 24 - 28 Benchmark Testing April TBA Progress Report April 17 Good Friday (No Classes) April 18 Memorial Day May 26 Last Day of Classes May 30 If necessary we will make up days on June 2, 3, 4 and 5.
1
WELCOME
SEVERE WEATHER School will not be in session when the weather makes it dangerous for school buses to run. In case of inclement weather, the local radio stations, KARV-610 AM and KCJC-100.9 FM will announce the decisions as early as possible. KFSM, channel 5, in Ft. Smith and KARK, channel 4 in Little Rock will also announce school closings. If during the school day weather conditions become bad enough to require buses to make their runs before the regularly scheduled time, local radio stations will be notified. Students who do not ride buses will be dismissed when their ride arrives. Please have your child prepared to know a backup plan for an early dismissal. Students will not be allowed to use the office phone.
The start of a new year always brings high expectations. It’s a time for fresh start and new beginnings. It is our goal for your children to have a meaningful and rewarding year. You will find our staff to be friendly and helpful. Our staff is looking forward to the opportunity of partnering with you to ensure the success of your children. DARDANELLE ELEMENTARY SCHOOL PROCEDURAL MANUAL
The DES Procedural manual provides our parents and students information that is necessary to maintain a safe positive learning environment at Dardanelle Elementary. It is the responsibility of each student and his/her parents to become thoroughly familiar with all operational procedures. If questions arise, don’t hesitate to contact our office and ask to speak to our principal or assistant principal for clarification. It is required for you to read and sign the “Student Procedural Manual Acknowledgement” located on page 19 and have your child return the form to their teacher. Keep in mind your signature does not mean that you agree with the manual, but merely that you have read and understood the procedures. LIZARD LOG
Our staff realizes the importance of our students learning at an early age how to utilize a planner and for this reason our district provides at no charge a Lizard Log to each student. It is the goal of the staff for their students to write down their homework assignments in the appropriate location for that day. By doing so, it will help keep our parents aware of what needs to be completed and the due dates of the assignments. The Lizard Log is one of the many tools that our staff utilizes to communicate with our parents. Likewise, we would encourage our parents to utilize the Lizard Log to communicate information with our staff. If for some reason your child needs to replace their Lizard Log you can purchase one in the main office for $5.00.
2
DARDANELLE ELEMENTARY SCHOOL MISSION STATEMENT
It is the mission of Dardanelle Elementary School to provide a safe, positive, challenging, and engaging environment. We believe all students can achieve proficiency or above as defined by state and national standards. We will follow an aligned system of curriculum, instruction, and assessment combining the strengths of all involved in the learning process. We are committed to strengthening relationships among students, parents, facility and community in an effort to provide a comprehensive community of support to ensure individual student success.
DARDANELLE ELEMENTARY SCHOOL CORE BELIEFS SCHOOL CLIMATE We at Dardanelle Elementary School are committed to fostering a SCHOOL CLIMATE that...
Is supported by an administration and the school community who value the professionalism and input of its members
Demonstrates mutual respect between students, teachers, support staff, administrators, and the school community
Is a non-threatening environment characterized by positive attitudes and body language, stability, and encouragement
Shares responsibility in success and failure
Is an enjoyable place to be for students, teachers, support staff, administrators and the school community
Offers a supportive framework for learning giving students, parents, and staff the necessary tools for success
Believes that all children have the right and ability to learn
3
DARDANELLE ELEMENTARY SCHOOL CORE BELIEFS (continued) STUDENT LEARNING We at Dardanelle Elementary are committed to fostering STUDENT LEARNING that...
Is characterized by eager learners coming to class prepared and wanting to learn
Is characterized by students who are confident in their abilities
Is an environment where there is an acceptance of individual learning
Is a whole society endeavor
Is a place where teachers have high expectations of all students
Is research-based and aligned to Arkansas Standards
Is aligned with instruction and assessment
Is balanced to meet the social, emotional, cognitive, and physical needs of every child
Can be easily integrated across all content areas in order for students to make clear connections and meaning
Is supported by meaningful and relevant professional development in which the staff receives the tools to deliver curriculum effectively and participates in a collaborative effort to deliver that instruction
INSTRUCTION We at Dardanelle Elementary are committed to fostering INSTRUCTION that...
Is delivered using research based and proven practice strategies
Is consistent in focusing on purposeful learning that begins with student’s prior knowledge
Delivers a standards-based curriculum in a way that is motivating and engaging
Has enough flexibility that allows enough time that ensures mastery of standards
Prepares students for their futures, not our past ASSESSMENT We at Dardanelle Elementary are committed to fostering ASSESSMENT that...
Is aligned to standards-based curriculum and instruction
Is a diagnostic tool used to identify and address strengths and weaknesses of both students and teachers in a timely fashion
Is a tool for guiding and modifying instruction and interventions
Should be continuous, ongoing, and varied in nature
Should be multi-sourced
Is both formative and summative
4
DARDANELLE ELEMENTARY SCHOOL SCHOOL /STUDENT /PARENT COMPACT
The staff at Dardanelle Elementary is committed to helping our students reach their full potential. In order to do this, we will have to have the commitment of the parents and the students. We believe that if each member entering into this compact will commit to their part of the compact, the end result will be that the child will reach their full potential for this school year. School Staff Agreement Because it is important for my students to reach their full potential, I will strive to do the following:
Be punctual
Show respect, love, and encouragement to all children in the school
Maintain a safe, positive learning environment
Maintain and promote high standards of academic achievement and behavior
Create an atmosphere of openness by communicating regularly with parents and
students
Communicate regularly with parents regarding their child’s educational progress as
well as their behavior
Invite and encourage my parents to take an active role in their child’s education
Provide the parents with information on the forms of academic assessment used to
measure student progress , the proficiency levels students are expected to meet and
the level that their child has reached
Provide the parents with strategies/tools/materials for the parents to utilize at home to
strengthen their child’s academic skills
Provide opportunities for parents to volunteer in their classroom and observe
classroom activities
Encourage parents to attend trainings and workshops provided by the school to help
them work with their child to improve achievement
Encourage the parents to utilize the resources available in the DES Parent Center to
improve their child’s achievement
Actively and consistently working toward the goal of preparing my students to compete
in a global economy
5
DARDANELLE ELEMENTARY SCHOOL SCHOOL/ STUDENT/ PARENT COMPACT (continued) Student Agreement Because I desire to reach my full potential, I will strive to do the following:
Attend school regularly and do my part to be punctual
Come to school appropriately and neatly dressed
Follow school rules and procedures
Maintain a positive attitude
Be attentive to the task at hand
Be willing to ask questions and clarify understanding of the task at hand
Be willing to participate and take part in group discussions
Be willing to do my part to ensure the success of my group during group work
Keep my workspace and materials organized
Maintain the necessary materials to complete classroom assignments on time
Deliver all types of communications to my parent/guardian and return any necessary
communications to my teacher(s)
Take home all materials necessary to complete homework assignment(s)
Read nightly
Parent/Guardian Agreement Since I want my child to reach their full potential, I will strive to do the following:
See that my child is punctual and attends school regularly
See that my child comes to school appropriately and neatly dressed
Support the school in its efforts to maintain a safe positive learning environment
Oversee the positive use of extracurricular time
Provide a quiet, well-lighted place to study
Establish a time for homework and monitor homework completion
Encourage my child’s efforts and be available for questions
Read with my child/let my child see me reading
Utilize the strategies/tools/materials provided by my child’s teacher to strengthen my
child’s academic skills at home
Participate in decisions relating to the education of my child
Attend parent/teacher conferences and maintain frequent communication with the
teacher(s)
Maintain an open line of communication with the school
Return requested materials to school
6
PARENT CENTER DES Parent Center is located in our media center and is open during school hours for DES parents to utilize. We have computers, internet access, numerous books, pamphlets and other informative material regarding responsible parenting as well as material geared toward parental academic support at home. If you are unable to visit our Parent Center but are interested in checking out material contact Ms. Furr, Parent Facilitator at 229-3707 or at [email protected] and she will assist you in checking out the material from our center. DARDANELLE ELEMENTARY SCHOOL PARENTAL INVOLVEMENT PLAN The administration and staff at Dardanelle Elementary believe that involving parents in their child’s education is vital for the child to reach his or her potential. Therefore, we desire to create a partnership with parents to improve the social, emotional and academic growth of our students. The DES Parental Involvement Plan promotes parental involvement and provides access to educational/parental resources available on our campus. You can view our plan on the district website page at http://district.dardanelle.k12.ar.us/ or request a hard copy of the plan by contacting Ms. Furr, Parent Facilitator at 229-3707 or at [email protected]. PINNACLE PARENT VIEWER Mrs. Wade, Library Media Specialist, will provide you with your child’s user name and password in order for you to monitor your child’s grades. If you don’t have a computer, we have computers in the DES Parent Center for you to utilize during the school day. ACCESSING STUDENT RECORDS As a parent or legal guardian you have access to your child’s records. You are welcome to inspect the content of records and to challenge anything contained within the records that you consider to be inaccurate or misleading. During your review of your child’s records if there is any part of the records you don’t understand let our secretary know and she will contact the necessary personnel to assist you. HOURS OF OPERATION Our doors are open at 7:20 and the main office is closed at 4:00. Our entrance door remains open until 5:00. Remember children dropped off prior to 7:20 have no adult supervision.
7
TARDIES Keep in mind that the tardy bell rings at 7:55. If your child arrives late to school, he or she must check in the main office and receive a tardy slip. Any student arriving after 9:00 will be counted ½ day absent. This will impact your child’s perfect attendance. Excessive tardiness could result in a conference with the parent. ATTENDANCE Mrs. Akers, our registrar, is willing to discuss any questions you might have concerning your child’s absences. You can reach her at 229-3707 or email her at [email protected] with your concerns. REPORTING ABSENTEES On the day that your child is absent you will need to call the office at 229-3707 and speak with our secretarial staff. In order for our secretary to document the call, you will need to identify yourself and tell the secretary the name of your child, the name of their teacher and the reason why your child is absent. If you were unable to call, you will need to write a note to explain your child’s absence from school. The note will need to include the following information:
Child’s full name
Date of absence(s)
Reason
Teacher’s name
Your signature Your child will need to give the note to their teacher upon their arrival back to school. If you don’t want to send the note by your child you can drop it off or fax it to Mrs. Akers at 479-229-4686. STUDENT CHECKOUT PROCEDURE Parents must sign out their child in the main office. Keep in mind if a child is checked out prior to 11:30 they will be counted absent for a whole day. Those that are checked out after 11:30 will be counted absent for ½ day. Checking out after 2:30 so long as you submit a doctor note will not count as a ½ day absence. Anyone checking a student out of school must have the parent’s permission and be included on the Student Release Form, which is included on the back of the DES Medical Information Form.
8
CAR RIDERS If you are bringing your children to school in the morning you will need to form one lane and pull as far forward as possible prior to your child exiting the vehicle. Your child will need to exit the vehicle on the building side. Keep in mind that we do not open our doors until 7:20. When picking up your child in the afternoon, you will need to form two lanes of traffic. Due to the two lanes of traffic you will need to obey the staff member directing traffic. The staff member on duty will instruct your child to go to your vehicle or will walk them across to your vehicle if you are in the outside lane. TRANSPORTATION For the safety of all children students are not allowed to walk or ride a bike to or from our school. If you want your child to go home differently you will need to write a note or call no later than 2:45 explaining the method of transportation, address that they are going to and the name of whom they are staying with. Your child’s teacher will send the note to the office for the principal or assistant principal to approve. If the note is not approved (sometimes other buses may be full and can’t accommodate your child) you will be contacted to make the necessary arrangements for transporting your child. Remember that your child will not be allowed to change their regular going home routine without a note or call from home. VISITORS All visitors will need to sign in with office personnel located in the main office and receive a visitor pass. This pass will need to be worn during your visit at our school. Prior to leaving the building you will need to sign out. VOLUNTEERS Volunteers will not only need to sign in and receive a visitor pass but they will also need to sign the Volunteer Book. SCHOOL MEALS Breakfast is served from 7:20 to 7:50. Children on late buses will be served. Our students have 30 minutes for lunch.
9 FREE/REDUCED PRICE SCHOOL MEALS FAMILY APPLICATION
Reduced or free meals are available for those families who qualify. Applications can be picked up in the main office. LUNCH CHARGES Students are not allowed to charge breakfast or lunch. Should you have any questions regarding your child’s meals please feel free to contact Mrs. Reid at 229-3707 or email her at [email protected] . SNACKS The Dardanelle School District Wellness Policy encourages you to provide healthy snacks during classroom functions. Hopefully, this list of healthy snacks might be beneficial in assisting you:
Granola Bars
Multigrain Bars
Sunflower or Pumpkin Seeds
Fresh Fruit
Fresh Vegetables
Baked Doritos
Baked Potato Chips
Pretzels
Chex Mix
Morning Mix
Nature Valley Bars
Nabisco Corn Nuts
Kudos Mild Chocolate Bars, Chocolate Chip and M&M’s Flavored Bar If you plan to bring snacks for the children in your child’s class their teacher will need to approve it prior to the snacks being brought. Keep in mind that snacks have to be store bought. Dardanelle Elementary School Rules:
1. Keep hands, feet, and hurtful words to yourself. 2. Complete assignments on time. 3. Use and handle supplies and school property as intended.
10 RULES/PROCEDURES Your child’s teacher will provide you with a copy of their classroom rules and procedures.
Peanut Butter (4 pack) Crackers
Peanuts
Almonds
Cheese and Crackers
Soy Nuts
Melba Toast
Rice Cakes
Natural Fruit Leathers (Roll Ups) Apricot, Peach, Raspberry, Strawberry
Trail Mix
Failure to follow established school or classroom rules may result in, but will not be limited to the following consequences:
student-teacher conferences
student-principal conference
parent-teacher conference
loss of privilege
corporal punishment
in-school suspension
suspension
expulsion HANDLING BUS INCIDENTS A “Bus Conduct Report” will be handled in the following manner: 1st offense – conference with the administrator (unless the incident involved fighting) 2nd offense – corporal punishment or 3 days bus suspension 3rd offense – 5 days bus suspension 4th offense – 10 days bus suspension 5th offense – Loss of bus privilege COMMUNICATING MISBEHAVIOR We feel that parents will want to know when their child is conducting himself/herself in an inappropriate manner. For the most part, parents will be notified by receiving a note in the Lizard Log or receiving a discipline notice from one of the administrators. However, serious infractions may warrant a telephone call. CONCERNS If you have a concern, you should first discuss your concern with the staff member involved. If your concern is not resolved at this level, you will need to set up an appointment with our principal or assistant principal to discuss your concern and allow him or her opportunity to resolve your grievance. If the problem is not resolved to your satisfaction after meeting with the principal or assistant principal, you can file a written grievance with the superintendent. If the superintendent is unable to resolve the situation, you may request that the superintendent schedule a hearing before the Board of Education.
11 REPORTING BULLYING
Our staff encourages students to report bullying immediately to the nearest available staff member. Should you become aware of any form of bullying, please contact the office as soon as possible. INAPPROPRIATE CLOTHING/GROOMING If a student’s grooming or clothing is unacceptable, adequate time shall be allowed to make proper adjustments. If available, students will be given appropriate clothing to wear. If the student continues to ignore the required changes they will be subject to disciplinary action. CELL PHONES/ELECTRONIC DEVICES If your child is in possession of any electronic device, that device must remain on them in a concealed manner and in the off position or can be given to the teacher to hold. TELEPHONE The school telephone is for business calls only. Personal calls home are not permitted. TEXTBOOKS Lost textbooks must be paid for in full so that the books may be replaced for future use. Fines will be assessed for damaged books based on the extent of the damage and the cost of the repair. Failure on the part of the student to pay for lost or damaged books will deprive them of further use of free textbooks until such assessment is paid. PHYSICAL EDUCATION For your child’s comfort and safety it is advised that they wear tennis shoes on the day they have physical education. If your child has some limitations that prevent them from participation in physical activities it needs to be indicated in a written note from the child’s doctor. The note can be faxed to Annette Sigle, our school nurse at 479-229-4686 or you can drop off the note in the main office.
12 LIBRARY MATERIALS
Lost library materials must be paid for in full so that they can be replaced for future use. Fines will be assessed for damaged books based on the extent of the damage and the cost of the repair. Failure on the part of the student to pay for lost or damaged material will deprive them of further use of library materials until such assessment is paid. EXTRACURRICULAR ACTIVITIES We seek your permission to involve your child in activities that are planned throughout the course of the year. Information about trips and other events will be provided to parents prior to each trip. Transportation to and from field trips outside our immediate area will be provided by the district. Students participating in such activities will be required to ride in district vehicles. If you want your child to ride home with you after the activity you will need to visit with the sponsor prior to the trip. The sponsor will either approve or deny your request. The sponsor must notify the office of your request and their decision.
13
PLEASE COMPLETE
THE
FOLLOWING FORMS
AND
RETURN TO YOUR
CHILD’S TEACHER
Dardanelle Elementary Volunteer Survey
Let’s work together! If you would like to get involved at Dardanelle Elementary we’d love to have you! Please check the volunteer positions you’d be willing to fill and have your child return the completed survey to their teacher. Soon you will receive a follow-up call or e-mail about opportunities to volunteer. If you have any questions about any of the following volunteer opportunities, please feel free to contact me. My name is Jean Furr and I serve as the Parent Facilitator for DES. You can reach me by phone at (479) 229-3707 or by email at [email protected]. I look forward to working with you throughout the school year! Volunteer’s Name: _________________________________________
E-Mail Address: ______________________________________
Phone: ___________________ ____________________
Home Cell
Child’s Name: ________________________________________
Teacher’s Name: ______________________________________
Best Time For You: __ Morning __ Afternoon __ Evening
Volunteer Opportunities
___ 1. Math Tutor
___ 2. Reading Tutor
___ 3. Tutor for English Language Learners (ELL)
___ 4. Help students with organization
___ 5. Chaperone (field trips/class events)
___ 6. Translate for students or teachers. Language ____________
___ 7. Translation of written material from English to Spanish
___ 8. Library/Media Assistant
___ 9. Special Project Assistant (i.e. cut out projects, classroom parties, etc.)
___ 10. Clerical work
___ 11. Photograph school events
___ 12. Video record school events
___ 13. Assist at upcoming special school events (i.e. Thanksgiving Feast, Book Fair,
Parental Involvement Nights, etc.)
___ 14. Design advertisement for upcoming special school events
___ 15. Make copies for staff
___ 16. Laminate materials for the staff
___ 17. Other _______________________________________________________
14 Dardanelle Elementary School Student Medical Information
Student’s Name________________________ SS#____________DOB______________ Sex____ Grade______ Address____________________________________________ Parent/Guardian______________________________ Phone___________________ Father’s Work________________________________ Phone___________________ Mother’s Work_______________________________ Phone___________________ Family Doctor_______________________________ Phone___________________ Local person to contact if above cannot be reached: Name_____________________________ Address__________________________ Home Phone _____________________ Work Phone_______________________ Is student transported by car or bus to and from school? Car____ Bus_____ Does student have any health problems that might interfere with normal school activities, including participation in regular physical education activities? Yes____ No____ If yes, explain___________________________________________________________ Does student take medication? Yes____ No ____ If yes, indicate type of medication ______________________________ Side Effects if any_________________________ Has student been diagnosed with ADD/ADHD? Yes___ No___ If yes, please attach a copy of the evaluation/report confirming ADD/ADHD. Does student have any health problems that the teacher and school nurse should know about (diabetes, asthma, sickle cell disease, epilepsy, hearing problems, allergies, etc.)? Yes___ No___ If yes, explain________________________________________________________ If your child is allergic to be or wasp stings, please indicate if the allergy is severe (difficulty breathing, hives, severe swelling, etc.). Yes___ No___ (only local swelling/redness) Please note if your child has allergies that might require the use of an EpiPen, Benadryl or other medications to prevent Anaphylaxis. You will need to bring that medication to the health room to be kept in case of an emergency. Explain________________________________________________________________ Is your child covered by health insurance? Yes___ No___ Authorization for ambulance or emergency services if needed: Yes___ No___ May this information be shared with appropriate staff involved with your child? Yes___ No___
15 Authorization to Release Children in An Emergency
Our school has developed a crisis plan in case of any crisis which might occur. This is done in compliance with federal laws. The emergency plan is devoted to the welfare and safety of your child during school hours. The plan is available for inspection in the school office. We are requesting your assistance at this time: Should there be an emergency, such as a major fire, tornado, explosion, etc., your child may be required to remain in the care of the school until it is deemed safe by an Emergency Services authority that the child can be released. At that point, children may be released only to properly authorized parents and/or designees. Therefore, please list as many names, (with local telephone numbers and addresses) as possible, of those persons to whom you would allow your child’s release in the event of an emergency. Be sure to notify those persons listed that you have authorized their supervision in case of emergency. In the event that you should be unable to come to school, it is essential that others be designated to care for your child. No child will be released to the care of unauthorized persons. We appreciate your cooperation in this important matter. Child______________________________Teacher_______________________ Please release my child to the following persons listed below:
Name Relationship
Phone Address
Parent/Guardian__________________________________ Date:______________ Home Phone: ___________________________ Work Phone:________________
16 DES EXTRACURRICULAR ACTIVITIES PERMISSION FORM _________________________I give permission for my child to participate in extracurricular activities as described in the student handbook.
_________________________I do not give permission for my child to participate in extracurricular activities. DES – SCHOOL/ STUDENT / PARENT COMPACT Our signatures indicate that we will strive to uphold our part of the compact: ____________________________ ___________________ Teacher’s Signature Date ____________________________ ___________________ Parent’s Signature Date ____________________________ ___________________ Student’s Signature Date DES PROCEDURAL MANUAL ACKNOWLEDGEMENT My signature indicates that I have read and understood the manual for Dardanelle Elementary School. ____________________________ ___________________ Parent’s Signature Date ____________________________ ___________________________ Student’s Name Teacher’s Name
Other Children Enrolled in the Dardanelle School District
Child’s Name Grade
Any change of name, address, or phone number should be reported to the office as soon as possible.
17