Read the following list of Required Enrollment Documents before

Read the following list of Required Enrollment Documents before

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If you are NOT the Parent/Legal Guardian, you must first go file a
&DUHJLYHU)RUP with the following Office: Child Welfare and Attendance Office
Gianna Ochoa at .
3105 G Street, Merced, CA
2. If you do not have a PG&E, MID bill or Rental Agreement in the parent’s
name, you must first go file an $IILGDYLWRI5HVLGHQFH with the following
office:
Child Welfare and Attendance Office
Gianna Ochoa at 3.
3105 G Street, Merced, CA
If you do not have a 7UDQVFULSW'URSVOLS with grades from previous
school, you must call your former school and have them fax this
information to us.)$;
4. If you do not have ,PPXQL]DWLRQ5HFRUGV you must call your former
school and have them fax this information to us. 7GDS,PPXQL]DWLRQPXVWEH
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If your student was born in another country, you must provide a
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Si usted NO es el Padre o Guardián Legal del estudiante, debe primero
registrarse como Cuidador del Estudiante con la oficina de Distrito. La
forma que necesita llenar se llama: &DUHJLYHU)RUP Oficina de Distrito Child Welfare and Attendance
Gianna Ochoa 325-2111.
3105 G Street, Merced, CA
2. Si usted NO tiene consigo una Factura de PG&E o un Contrato de Alquilo
bajo su nombre, debe primero obtener permiso con la oficina de Distrito
para que su estudiante asiste Golden Valley High School. La forma que
necesita llenar se llama: $IILGDYLWRI5HVLGHQFH
Oficina de Distrito Child Welfare and Attendance
Gianna Ochoa at 325-2111.
3105 G Street, Merced, CA
Si usted NO ha informado a la escuela previa que su estudiante se ha
mudado y no ha obtenido el 7LURGH&ODVHV\&DOLILFDFLRQHV$FWXDOHV
(Transcript/Drop slip) debe primero llamar a la escuela previa y dar de baja
a su estudiante. El Tiro de Clases y las Calificaciones Actuales se pueden mandar
por fax a nuestro numero:
4. Si usted NO trae consigo el comprobante de las 9DFXQDV específicamente
de la vacuna del 7GDSpara la toz ferinapor ley, no se podrá inscribir a su
estudiante sin ese comprobante.
Si su estudiante nació en otro país, tomarémos una copia de su $FWDGH
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Child Welfare, Attendance & Safety
3105 G Street, Merced, CA (Corner of G & Olive)
Atwater High School ▪ Buhach Colony High School ▪ El Capitan High School
Golden Valley High School ▪ Livingston High School ▪ Merced High School
Sequoia High School ▪ Yosemite High School
Affidavit of Residence and the Caregiver’s Authorization Affidavit must be
approved by the Child Welfare, Attendance and Safety Office prior to enrolling a
student or updating the student’s information at a school site.
Affidavit of Residence with Address
Identification Card (Cannot be expired)
Proof of Residency from Homeowner/Renter (All documents have to be current,
present/prior month only):
• Utility Bill: PG&E, Water, Garbage
• Government Issued Correspondence: DMV, Medi-Cal, Cash Aid, Welfare
• Mortgage Statement
• Renters Agreement (Cannot be hand written)
Caregiver’s Authorization Affidavit
Identification Card (Cannot be expired)
Proof of Residency from Homeowner/Renter (All documents have to be current:
present/prior month only):
• Utility Bill: PG&E, Water, Garbage
• Government Issued Correspondence: DMV, Medi-Cal, Cash Aid, Welfare
• Mortgage Statement
• Renters Agreement (Cannot be hand written)
Parent/Guardian of student does not have to be present and their signature is not
required on the document.
If you have any questions please call Gianna Ochoa - CWAS Secretary at 209-385-6514.
«LN» Merced Union High School District Registration Form
School Use: AERIES # Perm # Grad Yr:
Programs:
EL Foreign Exchg
Special Ed
ESTUDIANTE INFORMACIÓN: Apellido (Jr. II, III) Primer Nombre Segundo Nombre Sexo: Grado: Fecha de Nacimiento Ciudad de Nacimiento Estado Fecha en que entro a los EEUU Empezó escuela en EEUU (fecha)
País Empezó escuela en California (fecha)
Dirección donde recibe su correo: Cuidad: Use esta sección para hacer cambio a dirección de correo Dirección donde vive el estudiante: Use esta sección para hacer cambio a dirección de donde vive MADRE INFORMACIÓN: Madre/Guardián: Estudiante es ciudadano Si Estudiante esta en Foster Care Si Estado: Código Postal: Cuidad: Estado: Código Postal: Vive con estudiante: Use esta sección para hacer cambios de la madre/guardián No No Si No 50/50 (ambos) Custodia especial: Si No Sí, por favor provee documentación Teléfono de casa: Teléfono Celular de madre: Use esta sección para hacer cambios Use esta sección para hacer cambios al correo electrónico de la madre
( ) ( ) ( ) Correo electrónico de madre/guardián Teléfono del Trabajo del madre:
PADRE INFORMACIÓN: Padre/Guardián Vive con estudiante: Si No 50/50 (ambos) Custodia especial: Si No Sí, por favor provee documentación Use esta sección para hacer cambios del padre/guardián Teléfono de casa: Teléfono celular del padre: Use esta sección para hacer cambios ( ) Teléfono del trabajo del padre:
Correo electrónico del padre/guardián Use esta sección para hacer cambios al correo electrónico del padre ( ) ( ) Alguno de los padres es un miembro Activo de las Fuerzas Armadas (Ejército, Armada, Fuerza Aérea, Infantería de Marina) o esta en Tiempo completo en la Guardia Nacional del Ejército Si No Hispano o Latino (Persona de Cuba, México, Puerto Rico, Sur o Centro América, u otra cultura de origen Español) No Hispano o Latino CUAL ES LA NACIONALIDAD DE SU HIJO(A)? (Por favor cheque una) ¿CUAL ES LA RAZA DE SU HIJO(A)? (Por favor cheque hasta cinco categorías raciales) La pregunta arriba mencionada es sobre étnica, no raza. No importa que haya seleccionado arriba, por favor continúe y responda lo siguiente marcando una o más cajitas para indicar que considera es su raza. Indo(a) americano o Nativo de Alaska (Personas Africano(a) Americano o Negro Cambodia Guadañan Otro Asiático que sean originales de cualquier gente Filipino/Filipino Americano Hmong Hawaiano Samoano originalmente del Norte, Central o Sur América). Otra Isla Pacifica Laotian Japonés Tahitiano Blanco (Personas que tengan orígenes en cualquier Asiático(a) Indio Chino Corean Vietnamés gente original de Europa, África del Norte o del Medio Este). Educación de los Padres o Guardián: (elija uno) Idioma que habla en casa: Idioma de correspondencia: No graduado de la secundaria Graduado de la secundaria Escuela previa del estudiante: Algún Colegio Nombre: Ciudad: Numero telefónico: Graduado de colegio Bachillerato o más alto No respuesta Esta escuela es: Regular Alternativa Continuación Privada Elija los servicios especiales que el estudiante recibe: Ed. especial Otro Recursos (RSP) Dotado (GATE) El estudiante ha asistido escuela en el condado de merced: El estudiante ha sido expulsado: Si Si Día Especial (SDC) Para Leer No Año: No El estudiante esta en probatoria: Yes Habla/Lenguaje En Matemáticas Plan 504 EL Nombre de escuela: Si si, el nombre del oficial de probatoria: No (DOCUMENTO CONTINÚA AL LADO DORSO) → → → INFORMACION Y LIBERACION PARA FOTOGRAFIA/TRABAJO PARA SER PUBLICADO (véase los detalles completos en “Consentimiento e información para liberar información”) Trabajos del estudiante, fotografía y/o primer nombre puede ser considerado para publicar en la Red del Internet mundialmente durante el año escolar. Todo el trabajo del estudiante aparecerá con una nota prohibiendo copiar sin el permiso en escrito de MUHSD, del estudiante y de los padres del estudiante. Ningún nombre del estudiante, dirección o teléfono será publicado en la red del Internet de MUHSD o paginas creadas con los recursos de MUHSD. En adición, MUHSD puede tomar fotografías de estudiantes, solos o en grupo, para uso en presentaciones audiovisuales y relacionadas con materiales que se imprentaran que pueden ser proporcionadas al personal y/o a los empleados de otros distritos escolares. MUHSD no ejercitara control sobre las personas que pudieran ver y copiar lo similar del estudiante o como tales personas pudieran usar las fotografías. YO ENTIENDO QUE DANDO O NEGANDO CONSENTIMIENTO EN LA FORMA DE INSCRIPCION DE MUHSD PARA LIBERAR QUE LA FOTOGRAFIA DE MI HIJO(A) O TRABAJO PARA SER PUBLICADO EN CUALQUIER MEDIA NO ES CONDICION PARA INSCRIBIR A MI HIJO EN CUALQUIER PROGRAMA OPERADO POR EL DISTRITO DE MERCED UNION HIGH SCHOOL. EL PERMISO PUEDE SER REVOCADO, EN ESCRITO, A CUALQUIER TIEMPO. SIN TAL REVOCACION, ESTE CONSENTIMIENTO DEBERA PERMANECER EN EFECTO DURANTE TODO EL PERIODO DE INSCRIPCION DE EL ESTUDIANTE CON EL DISTRITO. Doy mi consentimiento y libertad para que la fotografía o trabajo de mi hijo(a) sea publicado en cualquier media Si No INFORMACION SOBRE EL CONTACTO DE EMERGENCIA Si su hijo(a) se enferma o se lastima en la escuela y no podemos comunicarnos con usted, necesitamos el nombre de una persona relacionada con usted, amigo o vecino con quien comunicarnos que pueda atender a su hijo(a). Estos individuales son la única gente a la que usted da consentimiento para que recojan a su hijo(a) de de la escuela para cualquier razón o solamente si la oficina recibe permiso en escrito. Contacto de Emergencia #1 Relación Teléfono de la casa Teléfono del trabajo Numero del celular Contacto de Emergencia #2 Relación Contacto de Emergencia #3 Relación INFORMACION MEDICA ¿Tiene el estudiante problemas crónicos de salud? Si Teléfono de la casa Teléfono del trabajo Numero del celular Teléfono de la casa Teléfono del trabajo Numero del celular No Por favor cheque lo que se apliqué a su hijo(a): Asma (usa inhalador) Oídos (usa aparato para oír) Alergias (polvo/polen) ADD/ADHD Diabetes
Ataques
Sangra de la nariz Problemas del corazón
Ojos (usa lentes)
Anafilaxias (alérgico severo a piquete de avispas o fuerte alergia a la comida) Alergias a la comida (por favor liste):
¿Esta el estudiante bajo receta médica regularmente? Si No
Por favor liste: Si No
¿Es el estudiante alérgico(a) a alguna medicina? Por favor liste: La ley del estado autoriza a los oficiales escolares hacer arreglos para tratamientos de emergencia razonables por un doctor u hospital cuando el estudiante este enfermo o se haya lastimado solamente que el padre o guardián haya entregado en escrito al distrito escolar objeción para cualquier tratamiento médico aparte de primeros auxilios. (Código Ed. 11902.1). En caso de una emergencia se hará un sincero esfuerzo para comunicarnos con usted, permitiéndose las circunstancias. He leído lo anterior y doy mi consentimiento a tratamiento en caso de emergencia por un doctor u hospital estimando lo razonable en el evento que mi hijo(a) se enferme o lastime en la escuela o en cualquier actividad patrocinada en o fuera de los terrenos escolares. Firma del Padre/Guardián Fecha Merced Union High School District Registration Form
School Use: AERIES # Perm # Grad Yr:
Programs:
EL Foreign Exchg
Special Ed
STUDENT INFORMATION: Last Name ‐ Legal Suffix (Jr. II, III) Birth Date: Birth City: First Name – Legal Middle Name State: Gender: Grade: Country: Date entered United States Date First Attended US School Date first attended CA School Student’s Mailing Address (Primary): Please Circle One: Mother or Father City: Use this section to make changes to Primary Residence Address Student’s Residence Address (if different): Please One: Mother or Father City: Use this section to make changes to Primary Mailing Address MOTHER INFORMATION: Mother/Guardian: Student is US Citizen Yes Student in Foster Care Yes State: Zip Code: State: Zip Code: No No Mother’s Work Phone: Resides with Student: Yes No 50/50 (joint) Custody Issues: Yes No If YES, Please provide documentation Mother’s Email Address: Use this section to make changes to Mother’s email address ( ) ( ) Use this section to make changes to Mother/Guardian Information Home Phone: Mother’s Cell Phone: Use these sections to make changes ( ) FATHER INFORMATION: Father/Guardian: Father’s Work Phone: Resides with Student: Yes No 50/50 (joint) Custody Issues: Yes No If YES, Please provide documentation Father’s Email Address: Use this section to make changes to Father’s email address ( ) ( ) Use this section to make changes to Father/Guardian Information Home Phone: Father’s Cell Phone: Use these sections to make changes ( ) Is either Parent/Guardian a member of the Armed Forces (Army, Navy, Air Force, Yes No Marine Corps, or Coast Guard) on Active Duty or Full‐Time National Guard Duty? Hispanic or Latino (A person of Cuban, Mexico, Puerto Rican, South or WHAT IS YOUR CHILD’S ETHNICITY? (Please check one) Central American, or other Spanish culture or origin, regardless of race) Not Hispanic or Latino WHAT IS YOUR CHILD’S RACE? (Please check up to five racial categories) The question above is about ethnicity, not race. No matter which ethnicity you selected above, please answer the following by marking one or more boxes to indicate what you consider your race to be. American Indian or Alaska Native (Persons having African American or Black Cambodian Guamanian Other Asian origins in any of the original people of North, Central Filipino/Filipino American Hmong Hawaiian Samoan or South America, including Latin America) Other Pacific Islander Laotian Japanese Tahitian White (Persons having origins in any of the original Asian Indian Chinese Korean Vietnamese people of Europe, North Africa, or the Middle East) Parent Education: (Check One) Home Language: Correspondence Language: Not a High School Graduate High School Graduate Some College College Graduate Graduate Plus Post Graduate Unknown/Decline to state «HL» «CL»
Student’s Previous School: Name: City: Phone Number: This school is: Regular Alternative Continuation Charter/Private Resource (RSP) Special Day (SDC) Speech/Language Check special services student has received: Special Ed Gifted (GATE) Reading Intervention Math Intervention (please check all boxes that apply) Or Other: Has student previously attended school in Merced County? Yes No Year: School Name: Has student ever been expelled? Yes No Is student on Probation? Yes 504 Plan EL If yes, list P.O. name: No (Form continues on the reverse side) INFORMATION AND RELEASE FOR PHOTO/WORK TO BE PUBLISHED (see packet for complete details on “Consent & Release Information”) Student’s work, photo and/or first name may be considered for publication on the World Wide Web during the school year. All student work will appear with a notice prohibiting copying without the express written permission of MUHSD, the student and the parent(s). No student’s full name, home address or telephone number will be published on the MUHSD web pages or pages created with MUHSD resources. In addition, MUHSD may take photographs of students, singly or in a group, for use in audiovisual presentations and related printed materials that may be provided to District staff and/or to the staff of other school districts. MUHSD will not exercise control over the persons who may view and copy student’s likeness or how such persons may otherwise use the photographs. I UNDERSTAND THAT GIVING OR DENYING CONSENT ON THE MUHSD ENROLLMENT FORM FOR RELEASE OF MY CHILD’S PHOTO OR WORK TO BE PUBLISHED IN ANY MEDIA IS NOT A CONDITION OF ENROLLING MY CHILD IN ANY PROGRAM OPERATED BY THE MERCED UNION HIGH SCHOOL DISTRICT. PERMISSION MAY BE REVOKED, IN WRITING, AT ANY TIME. ABSENT SUCH A REVOCATION, THIS CONSENT SHALL REMAIN IN EFFECT THROUGHOUT THE STUDENT’S PERIOD OF ENROLLMENT WITH THE DISTRICT. I give consent and release for my child’s photo or work to be published in any media. Yes No EMERGENCY CONTACT INFORMATION If your child should become ill or is injured at school and we cannot contact you, we will use an emergency contact (relative/friend/neighbor) to care for your child. These individuals will be the only people allowed to transport your child from school for any reason unless the office receives a written release. Please provide more than one emergency contact. Emergency Contact #1 Relationship to Student
Emergency Contact #2 Relationship to Student
Emergency Contact #3 Relationship to Student
Home Phone
Work Phone Cell Phone
Home Phone
Work Phone Cell Phone
Home Phone
Work Phone Cell Phone
MEDICAL INFORMATION Does student have any chronic health problems? Yes No If YES, please check those which apply to your child: Asthma (carries inhaler) ADD/ADHD
Diabetes
Seizures
Nose Bleeds Heart Problems
Ear (hearing aid) Eye (glasses)
Anaphylaxis (severe bee sting or food allergy) Allergies (dust/pollen) Allergies to food (Please list):
Does student take prescription medication on a regular basis? Yes No
If YES, please list below: Is student allergic to any medication? Yes No
If YES, please list below: State law authorizes school officials to arrange for reasonable emergency treatment by a physician or hospital when a pupil is ill or injured at school unless a parent or guardian files with the school district a written objection to any medical treatment other than first aid. (Ed Code Sec. 11902.1). Should an emergency arise a reasonable effort will be made to contact you, circumstances permitting. I have read the foregoing and consent to such emergency treatment by a physician or hospital as is deemed reasonable in the event my child is ill or injured at school or at any school sponsored activity on or off the school grounds. Signature of Parent/Guardian Date ENROLLMENT FORM: The information you provide will be used to determine if your child qualifies for any additional assistance under
ESSA/La información que usted provea será usada para determinar si su hijo/a califica para alguna asistencia adicional bajo ESSA
STUDENT SERVICES QUESTIONNAIRE/CUESTIONARIO PARA SERVICIOS DE ESTUDIANTE
ESTUDIANTE
Student/Estudiante
Birthdate/Fecha de
Nacimiento
Grade/Grado
English
School/Escuela
Español
1. Does your child/family CURRENTLY live in :
In a single family residence (house, apartment, mobile
home)
Sharing with other family/individuals due to financial
issue.
In a shelter or transitional housing program
In a motel, hotel, car or campsite
No permanent residence (moving from place to place)
My place of residence does not have consistent water, gas,
and/or electricity.
My family does not have enough food to eat in the
residence.
My home is overcrowded – please indicate the number of
people in the home ______and rooms______.
Other:________________________________________
1. Su hijo/a y familia vive PRESENTEMENTE en:
Una residencia de una sola familia (casa, apartamento,
remolque-residencial, tráiler)
Compartiendo con familiares/individuos debido a
problemas financieros
Un refugio, alberge, o programa de casa de transición
Un motel, hotel, carro o un lugar de campamento
No tiene residencia permanente (se mueve de un lugar a
otro)
Mi lugar de residencia consistentemente no tiene agua, gas
o electricidad.
Mi familia no tiene suficiente comida para comer en la
residencia.
Mi hogar esta abarrotado de personas: Indique el número
de personas en la residencia____ y habitaciones____.
Otro:_______________________________________
If determined to be eligible, please indicate services needed:
Si es determinado que su hijo/a es elegible, por favor
indique que servicios necesita:
Desayuno y almuerzo gratis en la escuela
Transportación de y a la escuela
Asistencia con actividades escolares (ayuda con
accesorios de deportes, la bata degradación)
Asistencia para obtener documentos (acta de nacimiento o
expedientes escolares)
Materiales escolares
Referencias a agencias en la comunidad como referencias
de vivienda o asistencia de servicios públicos
Ropa para la escuela para el estudiante de grados 9 a 12
Ayuda con acceso a servicios de salud (referencias a
servicios, o ayuda con transportación)
Tutoría, ayuda con tarea
Consejería o apoyo para comportamiento problemático
Consejería académica
Ayuda con costos para el examen de GED para los padres
Otros (Por favor indique):_______________________
____________________________________________
Free school breakfast, and lunch
Transportation to-and from school
Assistance with school activity fees (i.e. help with practice
gear, cap & gown for seniors, etc.)
Assistance obtaining records (i.e. birth
certificate, school records)
School supplies
Referral to community agencies (i.e. help referrals, utility
assistance, etc.)
School clothing for high school students
Assistance accessing health services (i.e. referrals to health
services, or transportation assistance)
Tutoring or other instructional support
Counseling or Behavior Support
Academic guidance
Assistance with cost of GED tests for parents
Other (Please specify);__________________________
____________________________________________
Parent Signature/Firma del Padre & Phone Number/Numero de Telefono
Date/Fecha
2016-2017
2016-2017
Migrant Education Program
Eligibility Survey
The Region III Migrant Education Program serves eligible migrant students in the counties of Madera, Merced and
Stanislaus.
Students that qualify may benefit from the following free services:
Supplemental School Assistance: After School site based and home based tutoring, high school counseling, credit
recovery and college/university application process
Health Assistance: Scheduling doctor appointments, transportation to medical appointments, translation during medical
appointments and applying for health coverage
Social Services Assistance: Linking with community resources that provide: food, clothes, etc.
Other Services: Summer educational services, educational field trips, student leadership activities, parent advocacy and
leadership development opportunities
In order to determine the eligibility of your child, please answer the following three questions and complete the
information on the bottom of this form. Once completed, return this survey to your school’s office. Please be aware that
the Migrant Education Program staff may contact you for a personal interview to determine eligibility and to discuss free
services available to your children. For more information regarding the Migrant Education Program services, please call
(800) 722-2717.
1. Have you and your children moved within the last 3 years?
2. Do you or have you worked in: agriculture, cannery, dairy, forestry or
fishing in the last 3 years?
3. Have you traveled to Mexico or to another state with your family in the last 3 years?
Yes___No___
Yes___No___
Yes___No___
Date: ________________________
Parents’ Names: ___________________________________________________________________________
Address: _________________________________________________________________________________
Telephone: _____________________________________
Name of Children
Date of Birth
School Name
1._____________________________
________________
______________________
2._____________________________
________________
______________________
3._____________________________
________________
______________________
4._____________________________
________________
______________________
5._____________________________
________________
______________________
Encuesta de Elegibilidad
Programa de Educación Migrante
El Programa de Educación Migrante de la Región III sirve a los estudiantes que califican dentro de los condados de
Merced, Madera y Stanislaus.
Los estudiantes que califican se podrían beneficiar de los siguientes servicios gratuitos:
Servicios Suplementarios de Instrucción: Tutoría después de clases en la escuela o en el hogar, consejería para
estudiantes en la preparatoria, recuperación de créditos y ayuda con el proceso para entrar al colegio o a la universidad
Salud: Asistencia con sus citas médicas, transportación a sus citas, traducción durante sus citas médicas y completando
sus aplicaciones para recibir cobertura médica.
Servicios Sociales: Conexión con agencias que proveen recursos tales como: comida, ropa, etc.
Servicios Adicionales: Servicios educativos de verano, paseos educativos, actividades de liderazgo para estudiantes,
capacitación y oportunidades de liderazgo para padres.
A fin de determinar la elegibilidad de sus estudiantes, haga el favor de contestar las siguientes tres preguntas y
completar la información en la parte inferior de esta forma. Una vez que complete la forma, regrésela a la oficina de la
escuela donde asiste su hijo/a. Usted podría ser contactado por uno de los empleados del Programa de Educación
Migrante quien le hará una entrevista para determinar si sus hijos califican para recibir los servicios que ofrece nuestro
programa. Para más información acerca del Programa de Educación Migrante, llámenos al (800) 722-2717.
1. ¿Se ha movido con sus hijos dentro de los últimos tres años?
Si___ No___
2. ¿Trabaja o ha trabajado en agricultura, empacadoras, lecherías
silvicultura, pesca, o en un rancho?
3. ¿Ha viajado a México o a otro estado con su familia en los últimos tres años?
Si___No___
Si___No___
Fecha: ________________________
Nombre de los Padres: _______________________________________________________________________
Dirección: _________________________________________________________________________________
Telefono: _____________________________________
Nombre del Nino (s)
Fecha de Nacimiento
Nombre de la Escuela
1._____________________________
________________
______________________
2._____________________________
________________
______________________
3._____________________________
________________
______________________
4._____________________________
________________
______________________
5._____________________________
________________
______________________
MERCED UNION HIGH SCHOOL DISTRICT
RESPONSIBLE USE OF INTERNET AND TECHNOLOGY RESOURCES
CONTRACT FOR STUDENTS AND PARENTS
TERMS AND CONDITIONS FOR USE
Merced Union High School District’s (District) Responsible Use of Internet and Technology Resources Contract
for Students and Parents (Contract) applies to student use of the Internet and Technology Resources, including
computers and Electronic Communication Devices, provided by the District, used on District property, and/or used
off campus in connection with District activity or attendance. All such use must be responsible, proper, and
supportive of the instructional program for the advancement of student learning. Electronic Communication
Devices (ECDs) means any electronic apparatus capable of sending, receiving, reproducing, recording, storing,
processing, displaying, and/or transmitting data, voice, text, and/or video/photo images. This generally includes,
but is not limited to, cell phones, laptops, netbooks, Chromebooks, Smartphones, tablets, Media Players, memory
sticks, and other current and future similar devices.
The Internet offers access to computers and people across the world through, for example, e-mail, chat rooms,
and social networking sites. The protection of students is of paramount concern to the Merced Union High School
District. The District uses a CIPA (Child Internet Protection Act) compliant filter, and school staff monitor and
supervise student use of the Internet and District Technology Resources provided by the District and used on
District property. However, it is impossible to control access to all material. As a result, users (and parents of
users who are students) must understand that neither the MUHSD nor its staff members control or condone the
content of the information available through the Internet or Technology Resources. Some of the information
available through the Internet and Technology Resources is controversial and may be offensive.
Internet and Technology Resources must be used in a responsible, efficient, ethical, legal, and safe manner.
Care of electronic devices distributed by MUHSD is the responsibility of the student and parent/guardian to which
it is assigned. This includes costs associated with damages and lost or theft. The District provides each student
free Internet access while on-campus and a District e-mail account for educational/instructional purposes. Each
student is responsible at all times for their proper use.
SAFETY For the safety of the students, we suggest that users:
• Change passwords frequently and do not give passwords to any others
• Do not share account numbers, home addresses, last names, Social Security numbers, telephone
numbers, or any other identifiable information, unless instructed otherwise by school personnel
• Do not share passwords or accounts
• Never arrange a face-to-face meeting with someone you “meet” on the Internet
IRRESPONSIBLE USES In order to use the Internet and Technology Resources provided by the District, used
on District property, and/or used off campus in connection with District activity or attendance users must not
engage in any irresponsible uses including, but not limited to, the following:
• Any practices or activity prohibited by law, Board policy, or administrative regulations
• Accessing, posting, forwarding, texting, submitting, publishing, or displaying inappropriate matter that is
threatening, obscene, libelous, slanderous, disruptive, unlawful, or sexually explicit; incites students to
commit unlawful acts on school premises; or that could be construed as harassment, discrimination, or
disparagement of others based on their actual or perceived sex, gender, ethnic group identification, race,
national origin, religion, physical or mental disability, age, or sexual orientation
• Engaging in cyberbullying, sexting, or harassment
• Engaging in use for the purpose of seeking financial or personal gain, engaging in political activity, or
conducting commercial activity
• Engaging in any illegal activity in violation of state or federal laws or regulations
• Encouraging the use of drugs, alcohol, or tobacco
• Promoting unethical activities, such as cheating on assignments or tests
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Copying copyrighted material, commercial software, or files in violation of copyright laws
Intentionally uploading, downloading, or creating computer viruses and/or maliciously attempting to harm
or destroy District equipment or materials, or manipulating the data of any other user, including so-called
“hacking”
Interfering with other users’ ability to send or receive email
Attempting to read, delete, copy, modify, or use another individual’s identity or private information
Using others’ passwords
Trespassing in others’ folders, work or files
Impersonating another person or falsifying location, identity, or computer information
Accessing social networking sites, chat rooms, music or video, unless approved by District
Instant Messaging, unless approved by District
Posting personal information (yours or others) for purposes that are not academic or educational
Use of proxies or other means of accessing filtered web sites
Use of unauthorized software
The MUHSD reserves the right to monitor all Internet and Technology Resources for improper use. Electronic
communications and downloaded material, including files deleted from a user’s account, may be reviewed by
District officials to ensure proper use of the system. Note that system operators will have access to all user
accounts, including e-mail sent while using the District’s Internet connections. Where legal violations have
occurred, law enforcement will be notified and potential criminal charges filed.
VIOLATIONS OF THIS CONTRACT: The principal or designee shall make all decisions regarding whether or not
a student has violated this Contract. The decision of the principal shall be final. Irresponsible use may result in
cancellation of the student’s user privileges, disciplinary action, and/or legal action in accordance with law and
Board policy.
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MERCED UNION HIGH SCHOOL DISTRICT
RESPONSIBLE USE OF INTERNET AND TECHNOLOGY RESOURCES
CONTRACT FOR STUDENTS AND PARENTS
STUDENT ACKNOWLEDGMENT AND PARENT/GUARDIAN CONSENT
Student’s Name: ________________________________________________ I.D. # ______________________
School:
______________________________________________________ Class of: ____________
STUDENT ACKNOWLEDGEMENT:
By signing below, I acknowledge and understand that if I violate the District’s Responsible Use of Internet and
Technology Resources Contract for Students and Parents or use the Internet or the District’s Technology
Resources in an irresponsible manner, my use privileges may be taken away, my parent/guardian may be
notified, and I may be subject to student discipline.
Student’s Signature: ________________________________________ Date: ___________________________
PARENT/GUARDIAN CONSENT:
I have read the District’s Responsible Use of Internet and Technology Resources Contract for Students and
Parents (Contract) and hereby agree to its provisions. I understand that the use of the Internet and Technology
Resources can connect students to computers throughout the world and that it is impossible for the District to
control access to all material available through the Internet and Technology Resources. When using the Internet
or Technology Resources, I realize that students may read or access material that I might consider controversial
or offensive.
The MUHSD has my permission to give an Internet account to my child. I understand that my child may keep this
account as long as the Contract is not violated and that the principal or designee shall make all decisions
regarding whether or not a student has violated this Contract.
In consideration of the above, I agree to not hold the District or any District staff responsible for the failure of any
technology protection measures, violations of copyright restrictions, or users’ mistakes or negligence. I also agree
to indemnify and hold harmless the District and District personnel for any damages or costs incurred.
Parent’s name: ___________________________________
Parent’s signature: _________________________________________ Date: _________________
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