1. education
2. school

Inver Grove Heights Community Schools
Kindergarten Registration
January 12, 2015 at Pine Bend Elementary School
What to complete and
bring to registration:
Kindergarten registration for the 2015-2016 school
year will take place on Monday, January 12 from
5:30-7:00 p.m. at Pine Bend Elementary School,
9875 Inver Grove Trail, IGH, MN 55076.
5:30 p.m. 6:00 p.m.
Registration Begins
Principal Welcome Message
If you have any questions
or would like to schedule a
school visit, please call:
Pine Bend Elementary School
651-306-7701
Enrollment Form
Home Language Questionnaire
Student Transportation Form
Verification of Daycare Enrollment
(if attending daycare before or after school)
(if non-resident student)
Technology Use Agreement
Immunization Record
Birth or Baptismal Certificate
Open Enrollment Form*
*Please note the district will be pleased to accept your open
enrollment into the district, however, building placement
cannot be guaranteed for Fall 2015.
Minnesota Kindergarten Requirements
MUST be five years old by Sept. 1, 2015
MUST have all required immunizations to enter school
MUST have had an early childhood screening
If you are unable to attend the Kindergarten
Registration on January 12, you may register at the
District Office (2990 80th St. E.) during normal
business hours. Registration questions? Call Eric
Bermudez at 651-306-7825.
Si usted prefiere recibir estos formularios en español, llame por favor
a Abbie Losinski al 651-955-6610
o Eric Bermudez al 651-306-7825.
Frequently Asked Questions about Kindergarten
What time are classes?
Kindergarten runs on the district’s elementary schedule, which is from 8:30 a.m. – 3:10 p.m.
Can my child start school if his/her immunization records are not turned in?
No. In accordance with Minnesota State law, all required immunizations must be completed by the
first day of school. Parents may get a legal exemption for medical reasons or conscientiously held
beliefs. For more information, call your doctor/clinic.
Where can I get low-cost immunizations?
Low-cost immunizations are available through the Dakota County Public Health program. The
suggested cost for each vaccination is $14, but no one who qualifies for vaccinations will be turned
away if they are unable to pay the cost. Please call Dakota County Public Health at 952-891-7999 for
more information.
What do I have to do if my child needs to take medication at school?
Any student taking medication at school must have written parent and physician permission and the
medication must be in a pharmacy-labeled container. Over-the-counter medication must be in the
original container. Medication forms can be obtained from any school health office or on the district
website at www.isd199.org/departments/health_services/medication.
What if I cannot locate my child’s birth certificate?
County offices can provide a copy of your child’s birth certificate for a fee. Additionally, baptismal
certificates can also be presented as verification of birth date and full legal name.
What is School-Age Care (Kids’ Choice)?
School-Age Care is a fee-based childcare service available before school from 6:30–8:30 a.m. and after
school from 3–6 p.m. For more information on availability and rates, please contact the Extended Day
office at 651-306-7502.
- more on reverse side -
How do I find out about busing information?
Busing information will be printed in the August issue of the 199 Reporter. It will include approximate
times for pick up and the location of the bus stop. It will also be published on the district website at
www.isd199.org/departments/transportation.
What if my child goes to a daycare?
There is a line provided on the enrollment form for a daycare address. If the student will have different
pick-up and drop-off addresses (takes one bus to school and a different bus home), that information
should be completed on the transportation form. Additionally, please complete the verification of
daycare enrollment form.
Does someone help my child to and from the bus?
For the first few weeks of school, the kindergarten teachers wait at the doors for the students when they
get off the bus. Additionally, they are walked out to their buses after school. Badges are also provided
for your child to wear every day for the first few weeks of school. A student’s name, address, day care
address (if applicable), bus route, school, parent’s name and home phone number are listed on the
badges.
Does my child need an Early Childhood screening to start kindergarten?
Yes. Minnesota State law requires that all children be screened before they start kindergarten.
Screenings may be scheduled at 3203 68th St. E., Inver Grove Heights, MN 55076. Screenings are free
and take about an hour. Please call 651-306-7520 for more information or to schedule an appointment.
If you have misplaced your screening card, the school will be able to verify screening with Family
Connections. If your child’s screening was done in another district, please provide a copy of the early
childhood screening to the district office.
Below are the elementary school phone numbers, should you have any other questions.
Hilltop Elementary School
651-306-7400
Pine Bend Elementary School
651-306-7701
Salem Hills Elementary School
651-306-7300
If for any reason your child will not be attending Inver Grove Heights Community Schools, please call
Bev Mueller at 651-306-7101.
SchoolView Parent Portal
Connect online to your student’s grades, attendance and more – and pay for meals and activities – all
through the TIES SchoolView parent portal. Research shows that students are more successful if parents are
involved in their education. A one-time sign-up for SchoolView gives parents access to their student’s
accounts throughout his or her attendance in the Inver Grove Heights Community Schools.
A confidential access key is required to obtain access to SchoolView.
•
Parents with students in elementary school must go to their elementary office to get their confidential
family access key. State- or federally-issued identification, such as a current driver's license or
passport, is required.
SchoolView lets you view:
•
•
•
•
•
•
•
Attendance with email alerts when your student is absent or tardy
Grades
Schedule
Health information
Report cards
Test history
Transportation information, including bus stops and times
Make paying easy with FeePay™
The FeePay™ system in SchoolView lets you pay securely online for your student’s meals. FeePay™ also lets
you monitor what your student is eating to help encourage healthy nutritional choices.
SchoolView contact information
Hilltop Elementary School
Mary Beskar
651-306-7400
mary.beskar@isd199.org
Pine Bend Elementary School
Sara Pearce
651-306-7701
sara.pearce@isd199.org
Salem Hills Elementary School
Sue Erickson
651-306-7300
sue.erickson@isd199.org
Revised 10/2014
ENROLLMENT FORM
(Please PRINT. Please complete entire form)
STUDENT INFORMATION
Full LEGAL Name
_____________________________________________________________________________________
Last
First
Middle
Birth date ____________ Gender _____ Enrolled Grade ____ Primary Home Language________________
MM/DD/YYYY
M/F
Ethnicity/Race Information
Is this student Hispanic/Latino?
Yes
No
Regardless of your answer above, please continue
to answer by checking all that apply to indicate the
student’s race:
American Indian/Alaskan Native
Asian
Black/African American
Native Hawaiian/Pacific Islander
White
(This information is used for reporting ethnic composition for
administrative and Office of Civil Rights purposes. It will be treated in
accordance with the Federal Data Privacy Act of1974 and State of
Minnesota Privacy Law.)
Has the student received any of the following
services?
504 Plan
Title 1
English Language Learner
Gifted and Talented
Special Education: Current IEP/IFSP Yes
No
If yes, please check any of the following:
Emotional/Behavior (EBD)
Developmental Cognitive Disability (DCD)
Learning Disability (LD)
Autism
Other____________________________
Does the student have any special health
problems?
Yes
No
If yes, please describe _______________________
______________________________________
Was the student born in the U.S.?
Yes
No
Has the student ever attended school in Minnesota?
Yes
No
Has the student attended ISD 199 schools before?
Yes
No
For Kindergarten only: Has your child been screened?
Yes
No
If so, WHERE? ______________________________
Last school attended _______________________________________________Grade attended ________
City, State __________________________________________Date of attendance ___________________
OFFICE USE ONLY
Home room # _______________
School # ________________
Begin Enrollment Date_____________ Teacher/Counselor ___________
Student ID # _____________
LLC ________ Prev Dist ___________ Transportation Code __________
Family # ________________
Resident District __________________ To SPED __________________
Verify IEP _______________
State Aid Code ___________________ Bus _______ AM
Verify birth certificate ______
______ PM
THIS IS A TWO-SIDED FORM
Revised 10/2014
CENSUS INFORMATION
Parent/Guardian #1:
Parent/Guardian #2:
Name ____________________________________
Name ____________________________________
Address __________________________________
Address __________________________________
_________________________ Apt # ___________
_________________________ Apt # ___________
Is this a permanent address?
Is this a permanent address?
Yes
No
Yes
No
Move in date ______________________________
Move in date ______________________________
Dwelling Type:
Townhouse
Mobile Home
Dwelling Type:
Townhouse
Mobile Home
Single Family
Duplex
Apartment
Condominium
Single Family
Duplex
Apartment
Condominium
Primary Language__________________________
Primary Language__________________________
Require Interpreter
Require Interpreter
Yes
No
Yes
No
Birth date (MM/DD/YY) ______________________
Birth date (MM/DD/YY) ______________________
Primary Phone _____________________________
Primary Phone _____________________________
Work ________________ Cell ________________
Work ________________ Cell ________________
E-mail __________________________Gender ___
E-mail __________________________Gender ___
M/F
Legal Relationship to student: _________________
M/F
Legal Relationship to student: _________________
If more than one address listed, where does student reside?
Parent/Guardian #1
Parent/Guardian #2
Pick-Up/Daycare Address (if different than above): _____________________________________________
If Parent/Guardian(s) listed above is NOT the LEGAL guardian of this student, please provide legal
guardian information below:
Name _______________________________________________________ Birth date ________________
MM/DD/YY
Phone ________________________ Relationship to student ____________________________________
Address _______________________________________City/State/Zip ___________/______/__________
Please list all other children living at the address where the student resides:
Last
Name
First
Name
Middle
Name
Gender
(M/F)
Birth date
(MM/DD/YY)
School
Grade
What relation is
Parent/Guardian #1
to the child?
_________________________________________ _____ __________ ________________ _____ ____________
_________________________________________ _____ __________ ________________ _____ ____________
_________________________________________ _____ __________ ________________ _____ ____________
_________________________________________ _____ __________ ________________ _____ ____________
In accordance with the Minnesota Data Practices Act, directory information (name, address, phone number, gender, date of birth) can be released
and made public.
Completion of this section is required
In compliance with the United States Department of Education, Improving America’s Schools Act (IASA, Title 1 – Part C, Section 1309), we are
required to ask the following question:
Have you recently (within the last 36 months) moved to this school district for temporary or seasonal agricultural or fishing work?
YES
NO
Signature (Parent/Legal Guardian) ________________________________________Date _____________
Home Language Questionnaire
Independent School District 199
School ________________________________
Student Identification Information
Student’s Legal Name
Student ID Number
Date of Birth (month/day/year)
Age
Grade Level
Student Primary Language:
Student Language Information
In order to help your child learn, your child’s teachers need to determine which language your child uses most.
Please respond to the questions below by checking the appropriate box.
1. Which language did your child learn first?
□ English
□ Other (specify): ________________
2. Which language is most often spoken in your home?
□ English □ Other (specify): ________________
3. Which language does your child usually speak?
□ English □ Other (specify): ________________
4. Which language do you use when speaking to your child?
□ English □ Other (specify): ________________
5. Are there any other languages spoken in the home?
□ English □ Other (specify): ________________
Parent/Guardian Verification of Information
I hereby verify that the above information is true and correct to the best of my knowledge and belief.
____________________________________
Parent/Guardian Name (Printed)
_______________________________________
Parent/Guardian Signature
Rev.11/12
_________________________
Date
Dear Parent or Guardian:
It will soon be time for your child to arrive at kindergarten…a time of anticipation, excitement and
independence. This letter is being sent to you so that your child may enter kindergarten next fall
without complication or delay.
Please ensure that your child is ready for school next fall. Minnesota's School Immunization Law
requires all kindergarten students to meet immunization compliance as they enter kindergarten, or
have a waiver of immunization exemption. The immunization dates or exemption record
MUST be on file in the school health office one week prior to the first day of school. If the
dates are not on file on the first day, your child will not be admitted to school.
Listed below are the immunizations necessary for your child to begin kindergarten. Check your
records or with your physician to see if your child is in compliance.
Students must have proper immunizations/exemptions to start school!
KINDERGARTEN REQUIREMENTS
DTaP
5 dates
Polio
4 dates
Hepatitis B
3 dates
MMR
2 dates
Varicella
2 dates
(See reverse side for specifics related to each type of immunization.)
Please prepare NOW for your child's entry to kindergarten. If your child attended preschool, do
not assume they have all the required immunizations; more immunizations may be needed.
After you obtain the required immunizations, please stop by your child's school to drop them off
with the nurse, mail them to the school or fax immunizations to the nurse's office anytime, including
during the summer. School addresses and fax numbers are located below.
Hilltop Elementary School: 3201 68th St. E., IGH, MN 55076 (FAX: 651-306-7444)
Pine Bend Elementary: 9875 Inver Grove Trail, IGH, MN 55076 (FAX: 651-306-7739)
Salem Hills Elementary: 5899 Babcock Trail, IGH, MN 55077 (FAX: 651-306-7321)
Return all immunization dates to your child's school health office a minimum of one
week prior to the first day of school.
Sincerely,
District 199 School Nurses
*Parents of kindergarten students may file a medical exemption signed by a health care provider, or
a conscientious objection signed by a parent/guardian and notarized. This form is on the reverse
side of this letter. Immunization dates can be written in on the reverse side of this letter. Thank you
for your attention to this matter.
Are Your Kids Ready?
Minnesota’s Immunization Law
Immunization
Requirements
The following immunizations are required beginning Sept. 1, 2014.
To enter into child care, early childhood programs, and elementary or secondary schools (public
or private), children need to have certain immunizations. Use this chart as a quick reference to
determine which vaccines are required for enrollment. See below for exemption information.
Birth through 4 years
Age: 5 through 6 years2
Age: 7 through 11 years
Age: 12 years and older
Early childhood programs
& Child care
For Kindergarten
For 1st through 6th
grade
For 7th through 12th
grade
Hepatitis B
Hepatitis B
Hepatitis B
Hepatitis B3
DTaP/DT
5 doses
DTaP
At least 3 tetanus and
diphtheria containing doses
Tdap4
Hepatitis A
3 doses
3 doses
5th shot not needed if 4th was after age 4
Polio
Polio
Polio
4 doses
4th polio not needed if 3rd was after age 4
MMR
MMR
At least 3 doses
MMR
2 doses
2 doses
Hib
3 doses
at age 11-12 years
Polio
At least 3 doses
MMR
2 doses
Meningococcal5
at age 11-12 years
Haemophilus influenzae type b
Pneumococcal
age 2-24 months
Varicella1
Varicella1
Varicella1
2 doses
2 doses
Varicella1
2 doses
Immunizations recommended but not required by the Immunization Law:
Influenza
Recommended annually for all children age 6 months and older
Rotavirus
Recommended for infants
Human papillomavirus
Recommended at age 11 years
1
If the child has already had chickenpox disease, varicella shots are not required. If the disease occurred after 2010, the
child’s doctor must sign a form.
2
First graders who are 6 years old and younger must follow the polio and DTaP/DT schedules for kindergarten.
3
An alternate 2-shot schedule of hepatitis B may also be used for kids from age 11 through 15 years.
4
Proof of at least three doses of diphthera and tetanus vaccination needed. If a child received Tdap at age 7-10 years another
does is not needed at age 11-12 years. However, if it was only a Td a Tdap dose at age 11-12 years is needed.
5
A booster dose is required at age 16 years or three years later if the first dose was given between age 13-15 years.
Exemptions
To go to school in Minnesota, students must show they’ve had these immunizations or file a legal
exemption with the school.
Parents may file a medical exemption signed by a health care provider or a conscientious objection
signed by a parent/guardian and notarized.
Looking for
Vaccination
Records?
For copies of your child’s vaccination records, talk to your doctor or call the Minnesota
Immunization Information Connection (MIIC) at 651-201-5503 or 1-800-657-3970.
Immunization Program
PO Box 64975
St. Paul, MN 55164-0975
651-201-5503 or 1-800-657-3970
www.health.state.mn.us/immunize
IC# 141-0903 (MDH, 10/2013)
Student Immunization Form
Student Name __________________________________________________
Birthdate ______________________Student Number ___________________
Minnesota law requires children enrolled in school to be immunized against certain
diseases or file a legal medical or conscientious exemption.
FOR SCHOOL USE ONLY
( ) Complete; booster required in ____________
( ) In process; 8 mos. expires ______________
( ) Medical exemption for __________________
( ) Conscientious objection for ______________
( ) Parental/guardian consent ______________
Parent/Guardian:
You may attach a copy of the child’s immunization history to this form OR enter the MONTH, DAY, and YEAR for all vaccines your
child received. Enter MED to indicate vaccines that are medically contraindicated including a history of disease, or laboratory
evidence of immunity and CO for vaccines that are contrary to parent or guardian’s conscientiously held beliefs.
Sign or obtain appropriate signatures on reverse. Complete section 1A or 1B to certify immunization status and section 2A to
document medical exemptions (including a history of varicella disease) and 2B to document a conscientious exemption.
Additionally, if a parent or guardian would like to give permission to the school to share their child’s immunization record with
Minnesota’s immunization information system, they may sign section 3 (optional).
For updated copies of your child’s vaccination history, talk to your doctor or call the Minnesota Immunization Information Connection
(MIIC) at 651-201-5503 or 800-657-3970.
School Personnel: Be sure to initial and date any new information that you add to this form after the parent/guardian submits it.
Also, record combination vaccines (e.g., DTaP+HepB+IPV, Hib+HepB) in each applicable space.
1st Dose
2nd Dose
3rd Dose
4th Dose
5th Dose
Mo/Day/Yr Mo/Day/Yr Mo/Day/Yr Mo/Day/Yr Mo/Day/Yr
Required (The shaded boxes indicate doses that are not routinely given; however, if your child has received them, please
write the date in the shaded box.)
Type of Vaccine
DO NOT USE () or ()
Diphtheria, Tetanus, and Pertussis (DTaP, DTP, DT)
• for children age 6 years and younger
• final dose on or after age 4 years
Tetanus and Diphtheria (Td)
• for children age 7 years and older
• 3 doses of Td required for children not up to date with DTaP,
DTP, or DT series above
5th dose not required if 4rd dose was given
on or after the 4th birthday
Tetanus, Diphtheria and Pertussis (Tdap)
• for children in 7th - 12th grade
Polio (IPV, OPV)
• final dose on or after age 4 years
4th dose not required if 3rd dose was given
on or after the 4th birthday
Measles, Mumps, and Rubella (MMR)
• minimum age: on or after 1st birthday
Hepatitis B (hep B)
Varicella (chickenpox)
• minimum age: on or after 1st birthday
• vaccine or disease history required
Meningococcal (MCV, MPSV)
• for children in 7th - 12th grade
• booster given at age 16 years
Recommended
Human Papillomavirus (HPV)
Hepatitis A (hep A)
Influenza (annually for children 6 months and older)
Additional exemptions:
• Children 7 years of age and older: A history of 3 doses of DTaP/DTP/DT/Td/Tdap and 3 doses of polio vaccine meets the minimum
requirements of the law.
• Students in grades 7-12: A Tdap at age 11 years or later is required for students in grades 7-12. If a child received Tdap at age
7-10 years another dose is not needed at age 11-12 years. However, if it was only a Td, a Tdap dose at age 11-12 years is required.
• Students 11-15 years of age: A 3rd dose of hepatitis B vaccine is not required for students who provide documentation of the
alternative 2-dose schedule.
• Students 18 years of age or older: Do not need polio vaccine.
Developed by the Minnesota Department of Health - Immunization Program www.health.state.mn.us/immunize
(12/13) #140-0155
Student Name ________________________________________________
Instructions, please complete:
Box 1 to certify the child’s immunization status
Box 2 to file an exemption (medical or concientious)
Box 3 to provide consent to share immunization information (optional)
1. Certify Immunization Status. Complete A or B to indicate child’s immunization status.
A. Received all required immunizations:
I certify that this student has received all immunizations
required by law.
Signature of Parent / Guardian OR Physician / Public
Clinic
________________ Date
B. Will complete required immunizations within
the next 8 months:
I certify that this student has received at least one dose
of vaccine for diphtheria, tetanus, and pertussis (if
age-appropriate), polio, hepatitis B, varicella, measles,
mumps, and rubella and will complete his/her diphtheria, tetanus, pertussis, hepatitis B, and/or polio vaccine
series within the next 8 months.
The dates on which the remaining doses are to be given are:
Signature of Physician / Public Clinic
________________ Date
2. Exemptions to School Immunization Law. Complete A and/or B to indicate type of exemption.
A. Medical exemption:
No student is required to receive an immunization if they
have a medical contraindication, history of disease, or
laboratory evidence of immunity. For a student to receive
a medical exemption, a physician, nurse practitioner, or
physician assistant must sign this statement:
I certify the immunization(s) listed below are
contraindicated for medical reasons, laboratory evidence
of immunity, or that adequate immunity exists due to
a history of disease that was laboratory confirmed
(for varicella disease see * below). List exempted
immunization(s):
B. Conscientious exemption:
No student is required to have an immunization that
is contrary to the conscientiously held beliefs of his/
her parent or guardian. However, not following vaccine
recommendations may endanger the health or life of the
student or others they come in contact with. In a disease
outbreak schools may exclude children who are not vaccinated in order to protect them and others. To receive
an exemption to vaccination, a parent or legal guardian
must complete and sign the following statement and
have it notarized:
I certify by notarization that it is contrary to my conscientiously held beliefs for my child to receive the following
vaccine(s):
Signature of physician/nurse practitioner/physician assistant
________________ Date
*History of varicella disease only. In the case of varicella
disease, it was medically diagnosed or adequately
described to me by the parent to indicate past varicella
infection in ___________ (year)
Signature of physician/nurse practitioner/physician
assistant (If disease occured before September 2010, a parent can sign.)
Signature of parent or legal guardian
________________ Date
Subscribed and sworn to before me this:
_______ day of ______________________ 20______
Signature of notary
3. Parental/Guardian Consent to Share Immunization Information (optional):
Your child’s school is asking your permission to share your child’s immunization documentation with MIIC, Minnesota’s
immunization information system, to help better protect students from disease and allow easier access for you to retrieve your
child’s immunization record. You are not required to sign this consent; it is voluntary. In addition, all the information you provide is
legally classified as private data and can only be released to those legally authorized to receive it under Minnesota law.
I agree to allow school personnel to share my student’s immunization documentation with Minnesota’s immunization information
system:
Signature of parent or legal guardian Developed by the Minnesota Department of Health - Immunization Program Date
www.health.state.mn.us/immunize
(12/13) #140-0155
STUDENT TRANSPORTATION
FORM
(Please PRINT. Please complete entire form)
This form must be completed for all students attending Hilltop, Pine Bend, or Salem Hills Elementary.
Student: _______________________________
_______________________________
(Legal Last Name)
(Legal First Name)
_________
(Middle Initial)
School: ___________________________________ Grade: ________ School Year: ________________
Parent: _______________________________
_______________________________
_________
(Legal First Name)
(Middle Initial)
(Legal Last Name)
Home Phone: ________________ Work Phone: ________________ Cell Phone: ________________
TRANSPORTATION INFORMATION – please check all appropriate boxes.
Start Date: ________________________
Daycare – Please note a Verification of Day Care Enrollment Form must also be submitted.
To School:
From School:
M
M
T
T
W
W
Th
Th
F
F
Daycare Provider: ____________________________________ Daycare Phone: ________________
(First & Last Name)
Daycare Provider Address: _____________________________________________________________
(Street Address)
_____________________________________________________________
(City, State, Zip Code)
Home
To School:
From School:
M
M
T
T
W
W
Th
Th
F
F
T
T
W
W
Th
Th
F
F
No Transportation
To School:
From School:
M
M
I understand it is my responsibility to bring my child to this location and to take my child from this
location to my residence. I understand the school district’s responsibility will be to transport my child
from the daycare/home to school and from school to the daycare/home.
The School Main Office must be notified of any change in this information during the current school year.
A new form must be filled out prior to each school year.
Parent/Guardian Signature: _____________________________________________ Date: _________________
VERIFICATION OF DAY CARE ENROLLMENT
Student:
(Child’s Full LEGAL Name)
School:
(lSD 199 School)
Start Date: ________________________
AM
PM
AM/PM
Day Care Facility:
Day Care Address:
City:
Zip Code:
Phone #:
My child will be attending:
Monday
Tuesday
Wednesday
Thursday
Friday
(Check all that apply)
Parent/Legal Guardian Signature
Date
Parent/Legal Guardian Printed Name
Relation to Child
DAY CARE USE ONLY:
The day care facility must fax or mail this day care verification letter, which must include the start date and
day care director’s/designee's signature, to the district office.
'
Day Care Facility Director/Designee Signature
Date
Day Care Facility Director/Designee Printed Name
Position
My signature verifies that the above student information is correct
and the student attends this day care facility.
PLEASE FAX TO THE DISTRICT OFFICE AT 651-306-7295 or
MAIL TO 2990 8O™ STREET EAST
ATTN: ENROLLMENT OFFICE
524 F1
ADOPTED: 10/02/00
REVISED: 04/04/05
REVISED: 03/26/07
REVIEWED: 03/23/09
REVISED: 06/14/10
REVIEWED: 03/14/11
REVISED: 04/25/11
REVISED: 04/23/12
TECHNOLOGY USE AGREEMENT FOR STUDENTS
Inver Grove Heights Independent School District 199
STUDENT APPLICATION PORTION OF DOCUMENT
User’s Full Name (please print):
Home Address:
Street Address, City, State, Zip code
Home Phone:
Cell Phone:
I am an Inver Grove Heights School District 199 student and will graduate in:
I have read Policy 524 titled Network/Internet Acceptable Use By Staff and Students. I
have reviewed Procedure 524 titled Network/Internet Acceptable Use By Staff and
Students and I understand or have had this information explained to me and will abide by
the Policy and Procedure.
User Signature:
Date: ___/___/20__
-------------------------------------------------------------PARENT OR GUARDIAN (If you are under the age of 18 a parent or guardian must also read
and sign this agreement.)
As the parent or guardian of this student I have read and understand the Network/Internet
Acceptable Use By Staff and Students Policy. I understand that this access is designed for
educational purposes. I also recognize it is impossible for Inver Grove School District to restrict
access to all controversial materials and will not hold them responsible for materials acquired on
the network. I hereby give permission for my child to access and use technology and certify that
the information contained on this form is correct.
It is the parent or guardian’s responsibility to supervise students at home even while doing
school assigned projects.
Parent or Guardian Name: (please print)
Signature:
M:\POLICIES\500's\Policy 524\524 F1 & F2 Rev and Approved April 2012.docx
Date: ___/___/20__
POLICY:
ADOPTED:
REVISED:
REVISED:
REVISED:
REVISED:
REVISED:
REVISED:
524
10/02/00
04/04/05
03/26/07
03/23/09
06/14/10
03/14/11
04/23/12
INDEPENDENT SCHOOL DISTRICT 199
Inver Grove Heights Community Schools
2990 80th Street East
Inver Grove Heights, Minnesota 55076
NETWORK/INTERNET ACCEPTABLE USE BY STAFF AND STUDENTS POLICY
I.
Purpose
The purpose of this policy is to set forth policy and guidelines for access to the school
district technology systems, acceptable and safe use of the Internet, digital
communications and school district technologies.
II.
General Statement of Policy
A. District 199 considers its own stated educational mission, goals, and objectives when
making decisions regarding student and employee access to the School District
technology system and the Internet, including digital communications. Electronic and
digital information research skills are fundamental to preparation of citizens and
future employees. Access to the School District systems and to the Internet enables
students and employees to explore thousands of libraries, databases, bulletin boards,
and other resources while engaging with people around the world.
District 199 expects that faculty will blend thoughtful use of the school district
technology systems and the Internet throughout the curriculum and will provide
guidance and instruction to students in their use. Users are expected to use Internet
access through the district system to further educational and professional goals
consistent with the mission of the School District and school policies. Uses which
might be acceptable on a user’s private personal account on another system may not
be acceptable on the District limited-purpose network and should not be presumed to
be.
Use of the District’s network/Internet resources is intended only for educational and
informational purposes, such as research, professional development, instruction,
collaborative education projects, and dissemination of District information. Use of
network/Internet resources must support the district curriculum and enhance student
learning opportunities and/or support accurate and appropriate communication of
District information. Instructional Materials Selection and Production Policy and
prescribe the identification process for instructional materials, including electronic
resources.
M:\POLICIES\500's\Policy 524\524 Revised - March 2012.docx
B. Use of the District network/Internet resources for personal gain or profit is not
permitted. Personal web pages, personal e-mail accounts and emails regarding
personal business may not reside on the District’s network.
C. All e-mail messages that are sent and/or received on the District network are
considered property of the District.
D. Use of District network/Internet including electronic communication by staff to
advocate, directly or indirectly, for or against a ballot proposition and/or the election
of any person to any office is not permitted. Only those staff authorized by the
Superintendent may express the District’s position on pending legislation or other
policy matters.
E. The District will follow required state and federal mandates related to Internet
filtering within specific timelines.
III.
Privileges and Responsibilities
Use of the school district system and access to the use of the Internet including electronic
communication is a privilege, not a right, used within District policy 524.
Legal References:
15 U.S.C. § 6501 et seq. – Children’s Online Privacy Protection Act
17 U.S.C. § 101 et. seq. – Copyrights
20 U.S.C. § 6751 et seq. – Enhancing Education through Technology Act
of 2001
47 U.S.C. § 254 - Children’s Internet Protection Act of 2000 (CIPA)
47 C.F.R. § 54.520 - FCC rules implementing CIPA
Minn. Stat. § 121A.0695 – School Board Policy; Prohibiting Intimidation
and Bullying
Minn. Stat. § 125B.15 – Internet Access for Students
Minn. Stat. § 125B.26 – Telecommunications/Internet Access Equity Act
Tinker v. Des Moines Indep. Cmty. Sch. Dist., 393 U.S. 503, 89 S. Ct. 733,
21 L.Ed.2d 731 (1969)
United States v. Amer. Library Assoc., 539
U.S. 194, 123 S. Ct. 2297, 56 L.Ed.2d 221 (2003)
Doninger v. Niehoff, 527 F.3d41 (2nd Cir. 2008)
Layshock v. Hermitage Sch. Dist., 412 F. Supp. 2d 502 (W.D. Pa. 2006)
M.T. v. Cent. York Sch. Dist., 937 A.2d538 (Pa. Commw. Ct. 2007)
J.S. v. Bethlehem Area Sch. Dist., 807 A.2d 847 (Pa. 2002)
Cross References:
Policy 403 - Discipline, Suspension, and Dismissal of School District
Employees
Policy 406 - Public and Private Personnel Data
Policy 505 - Distribution of Non-school Sponsored Materials on School
Premises by Students and Employees
Policy 506 - Student Discipline
Policy 515 - Protection and Privacy of Pupil Records
M:\POLICIES\500's\Policy 524\524 Revised - March 2012.docx
2
Policy 519 - Interviews of Students by Outside Agencies
Policy 521 - Student Disability Nondiscrimination
Policy 522 - Student Sex Nondiscrimination
Policy 603 - Curriculum Development
Policy 604 - Instructional Curriculum
Policy 606 - Textbooks and Instructional Materials
Policy 806 - Crisis Management Policy
Policy 904 - Distribution of Materials on School District Property by
Nonschool Persons
M:\POLICIES\500's\Policy 524\524 Revised - March 2012.docx
3
PROCEDURE:
524
ADOPTED: 04/23/12
INDEPENDENT SCHOOL DISTRICT 199
Inver Grove Heights Community Schools
2990 80th Street East
Inver Grove Heights, Minnesota 55076
NETWORK/INTERNET ACCEPTABLE USE BY STAFF AND STUDENTS
PROCEDURE
I.
Parental/Guardian Concern Regarding Access to Network/Internet Resources
If parents/guardians do not want their student to access network/Internet resources in
school, they must notify the principal in writing.
II.
Acceptable Use Guidelines
All staff and students will use the District’s technology resources, including electronic
communication resources in manner which does not interfere with, disrupt, or jeopardize
network/Internet users, services, or equipment. Such interference, disruption, or
jeopardy includes, but is not limited to:
A. Distribution of messages to inappropriate forums or mailing lists;
B. Propagation of computer viruses;
C. Unauthorized entry to other computational, information, or communications devices
or resources;
D. Failure to respect the legal protection provided by copyright, trademark, licenses,
and other laws to programs, data and documents;
E. Vandalism, harassment, bullying, and hazing;
1. Vandalism is defined as damage to, interference with, or destruction of the
data of another user, the Internet, the District network, or any other network
connected to the District network.
2. Harassment is defined as the persistent annoyance of another user or
interference with another user’s work.
3. Bullying is defined as using technology to intentionally and/or maliciously
place a student in reasonable fear of harm to his or her person or property; or
creating a hostile educational environment for a student.
M:\POLICIES\500's\Policy 524\524 PROCEDURE Revised - March 2012.docx
4. Hazing is defined as using technology to coerce a student into committing an
act, that creates risk of harm to a person, in order for the student to be initiated
into or affiliated with a student organization, or for any other purpose.
F. Illegal or criminal use of the District network;
G. Obstruction of other users’ access by consuming unwarranted amounts of system
resources (disk space, CPU time, printers) or by deliberately crashing the
machine(s);
H. Communication of personal information about oneself or others which does not
serve an education purpose, violates data privacy, or jeopardizes individual safety;
I. Communication by staff to advocate, directly or indirectly, for or against a ballot
proposition and/or the election of any person to office.
III.
E-mail Guidelines
•
•
•
Do not say anything in an e-mail that you would not want to see republished.
What you say can be republished and stored by others. When you delete an email from your mailbox; it remains in the system for some period of time.
Do not use the “Reply All” button if your message only needs to be returned to
one individual.
Make sure your e-mail activities do not violate any law or policy, for example, email must not:
-
•
•
IV.
Defame or disparage individuals or institutions;
Violate copyright law, through uploading, downloading or resending e-mail;
Harass or discriminate against someone; or
Include private information or data about someone
Do not open e-mail attachments if you are unsure of the origination source.
Conserve file size. Features such as wallpaper, stationary, graphics and music
with the body of an e-mail are strongly discouraged.
Consequences
Consequences for students who fail to abide by Policy 524 – Internet Acceptable Use and
Safety will be included in the building discipline procedure required by Policy 506 –
Student Discipline. Infractions by students will also be referred to legal authorities when
appropriate.
Legal References:
15 U.S.C. § 6501 et seq. – Children’s Online Privacy Protection Act
17 U.S.C. § 101 et. seq.- Copyrights
20 U.S.C. § 6751 et seq. – Enhancing Education through Technology Act
of 2001
47 U.S.C. § 254 - Children’s Internet Protection Act of 2000 (CIPA)
M:\POLICIES\500's\Policy 524\524 PROCEDURE Revised - March 2012.docx
2
47 C.F.R. § 54.520 - FCC rules implementing CIPA
Minn. Stat. § 121A.0695 – School Board Policy; Prohibiting Intimidation
and Bullying
Minn. Stat. § 125B.15 – Internet Access for Students
Minn. Stat. § 125B.26 – Telecommunications/Internet Access Equity Act
Tinker v. Des Moines Indep. Cmty. Sch. Dist., 393 U.S. 503, 89 S. Ct. 733,
21 L.Ed.2d 731 (1969)
United States v. Amer. Library Assoc., 539
U.S. 194, 123 S. Ct. 2297, 56 L.Ed.2d 221 (2003)
Doninger v. Niehoff, 527 F.3d41 (2nd Cir. 2008)
Layshock v. Hermitage Sch. Dist., 412 F. Supp. 2d 502 (W.D. Pa. 2006)
M.T. v. Cent. York Sch. Dist., 937 A.2d538 (Pa. Commw. Ct. 2007)
J.S. v. Bethlehem Area Sch. Dist., 807 A.2d 847 (Pa. 2002)
Cross References:
Policy 403 - Discipline, Suspension, and Dismissal of School District
Employees
Policy 406 - Public and Private Personnel Data
Policy 505 - Distribution of Non-school Sponsored Materials on School
Premises by Students and Employees
Policy 506 - Student Discipline
Policy 514 – Bullying Prohibition
Policy 515 - Protection and Privacy of Pupil Records
Policy 519 - Interviews of Students by Outside Agencies
Policy 521 - Student Disability Nondiscrimination
Policy 522 - Student Sex Nondiscrimination
Policy 526 – Hazing Prohibition
Policy 603 - Curriculum Development
Policy 604 - Instructional Curriculum
Policy 606 - Textbooks and Instructional Materials
Policy 806 - Crisis Management Policy
Policy 904 - Distribution of Materials on School District Property by
Nonschool Persons
M:\POLICIES\500's\Policy 524\524 PROCEDURE Revised - March 2012.docx
3
2014- 2015 SCHOOL YEAR PROGRAM
Inver Grove Heights School-Age Care is a Community
Education program brought to your by TriDistrict
Community Education and the Inver Grove Heights
School District.
We strive to provide a quality program that ensures a
safe, cooperative, student led environment that serves
the diverse needs of the school while striving through
continuous improvement to foster the development of
our youth as service leaders in the Inver Grove Heights
community.
IGH SAC PROVIDES...
• An atmosphere conducive to learning, friendships
and fun
• Experienced and compassionate staff
• All are valued and respected
• Clear ground rules for safety
• Conveniently located at your child’s school (or a school
in your district during the summer)
• Activities reflect interests, talents and values
• Art, computers, physical actives, reading, science,
service learning, homework assistance, indoor and
outdoor activities and more
• Great for working families
LOCATIONS
Hilltop Elementary School - NSD Site
Pine Bend Elementary School
Salem Elementary School
DATES & HOURS
September 2, 2014 - June 4, 2015
Before School: 6:00 a.m. - Start of the school day
After School: End of the school day - 6 p.m.
Non-School Days: 6:00 a.m. - 6 p.m.
PROGRAM FEES
Type of Care
Full Time
Part Time
Before School
$52/Week
$16/Day
After School
$52/Week
$16/Day
Type of Care
Before Deadline
After Deadline
Non-School Days
$32
$34
Early Release Days
$14.50
$16
Late pick-up or late payment fee - $10/incident
REGISTRATION
Register online at tridistrict.thatscommunityed.com. If you are
new to the program you will need to create a profile first.
Registration Fee: $30
If you have any questions regarding registration or billing
please call Pam, 651-306-7502.
Register Online at:
TRIDISTRICT.THATSCOMMUNITYED.COM
For additional information please call 651-306-7502 or
visit us online at www.ighsac.tridistrictce.org.