South Hunterdon Regional High School
School Office 609-397-2060 Fax 609-397-2366 South Hunterdon Regional High School Board of Education 609-397-1888 Fax 609-397-6495 301 Mt. Airy – Harbourton Road Lambertville, New Jersey 08530 Louis T. Muenker, D.Ed., Superintendent Kerry Sevilis, Business Administrator/Board Secretary William Ross, Director of Curriculum, Instruction, and Assessment Mark Collins, Principal CONSENT FORM PACKET Important Information for Parents and Guardians This section of the back to school mailing contains consent forms that are required by Federal and State laws and that have important ramifications for your child. These forms must be signed and returned to your student’s homeroom teacher by Friday, September 12th. Here is important information, to assist you in making your consent selections: _____Student/Parent Code of Conduct Agreement. The Code of Conduct can be found on the district website under academics, chose high school or middle school, then student handbook. Students and Parent/Guardians are asked to sign the Code of Conduct agreeing to abide by the expectations. _____Parental/Guardian Photo/Image Consent Form. South Hunterdon frequently recognizes students on the high school’s website, through an email “ListServ” service, and on FaceBook. This requires parental permission, required by the State of New Jersey. You can choose to give permission for a student’s name, photo, or other “identifiers” to appear on the school’s website or on ListServ. Please note: If you do not give this consent, your child can not be included in any recognitions on the website. If you want your child to receive these recognitions, check the “I give permission” choice on the consent form. _____Consent to Survey. Occasionally, South Hunterdon surveys students on adolescent social or health issues, usually in health classes. The enclosed information sheet gives details and requires you to give your consent. School Office 609-397-2060 Fax 609-397-2366 South Hunterdon Regional High School Board of Education 609-397-1888 Fax 609-397-6495 301 Mt. Airy – Harbourton Road Lambertville, New Jersey 08530 Louis T. Muenker, D.Ed., Superintendent Kerry Sevilis, Business Administrator/Board Secretary William Ross, Director of Curriculum, Instruction, and Assessment Mark Collins, Principal _____Media & Technology Agreement. In the best interest of our students’ safety and the protection of the technology systems, this agreement insures that all equipment and facilities only be used for legal and appropriate purposes. _____Military Recruiters Access to Student Information Consent Form. Federal law requires all high schools to provide the names, addresses and phone numbers of all 11th and 12th grade students. Parents have the option of deciding whether or not to release this information. The enclosed information sheet gives details and requires you to give your consent. _____ Safe Homes Parent Pledge Form. Consent to have name, address and phone number published in a Safe Homes Directory. _____ PTSO Membership Form. The PTSO is mostly a group of Parents along with Teachers and Students of South who are dedicated to both the community and school. We are here to help provide extra-special activities for the students and teachers providing unforgettable teen year memories. We are always looking for new members. South Hunterdon Regional High School 301 Mt. Airy – Harbourton Road Lambertville, New Jersey 08530 Louis T. Muenker, D.Ed., Superintendent Kerry Sevilis, Business Administrator/Board Secretary William Ross, Director of Curriculum, Instruction, and Assessment Mark Collins, Principal School Office 609-397-2060 Fax 609-397-2366 Board of Education 609-397-1888 Fax 609-397-6495 COMPUTER, TECHNOLOGY, & INTERNET USAGE AGREEMENT I, __________________________________________, parent/guardian of__________________________________________, (PLEASE PRINT) (PLEASE PRINT) agree to abide by the following guidelines for computer, technology and Internet usage at South Hunterdon Regional High School and as governed by Board of Education Policy 2361 and Regulations 2361. I will review the Regulations as published in the Student Handbook or on the school technology web pages at shrhs.org under the District Information > Technology tab. As a user of South Hunterdon Regional High School’s computer/technology facilities I agree and accept the following rules for acceptable use for both school issued devices and infrastructure or personally owned devices I use in school: 1. To use the computer/technology facilities for the purpose they were intended. 2. Passwords are the individual’s responsibility and should not be shared with anyone. 3. Files, folders and work are for the access of only those who create them viewing or modifying any other person’s data without permission is not permitted. 4. Access to restricted portions of the network operating system is not permitted. 5. Only approved software you have been granted express rights to by the network supervisor may be used. Installing or using illegal software, shareware, or freeware is not permitted. 6. Copyright laws must be adhered to. 7. Game playing, music and video streaming on the computer is only permitted for educational purposes when authorized by a teacher or the network supervisor. 8. Employing the computer/technology systems for commercial purposes is not permitted. 9. Damaging or intentionally wasting computer technology resources is not permitted. (i.e. use of “chain letters”, transmitting to mailing lists, or excessive printing.) 10. Sending or displaying any threatening, offensive, obscene, or harassing material in any form is illegal and subject to criminal charges. I agree that in the best interest of my child’s safety and for the protection of the technology systems, that equipment and facilities only be used for legal and appropriate purposes. Usage is only for legitimate educational research and class connected projects and assignments. I agree that penalties and costs incurred from violation of the computer and Internet guidelines will be the responsibility of the user. I also release South Hunterdon Regional High School and its officers, agents, and employees from any and all claims based on my child’s inappropriate, illegal, or improper use of the computer and Internet systems, and agree to indemnify without limitation or liability and hold South Hunterdon Regional High School harmless from any and all claims by third parties, including any claims based on allegations of copyright infringement from my child’s performance. I understand computer/technology data storage areas will be treated like school lockers. Network storage areas remain the property of the South Hunterdon Board of Education. The Board reserves the right to conduct routine inspections of files and communications to maintain system integrity and ensure all users are using the system responsibly. Users should not expect that files would always be private. Parent Signature _____________________________________________ Date ________________ Student Signature _____________________________________________ Date ________________ Address ___________________________________________________________________________ City __________________________________________ State _____________ Zip ______________ Telephone ________________________ Parent E-Mail __________________________________ South Hunterdon Regional High School 301 Mt. Airy – Harbourton Road Lambertville, New Jersey 08530 Louis T. Muenker, D.Ed., Superintendent Kerry Sevilis, Business Administrator/Board Secretary William Ross, Director of Curriculum, Instruction, and Assessment Mark Collins, Principal School Office 609-397-2060 Fax 609-397-2366 Board of Education 609-397-1888 Fax 609-397-6495 Student/Parent Code of Conduct Agreement 2014-2015 After reviewing the SHR Student Handbook, please sign the Code of Conduct Agreement and return it to your homeroom teacher by Friday, September 12th. The student handbooks can be found on the district website (www.shrhs.org) under academics, chose high school or middle school, then student handbook. My signature verifies that I have read, understand and agree to abide by this Code of Conduct: Student Signature: _______________________________________ Student Name:__________________________________________ Date:_______________________ I have reviewed the SHRHS Code of Conduct with my child and agree to abide by these expectations. Parent/Guardian Signature: _______________________________________ Parent/Guardian Name:__________________________________________ Date:_______________________ South Hunterdon Regional High School 301 Mt. Airy – Harbourton Road Lambertville, New Jersey 08530 Louis T. Muenker, D.Ed., Superintendent Kerry Sevilis, Business Administrator/Board Secretary William Ross, Director of Curriculum, Instruction, and Assessment Mark Collins, Principal School Office 609-397-2060 Fax 609-397-2366 Board of Education 609-397-1888 Fax 609-397-6495 PHOTO/IMAGE PARENTAL/GUARDIAN CONSENT FORM 2014-2015 Student Name (print) __________________________________ Grade _____ Dear South Parent/Guardian, Academics, athletics, arts – there is always a picture perfect moment happening at South. Throughout the year, we take hundreds of candid photos and videos to highlight student accomplishments, and we would like your approval to include your son or daughter in these pictures and videos. Each year, a number of events are photographed or videotaped for our web sites and various social media outlets, as well as our print publications such as the Southern Eagle. If you do not want your child’s image released in any of the circumstances, please indicate below. Please note: All school co/extra curricular events are open to the public. If your son or daughter is involved with any of these activities, we cannot guarantee that his or her name will not appear in the press. Before your child can participate in any of the above activities, you must give your permission by signing and returning this page to school. Thank you for your cooperation. ____ I give permission for my child to be interviewed, photographed, or videotaped for use in school/district publications, school district publications, or for use by the general news media for print or broadcast purposes; and for his/her name to be published in district publications and website, and in news publications and broadcasts. ____ I do not give permission for my child to be interviewed, photographed, or videotaped for use in school/district publications, school district publications, or for use by the general news media for print or broadcast purposes; and for his/her name to be published in school/district publications and website, and in news publications and broadcasts. Parent/Guardian Name (print) _______________________________ Date _______________ Parent/Guardian Signature ______________________________________ Relation to Student (if guardian) __________________________________ South Hunterdon Regional High School 301 Mt. Airy – Harbourton Road Lambertville, New Jersey 08530 School Office 609-397-2060 Fax 609-397-2366 Board of Education 609-397-1888 Fax 609-397-6495 Louis T. Muenker, D.Ed., Superintendent Kerry Sevilis, Business Administrator/Board Secretary William Ross, Director of Curriculum, Instruction, and Assessment Mark Collins, Principal Consent to Survey 2014-2015 In order to be in compliance with new directives issued by the State of New Jersey, schools must obtain parental consent in order to survey students regarding behaviors related to adolescent social and health issues. Although we generally only survey students regarding these issues occasionally, usually in our health classes, the survey results allow us to target areas for concern. Services and programs designed to address these areas of concern allow us to meet the needs of students and their families based on the survey results. Please complete the bottom of this form indicating whether or not we have permission to survey your son/daughter in school. Names are never collected as part of the survey process, so all information remains anonymous. A separate form should be completed for each student you have enrolled at the high school. Student Name ___________________________________Grade ___________ Please Print ___ I give permission for South Hunterdon to include my child when conducting surveys related to adolescent social/health issues. ___ I do NOT give permission for South Hunterdon to include my child conducting surveys related to adolescent social/health issues. Parent Name ______________________________________ Please Print Parent Signature ________________________________Date _____________ PLEASE RETURN THIS FORM TO: Your Student’s Homeroom Teacher when South Hunterdon Regional High School 301 Mt. Airy – Harbourton Road Lambertville, New Jersey 08530 Louis T. Muenker, D.Ed., Superintendent Kerry Sevilis, Business Administrator/Board Secretary William Ross, Director of Curriculum, Instruction, and Assessment Mark Collins, Principal School Office 609-397-2060 Fax 609-397-2366 Board of Education 609-397-1888 Fax 609-397-6495 Military Recruiters Access to Student Information Consent Form The No Child Left Behind federal education legislation requires all high schools to provide military recruiters with the name, address, and phone number of all grade 11 and 12 students. A school’s failure to comply with this requirement could result in a loss of federal education funding under the Elementary and Secondary Education Act that was signed into law in January 2002. Parents have the option of deciding if their child’s information is to be released to military recruiters. Please indicate below whether or not you want your child’s information released to military recruiters. Failure to respond will mean that military recruiters will have access to your child’s information. Student Name ____________________________________________________ Please Print Grade 11 12 (Please Circle) □ I agree to release my child’s information to military recruiters. □ I do NOT want my child’s information released to military recruiters. Parent Name _____________________________________________________ Please Print Parent Signature __________________________________________________ Date ____________________ PLEASE RETURN THIS FORM TO: Your Student’s Homeroom Teacher South Hunterdon Regional School District Random Drug and Alcohol Testing Program Pupil Consent to Test Form I understand fully that my performance as a participant and the reputation of my school are dependent, in part, on my conduct as an individual. I hereby agree to accept and abide by the standards, rules, and regulations set forth by the South Hunterdon Regional School District Board of Education and the sponsors for the activity in which I participate. I authorize the South Hunterdon Regional School District to conduct a test on urine, which I provide on-site, to test for alcohol and/or drug use if my name is drawn from the random pool. Pursuant to the regulations of the Pupil Random Drug and Alcohol Testing Policy, I also authorize the release of information concerning the results of such tests to designated district personnel. I understand that I may also be randomly drug tested for a period of one (1) calendar year from the submission of this form. Pupil Name (print) Current Grade Pupil ID# (leave blank) Pupil Signature Date Parent/Guardian Name (print) Work Phone Parent/Guardian Signature Date Home Phone Cell Phone I plan to participate in one or more of the following athletic programs: □ Band □ Baseball □ Basketball □ Bowling □ Cheerleading □ Chorus □ Cross Country □ Drama □ FFA □ Field Hockey □ Football □ Applying for a parking □ French Honor Society □ Golf □ Gourmet Crafters □ Key Club □ Literary Magazine □ Media Aides □ National Honor Society □ Newspaper □ Peer Leadership □ Play Productions □ REBEL □ Robotics Club □ Science Olympiad □ Ski Club □ Soccer □ Softball □ Spanish Honor Society □ Student Council □ Thespian Club □ Track □ Yearbook □ Weight Lifting □ Other: _____________ Revised 7/3/12 SHR PTSO I and set W 2014-2015 SHR PTSO Officers: President: Sue Bacorn (bacsuzie@aol.com) Vice President: Janine MacGregor (macgregorjs@aol.com) Treasurer: Janice Zuzov (janicezuzov@gmail.com) Secretary: Marianne Carter (momcarter99@gmail.com) Corresponding Secretary: Nina Cally (jjcncc@netzero.com) 301 Mount Airy-Harbourton Road Lambertville, NJ 08530 Hello South Families, It’s that time of year again! The 2014/2015 school year is just around the corner and it’s time to ask for your support of SOUTH’S PTSO. This year we are not only seeking your membership dues but we desperately need energetic members with fresh ideas who are willing to step up and take over. As many of you are aware, our current team has been at the helm for a very long time and it’s time to turn the reins over to the parents of younger students, who have a desire to get involved and make a difference. Through your generous support over the years, whether you paid membership dues or made donations PTSO, wouldn’t have been able to provide extra-curricular events and create lasting memories for each of our students. The preliminary calendar of events has been set (listed on back), and we’ve worked hard to focus on activities, like dances and socials, that are well attended. Running these events seems like second nature to those of us who have been here a turn or two and we tend to run like a well-oiled machine. However change is how we grow, and it’s time to think outside the box. PTSO needs new ideas and perspectives to evolve into the future SOUTH PTSO. The first organized event is the High School Homecoming Semi-Formal Dance on Friday, October 24, kicking-off an entire weekend of Homecoming festivities at South. The Middle School will also enjoy a Masquerade Dance sometime in October. Our meetings take place on the 2nd Wednesday of every month at 7:30 pm in the High School Commons. However, with everyone trying to settle back into a new school year routine PTSO will not host a formal meeting until October 8th. Anyone that is seriously considering tossing their hat into the leadership ring, I encourage you to contact any of the current team officers or the PTSO via e-mail at SHRPTSO@gmail.com with any questions or concerns. Also the current team will be available during back to school night on September 18th. You know us – you have seen the great things that we have accomplished and the impact that we have had over the years. In addition, to your annual membership, would you please consider joining the leadership team to steer the group into a bright new year? Just complete the membership form below and return it to the PTSO mailbox at school along with a $15.00 check made payable to SHR PTSO. Or, bring your membership form and fee to our October 8th meeting. Or visit our table during Back to School Night on September 18th. We are looking forward to a great year and a new PTSO team. Meetings: Every 2nd Wednesday of the month; 7:30 pm in the High School Commons Sue Bacorn SHR PTSO President PTSO Membership Form Family Membership: $15.00 (Please make checks payable to SHR-PTSO) Family & Contact Name: ________________________________ Contact numbers: home _________________cell ___________________ E-mail contact:_____________________ Student/grade_________/_____; __________/______; _________/______ SHR PTSO Calendar of Events 2014/2015 OCTOBER 10/17 Middle School Masquerade Dance 10/24 High School Homecoming Semi-Formal Dance (Kick-off for Homecoming Athletic Festival Weekend) NOVEMBER 11/14 PTSO Honor Roll Recognition Award Social Meeting Schedule 1/16 Eagle's Nest Coffee House/Open Mic November 12 1/25 PTSO Café at Winter Fest October 8 JANUARY FEBRUARY 2/6 December 10 January 14 Honor Roll Recognition Award Social February 11 March 11 April 8 APRIL 4/2 Honor Roll Recognition Award Social 4/26 PTSO Annual Rubber Ducky Race @ Shad Fest May 13 June 10 MAY 5/4-8 Teacher Appreciation Week JUNE 6/15 PTSO Scholarship Awarded @ Commencement Events scheduled are based on student participation and may be either Postponed or cancelled at the PTSO discretion. Who is the SHR PTSO and what do they do? The PTSO is mostly a group of Parents along with Teachers and Students of South who are dedicated to both the community and school. We are here to help provide extra-special activities for the students and teachers providing unforgettable teen year memories. The money raised through membership helps to sponsor annual events such as quarterly recognition bagel breakfasts for Honor Roll Students, the Middle School Masquerade Dance, the High School Semi-Formal Homecoming Dance, teacher generated school projects and numerous other events for which PTSO is asked to help sponsor... PTSO annually awards two $500 Academic Scholarships and one $500 “Eagle Spirit Scholarship”; this award is based solely on attributes that set a student apart in terms of character, initiative and perseverance. Nominations are submitted from the faculty and the award is based on the majority number of nominations received. Interested in joining? Come to a meeting the 2nd Wednesday of every month beginning in October. If you can’t make the meetings, but would like to be a part of this amazing group, e-mail the PTSO at SHRPTSO@gmail.com. Or simply complete the form located on the front and return with payment of $15.00 to the SHR PTSO mailbox located in the main office. SAFE HOMES PARENT PLEDGE FORM STUDENT NAME(S) GRADE IN SCHOOL SAFE HOMES parents agree to cooperate with schools, law enforcement and young people to create a healthy atmosphere in which the use of alcohol and other drugs is no longer the “norm.” SAFE HOMES parents are taking a stand against the alarming increase in alcohol and drug use among our youth. PARENT PLEDGE I will not allow parties and gatherings when I am not at home. I will not serve, nor will I allow, youth under the legal drinking age of 21 to consume alcohol in my house or on my property. I will not allow the use of illicit drugs at my home or on my property. THE FOLLOWING FIELDS ARE REQUIRED: PARENT NAME(S): EMAIL ADDRESS (REQUIRED): ADDRESS: HOME PHONE: (Parent Signature) (Date) Your signature indicates your consent to have your name, address and phone number published in a secure online directory. It also indicates that your best efforts will be made to implement the guidelines of SAFE HOMES. This pledge is in effect for the four years your child is in high school. This is not a legally binding contract. Please return this form to: Margaret Christofely, Student Assistance Counselor; South Hunterdon Regional High School 301 Mt. Airy – Harbourton Road Lambertville, NJ 08530 Phone (609) 397-2060 x1206 Fax (609) 397-2366 www.safecoalition.org
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