registration/enrollment information 2016 - 2017

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Presenting a false record or falsifying records is an offense under Section 37.10, Penal Code, and enrollment of the child under false
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TO: Persons Enrolling Students Under 11 Years Enrolling For the First Time in Crowley ISD
Texas Criminal Code, Article 63.019, requires that when a student under 11 years of age enrolls for the first time at
a school, the person enrolling the child should provide the name of each previous school attended by the child.
Crowley ISD will request verification from each previous school of the child’s name, address, birth date, grades,
and dates attended.
In addition, Texas Criminal Code requires that the person enrolling the student provide:
(1) A copy of the child’s birth certificate; or
(2) Other legal proof of the child’s identity and age, and a signed statement explaining the person’s inability to
produce a copy of the birth certificate.
If the person enrolling the student does not provide the documentation required above within 30 days, the
school will notify the local police department. The police department will check the missing children’s
clearinghouse to determine if the child has been reported missing.
Please provide the following:
Student’s Legal Name___________________________________________________________
Student’s Date of Birth__________________________________________________________
Birth Certificate provided: Yes
No
or
Other legal proof of identity and age, and signed statement: Yes
No
Statement: I am not able to provide a birth certificate because:__________________________
____________________________________________________________________________
Schools in which student have previously been enrolled:
1. School Name____________________________________________________________
Address________________________________________________________________
2. School Name____________________________________________________________
Address________________________________________________________________
3. School Name____________________________________________________________
Address________________________________________________________________
Signature: ________________________________________
Date:____________________
File copy in Cum Folder
Para: La persona que vaya a matricular a un estudiante menor de 11 años de edad Se está matriculando
por primera vez en Crowley ISD
El Código Penal de Texas, Artículo 63.019 exige que cuando se vaya a matricular en la escuela a un estudiante menor de 11
años de edad, la persona que vaya a matricular al niño(a) deberá proporcionar el nombre de las escuelas a las cuales el
estudiante haya asistido previamente. Crowley ISD solicitará de cada escuela previa el nombre del niño(a), la dirección, la
fecha de nacimiento, las calificaciones y las fechas de asistencia.
Además, el Código Penal de Texas exige que la persona que vaya a matricular al estudiante proporcione:
(3) Una copia de la partida de nacimiento del niño(a), u
(4) Otra prueba legal de la identidad del niño(a) y la edad, así como una declaración firmada que explique la razón por la
cual esta persona no puede presentar una copia de la partida de nacimiento del niño(a).
Si la persona que está matriculando al estudiante no proporcionara la documentación exigida dentro de un periodo de
30 días, la escuela notificará al departamento de policía local. El departamento de policía verificará la base de datos de los
niños desaparecidos para determinar si el niño(a) fue reportado como desaparecido.
Por favor, provea lo siguiente:
Nombre legal del estudiante______________________________________________________________
Fecha de nacimiento del niño(a) __________________________________________________________
¿Proporcionó la partida de nacimiento? Sí
No
o
¿Proporcionó otra prueba legal de la identidad, la edad y la declaración firmada? Sí
No
Declaración: No puedo proporcionar la partida de nacimiento porque: _____________________________
_____________________________________________________________________________________
Escuelas en las que estuvo previamente matriculado el estudiante:
4.
Nombre de la escuela_____________________________________________________________
Dirección_______________________________________________________________________
5.
Dirección_______________________________________________________________________
6.
Dirección_______________________________________________________________________
Firma: ________________________________________
Fecha: ____________________
2 doses
2 doses
2 doses
of MMR
1 dose
3 doses
1 dose
2 doses
2 doses of measles and
1 dose each of rubella and mumps vaccine
4 doses or 3 doses
The 1st dose of hepatitis A must be received on or after the 1st birthday.
For 7th – 12th grade: 1 dose required.
For students aged 11 - 15 years, 2 doses meet the requirement if adult
hepatitis B vaccine (Recombivax®) was received. Dosage and type of
vaccine must be clearly documented. Two (2) 10 mcg/1.0 ml doses of
Recombivax®. If Recombivax® is not the vaccine received, a 3-dose series is
required.
The 1st dose of varicella must be received on or after the 1st birthday.
For K – 5th and 7th - 12th grade: 2 doses are required.
For 6th grade: 1 dose is required.
For any student who receives the 1st dose on or after 13 years of age, 2 doses
are required.
The 1st dose of MMR must be received on or after the 1st birthday.
For K – 5th grade: 2 doses of MMR are required.
For 6th - 12th grade: 2 doses of a measles-containing vaccine, and 1 dose
each of rubella and mumps vaccine is required.
For K – 12th grade: 4 doses of polio; 1 dose must be received on or after the
4th birthday. However, 3 doses meet the requirement if the 3rd dose was
received on or after the 4th birthday.
3 dose primary
series and 1
Tdap/Td
booster within
last 5 years
5 doses or 4 doses
For K - 6th grade: 5 doses of diphtheria-tetanus-pertussis vaccine; 1 dose
must have been received on or after the 4th birthday. However, 4 doses meet
the requirement if the 4th dose was received on or after the 4th birthday. For
students aged 7 years and older, 3 doses meet the requirement if 1 dose was
received on or after the 4th birthday.
For 7th grade: 1 dose of Tdap is required if at least 5 years have passed since
the last dose of tetanus-containing vaccine.
For 8th - 12th grade: 1 dose of Tdap is required when 10 years have passed
since the last dose of tetanus-containing vaccine. Td is acceptable in place of
Tdap if a medical contraindication to pertussis exists.
3 dose primary
series and 1
Tdap/Td booster
within last
10 years
NOTES
Minimum Number of Doses Required by Grade Level
K – 6th
7th
8th - 12th
2
Receipt of the dose up to (and including) 4 days before the birthday will satisfy the school entry immunization requirement.
Serologic confirmation of immunity to measles, mumps, rubella, hepatitis B, hepatitis A, or varicella or serologic evidence of infection is acceptable in place of vaccine.
3
Previous illness may be documented with a written statement from a physician, school nurse, or the child's parent or guardian containing wording such as: "This is to verify that (name of student) had varicella disease
(chickenpox) on or about (date) and does not need varicella vaccine." This written statement will be acceptable in place of any and all varicella vaccine doses required.
1
Hepatitis A1,2
Meningococcal
Varicella1,2,3
Hepatitis B2
Measles, Mumps, and Rubella1,2
(MMR)
Polio
1
Diphtheria/Tetanus/Pertussis
(DTaP/DTP/DT/Td/Tdap)1
(Attention to notes and footnotes)
Vaccine Required
A student shall show acceptable evidence of vaccination prior to entry, attendance, or transfer to a child-care facility
or public or private elementary or secondary school in Texas.
IMMUNIZATION REQUIREMENTS
The Department of State Health Services (DSHS) is granted authority to set immunization requirements by the Texas Education Code, Chapter 38, Health & Safety,
Subchapter A, General Provisions.
This chart summarizes the vaccine requirements incorporated in the Texas Administrative Code (TAC), Title 25 Health Services, Sections 97.61 to
97.72. This chart is not intended as a substitute for consulting the TAC, which has other provisions and details. Click here for complete TAC language.
2015-2016 Texas Minimum State Vaccine Requirements for Students Grades K-12
Stock No. 6-14
Texas Department of State Health Services • Immunization Branch • MC-1946 • P. O. Box 149347 • Austin, TX 78714-9347 • (800) 252-9152
Rev. 4/2015KSS
Since many types of personal immunization records are in use, any document will be acceptable provided a physician or public health personnel has validated it.
The month, day, and year that the vaccination was received must be recorded on all school immunization records created or updated after September 1, 1991.
Documentation
All immunizations should be completed by the first date of atte ndance. The law requires that students be fully vaccinated against the specified diseases. A student
may be enrolled provisionally if the student has an immunization record that indicates the student has received at least one dose of each specified age-appropriate
vaccine required by this rule. To re main enrolled, the student must complete the required subsequent doses in each vaccine series on schedule and as rapidly as is
medically feasible and provide acceptable evidence of vaccination to the school. A school nurse or school administrator shall review the immunization status of a
provisionally enrolled student every 30 days to ensure continued compliance in completing the required doses of vaccination. If , at the end of the 30-da y period, a
student has not received a subsequent dose of vaccine, the stude nt is not in co mpliance and the school shall exclude t he student from school attendance until the
required dose is administered.
Provisional Enrollment
For children claiming medical exemptions, a written statement by the physician must be submitted to the school or child-care facility.
Instructions for requesting the official exemption affidavit that must be signed by parents/guardians choosing the exemption for reasons of conscience,
including a religious belief, can be found at www.ImmunizeTexas.com. Original Exemption Affidavit must be completed and submitted to the school or
child-care facility.
The law allows (a) physicians to write a statement stating that the vaccine(s) required would be medically harmful or injurious to the health and well-being of the
child or household member, and (b) parents/guardians to choose an exemption from immunization requirements for reasons of conscience, including a religious
belief. The law does not allow parents/guardians to elect an exemption simply because of inconvenience (for example, a record is lost or incomplete and it is too
much trouble to go to a physician or clinic to correct the problem). Schools and child-care facilities should maintain an up-to-date list of students with exemptions,
so they may be excluded in times of emergency or epidemic declared by the commissioner of public health.
Exemptions
2 dosis
2 dosis
2 dosis
MMR
4 dosis o 3 dosis
Serie primaria
de 3 dosis y
1 dosis de
refuerzo de la
vacuna Tdap o
Td en los
últimos 5 años
7.o
Serie primaria
de 3 dosis y
1 dosis de
refuerzo de la
vacuna Tdap o
Td en los
últimos
10 años
8.o - 12.o
1 dosis
3 dosis
1 dosis
2 dosis
2 dosis de una vacuna que contenga
sarampión, una dosis de la vacuna
contra la rubéola y una dosis de la
vacuna contra las paperas.
5 dosis o 4 dosis
Kínder - 6.o
Número mínimo de dosis requeridas por grado escolar
La 1a dosis de hepatitis A debe recibirse en o después del 1.er cumpleaños.
La 1 a dosis de la vacuna contra la varicela debe recibirse en o después del 1.er cumpleaños.
Para los grados de kínder - 5.o y de 7.o - 12.o: Se requieren 2 dosis.
Para el 6.o grado: Se requiere 1 dosis.
Para todos los estudiantes que reciban la 1a dosis al cumplir 13 años de edad o después, se
requieren 2 dosis.
Para los estudiantes de 11 a 15 años de edad, con 2 dosis cumplen con el requisito si
recibieron la vacuna contra la hepatitis B para adultos (Recombivax®). Deben documentarse
claramente la dosis y el tipo de vacuna. Dos (2) dosis de 10 mcg/1.0 ml de Recombivax®. Si
la vacuna que se recibió no es Recombivax®, se requiere una serie de 3 dosis.
La 1 a dosis de la vacuna MMR debe recibirse en o después del 1.er cumpleaños.
Para el kínder - 5.o grado: Se requieren 2 dosis de la vacuna MMR.
Para los grados de 6.o - 12.o: Se requieren 2 dosis de una vacuna que contenga sarampión,
una dosis de la vacuna contra la rubéola y una dosis de la vacuna contra las paperas.
Para el kínder - 12.o grado: 4 dosis de la vacuna contra la polio; debe recibirse 1 dosis en o
después del 4.o cumpleaños. Sin embargo, con 3 dosis cumplen con el requisito si la 3.a dosis
se recibió en o después del 4.o cumpleaños.
Para el kínder - 6.o grado: 5 dosis de la vacuna contra la difteria, el tétanos y la pertusis;
Debe haberse recibido 1 dosis en o después del 4.o cumpleaños. Sin embargo, con 4 dosis
cumplen con el requisito si recibieron la 4.a dosis en o después del 4.o cumpleaños. Para los
estudiantes de 7 años de edad o más, con 3 dosis cumplen con el requisito si recibieron 1 dosis
en o después del 4.o cumpleaños.
Para el 7.o grado: Se requiere 1 dosis de la vacuna Tdap si han pasado al menos 5 años desde
la última dosis de una vacuna que contenga tétanos.
Para los grados de 8.o - 12.o: Se requiere 1 dosis de la vacuna Tdap si han pasado 10 años
desde la última dosis de una vacuna que contenga tétanos. La vacuna Td es aceptable en lugar
de la vacuna Tdap si existe una contraindicación médica para la vacuna contra la pertusis.
NOTAS
2
Recibir la dosis hasta (e inclusive) 4 días antes del cumpleaños satisfará el requisito de inmunización para entrar a la escuela.
La confirmación serológica de la inmunidad al sarampión, las paperas, la rubéola, la hepatitis B, la hepatitis A o la varicela o la evidencia serológica de infección son aceptables en lugar de la vacuna.
3
La enfermedad previa puede documentarse con una declaración escrita de un médico, una enfermera escolar o el padre o tutor del niño que diga algo como: "Esto es para verificar que (nombre del estudiante) tuvo varicela el
(fecha) o por esa fecha y no necesita la vacuna contra la varicela". Dicha declaración escrita será aceptable en lugar de todas las dosis requeridas de la vacuna contra la varicela.
1
Hepatitis A
1,2
Meningocócica
Varicela1,2,3
Hepatitis B2
Sarampión, paperas y rubéola (MMR)1,2
Polio
1
Difteria, tétanos y pertusis
(DTaP, DTP, DT, Td, Tdap)1
(Vea las notas y las notas de pie de página)
Vacuna requerida
Los estudiantes deberán mostrar comprobantes de vacunación aceptables antes de entrar, asistir o ser transferidos
a una guardería o escuela primaria o secundaria pública o privada de Texas.
REQUISITOS DE INMUNIZACIÓN
El Código Educativo de Texas, capítulo 38, Salud y Seguridad, subcapítulo A, Disposiciones Generales, concede la autoridad de establecer requisitos de inmunización al
Departamento Estatal de Servicios de Salud de Texas (o DSHS).
Este gráfico resume los requisitos de vacunación incorporados en el Código Administrativo de Texas (o TAC), título 25, Servicios de salud, Secciones
97.61 a 97.72. El gráfico no tiene como propósito sustituir las consultas al TAC, el cual contempla otras disposiciones y detalles. Haga clic aquí para obtener el texto
completo del TAC.
Requisitos de vacunación mínimos estatales de Texas de 2015-2016 para estudiantes de kínder-12.o grado
Stock No. 6-14
Texas Department of State Health Services • Immunization Branch • MC-1946 • P O Box 149347 • Austin, TX 78714-9347 • (800) 252-9152
Rev. 04/2015 KSS
Dado que se usan muchos tipos de registros de inmunización personales, cual quier documento es a ceptable si un médico o el pe rsonal de salud púb lica lo ha
validado. Debe registrarse el mes, día y año en que s e recibió la vacuna en todos los registros de inm unización escolares creados o actualizados después del 1 de
septiembre de 1991.
Documentación
Todas las inmunizaciones se deben finalizar ante s de la pri mera fecha de asistencia. La ley exige que los estudiantes estén completamente vacunados contra las
enfermedades señaladas. Un estudiante se puede inscribir provisionalmente si el estudiante cuenta con registro de inm unización que indique que el estudiante h a
recibido al menos una dos is de cada vacuna apropiada para la edad específic a que esta regla exija. Para seguir inscrito, el est udiante debe completar las dosis
posteriores requeridas de cada serie de vacunas conforme al calen dario y tan rápidamente como sea médicamente posible y proveer comprobante suficiente de la
vacunación a la escuela. Una enfermera escolar o un administrador escolar revisará el estado de inmunización de un estudiante i nscrito provisionalmente cada 30
días para garantizar el cu mplimiento ininterrumpido en la fina lización de las dosis de vacunas re queridas. Si, al final del per iodo de 30 días, u n estudiante no ha
recibido una dosis posterior de la vacuna, el estudiante no está cumpliendo y la escuela excluirá al estudiante para que no asista a la escuela hasta que se administre
la dosis requerida.
Inscripción provisional
En el caso de los niños que soliciten exenciones médicas, deben presentar una declaración escrita del médico a la escuela o guardería.
Encontrará instrucciones para solicitar la declaración jurada de exención oficial que debe ser firmada por los padres o tutores que elijan la exención por
razones de conciencia, incluso creencias religiosas, en www.ImmunizeTexas.com. La declaración jurada de exención original debe rellenarse y
presentarse a la escuela o guardería.
La ley permite que (a) los médicos redacten una declaración en la que expongan que la vacuna o vacunas requeridas serían médicamente dañinas o perjudiciales
para la salud y el bienestar del niño o de una persona que vive en la casa y que (b) los padres o tutores elijan una exención de los requisitos de inmunización por
razones de conciencia, incluso creencias religiosas. La ley no permite que los padres o tutores elijan una exención simplemente por inconveniencia (por ejemplo, si
se pierde un registro o éste está incompleto y sería mucha molestia ir con un médico o clínica para corregir el problema). Las escuelas y las guarderías deben
mantener una lista actualizada de los estudiantes con exenciones, de forma que se les pueda excluir durante emergencias o epidemias declaradas por el director de
salud pública.
Exenciones
2016-17 Crowley ISD
Student Placement for
Language Support Programs
PK-2ND GRADE SPANISH BILINGUAL PROGRAM FOR FEEDER SCHOOLS

Meadowcreek Elementary Pre-K (1/2 Day)-2nd grade: Meadowcreek Elementary will function as a standalone campus for their students. Pre-K-2nd grade students eligible for the Bilingual Program from Meadowcreek
will remain at Meadowcreek Elementary School.

Hargrave Elementary Pre-K (1/2 Day)-1st grade: Hargrave Elementary will function as a stand-alone
campus for their students. Pre-K-1st grade students eligible for the Bilingual Program from Hargrave Elementary
will remain at Hargrave Elementary School.
Oakmont Elementary Pre-K (Full-Day)-2nd grade: will be held at Oakmont Elementary. All students eligible
for the Bilingual Program from the following campuses will attend Oakmont Elementary School for grades PreK-2nd.



DALLAS PARK ELEMENTARY
OAKMONT ELEMENTARY

OPTIONS FOR JACKIE CARDEN ELEMENTARY PK-2ND
Two-Way Dual Language Program at Oakmont Elementary Pre-K (Full Day)-2nd grade
One-Way Dual Language Program at Meadowcreek Elementary Pre-K (1/2 Day)-2nd grade

OPTIONS FOR HARGRAVE ELEMENTARY 2ND
(BILINGUAL PK-1 WILL REMAIN AT HARGRAVE)
Two-Way Dual Language Program at Oakmont Elementary 2nd grade
One-Way Dual Language Program Meadowcreek Elementary 2 nd grade

Parkway Elementary Pre-K (1/2 Day)-2nd grade: Parkway Elementary will function as a stand-alone
campus for their students. Pre-K-2nd grade students eligible for the Bilingual Program from Parkway will remain
at Parkway Elementary School.

Sycamore Elementary Pre-K (1/2 Day)-2nd grade: All students eligible for the Bilingual Program from
Sycamore will attend Sycamore Elementary School. Students from Poynter, Deer Creek, and Bess Race may
remain at Sycamore under the following conditions.
 Previously enrolled in a bilingual program at Sycamore
 Sibling is already attending the bilingual program at Sycamore

Deer Creek Elementary Pre-K (Full Day)-2nd grade: will be held at Deer Elementary. All newly enrolled
students eligible for the Bilingual Program from the following campuses will attend Deer Creek Elementary
School for grades PreK-2nd.



POYNTER ELEMENTARY
BESS RACE ELEMENTARY
DEER CREEK ELEMENTARY
Campuses will offer the Spanish and Vietnamese Bilingual Program first before offering ESL for students
with Spanish or Vietnamese documented on the Home Language Survey. Bilingual Program Benefits form
must be provided and kept in the LEP Red Folder/Permanent Records, for Bilingual Program denials.
In its efforts to promote nondiscrimination, Crowley ISD does not discriminate on the basis of race, religion, color, national origin, gender, or
disability in providing education services, activities, and programs, including vocational programs, in accordance with Title VI of the Civil Rights Act
of 1964, as amended; Title IX of the Educational Amendments of 1972; and Section 504 of the Rehabilitation Act of 1973, as amended.
3RD-4TH GRADE SPANISH BILINGUAL PROGRAM FOR FEEDER SCHOOLS

Meadowcreek Elementary 3rd-4TH grade: will be held at Meadowcreek Elementary.

Oakmont Elementary 3rd-4th grade: All students eligible for the Bilingual Program from the following
campuses will attend Oakmont Elementary School for grades 3rd-4th.


DALLAS PARK ELEMENTARY
OAKMONT ELEMENTARY

OPTIONS FOR JACKIE CARDEN ELEMENTARY 3RD-4TH
Two-Way Dual Language Program at Oakmont Elementary 3rd-4th grade
One-Way Dual Language Program at Meadowcreek Elementary 3rd-4th grade

OPTIONS FOR HARGRAVE ELEMENTARY 3RD-4TH
Two-Way Dual Language Program at Oakmont Elementary 3rd-4th grade
One-Way Dual Language Program Meadowcreek Elementary 3rd-4th grade

Parkway Elementary 3RD-4TH grade: Parkway Elementary will function as a stand-alone campus for their
students. Third through fourth grade students eligible for the Bilingual Program from Parkway will remain at
Parkway Elementary School.


Deer Creek Elementary 3RD-4TH grade: will be held at Deer Elementary. All newly enrolled students eligible
for the Bilingual Program from the following campuses will attend Deer Creek Elementary School for 3rd to 4th
grades.




POYNTER ELEMENTARY
BESS RACE ELEMENTARY
DEER CREEK ELEMENTARY
Sycamore Elementary 3RD-4TH grade: All students eligible for the Bilingual Program from Sycamore will
attend Sycamore Elementary School. Students from Poynter, Deer Creek, and Bess Race may remain at
Sycamore under the following conditions.


Previously enrolled in a bilingual program at Sycamore
Sibling is already attending the bilingual program at Sycamore
PK (Full Day) -4th VIETNAMESE BILINGUAL PROGRAM

District Vietnamese Bilingual Program PreK-4th grade: All students district-wide that are eligible for the
Bilingual Program in Vietnamese in grades Pre-K-4 will attend Jackie Carden Elementary School.
En sus esfuerzos para no promover la discriminación, Crowley ISD no discrimina en base a la raza, religión, color de la piel, nacionalidad, sexo o discapacidad proveyendo los servicios y los
programas educativos, incluyendo los programas de formación profesional, de acuerdo con el Título VI de la Ley de los Derechos Civiles de 1964 y sus modificaciones; Título IX de las Enmiendas
Educacionales de 1972; y la Sección 504 de la Ley de Rehabilitación de 1973 y sus modificaciones.
2016-17 Crowley ISD
Student Placement for
Language Support Programs
5TH-6TH SPANISH ONE-WAY DUAL LANGUAGE PROGRAM FOR FEEDER SCHOOLS

David L. Walker Feeder Bilingual Program 5-6th grade: All students eligible for the Bilingual Program from
the following campuses in grades 5 and 6 will attend David Walker Intermediate.
David Walker Intermediate-Home
Campus

SH Crowley Intermediate-Home Campus
Mary Harris Feeder Bilingual Program 5-6th grade: All students eligible for the Bilingual Program from the
following campuses in grades 5 and 6 will attend Mary Harris Intermediate School.
Mary Harris Intermediate-Home
Campus
Sue Crouch Intermediate-Home Campus
5th-6th VIETNAMESE BILINGUAL PROGRAM

District Vietnamese Bilingual Program 5th-6th grade: will be held at Mary Harris Intermediate. All students
district-wide that are eligible for the Bilingual Program in Vietnamese in grades 5-6 will attend Mary Harris
Intermediate School.
ESL PROGRAMS




All elementary campuses will continue to offer an ESL program for students in Pre-K-6th grade.
Middle School –All middle school campuses will offer the ESL program.
Newcomers program will be held at HF Stevens Middle School
High Schools:
o
o
Both NCHS 9th and CHS 9th Grade campuses will offer an ESOL I and Sheltered Instruction classes, as
needed.
Both NCHS and CHS campuses will offer ESOL I and II as well as Sheltered Instruction classes as
needed.
Student enrollment at each program location is subject to classroom size limits based upon guidelines established by the
Texas Education Agency.
Campuses will offer the Spanish and Vietnamese Bilingual Program first before offering ESL for students
with Spanish or Vietnamese documented on the Home Language Survey. Bilingual Program Benefits form
must be provided and kept in the LEP Red Folder/Permanent Records, for Bilingual Program denials.
In its efforts to promote nondiscrimination, Crowley ISD does not discriminate on the basis of race, religion, color, national origin, gender, or
disability in providing education services, activities, and programs, including vocational programs, in accordance with Title VI of the Civil Rights Act
of 1964, as amended; Title IX of the Educational Amendments of 1972; and Section 504 of the Rehabilitation Act of 1973, as amended.
3(,06'DWD6WDQGDUGV
$SSHQGL[) (WKQLFLW\DQG5DFH5HSRUWLQJ*XLGDQFH
Exhibit 1A
Texas Education Agency
Texas Public School Student/Staff Ethnicity and Race Data Questionnaire
The United States Department of Education (USDE) requires all state and local education institutions to
collect data on ethnicity and race for students and staff. This information is used for state and federal
accountability reporting as well as for reporting to the Office of Civil Rights (OCR) and the Equal
Employment Opportunity Commission (EEOC).
School district staff and parents or guardians of students enrolling in school are requested to provide this
information. If you decline to provide this information, please be aware that the USDE requires school
districts to use observer identification as a last resort for collecting the data for federal reporting.
Please answer both parts of the following questions on the student’s or staff member’s ethnicity and race.
United States Federal Register (71 FR 44866)
Part 1. Ethnicity: Is the person Hispanic/Latino? (Choose only one)
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Not Hispanic/Latino
Part 2. Race: What is the person’s race? (Choose one or more)
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Texas Education Agency – March 2010
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Exhibit 1B
Agencia de Educación de Texas
Cuestionario de Información de Datos Raciales y de Etnicidad de Estudiantes/Miembros de Personal de las
Escuelas Públicas de Texas
El Departamento de Educación de Estados Unidos (USDE) requiere que todas las instituciones estatales y
locales de educación, recopilen datos sobre etnicidad y raza de los estudiantes y de miembros de personal.
Esta información es utilizada para los reportes estatales y federales así como para reportar a la Oficina de
Derechos Civiles (OCR) y a la Comisión de Igualdad en el Empleo (EEOC).
Al personal del distrito escolar y los padres o representante legal de estudiantes que deseen matricularse
en la escuela, se le requiere proporcionar esta información. Si usted rehúsa proporcionarla, es importante
que sepa que el USDE requiere que los distritos escolares usen la observación para identificación como
último recurso para obtener estos datos utilizados para reportes federales.
Favor de contestar ambas partes de las siguientes preguntas sobre la etnicidad y raza del estudiante así
como del miembro de personal. Registro Federal de Estados Unidos (71 FR 44866).
Parte 1. Etnicidad: ¿Es la persona Hispana/Latina? (Escoja solo una respuesta)
Hispano/Latino –8QDSHUVRQDGHRULJHQFXEDQRPH[LFDQRSXHUWRUULTXHxRFHQWURRVXGDPHULFDQRRGHRWUD
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No Hispano/Latino
Parte 2. Raza. ¿Cuál es la raza de la persona? (Escoja uno o más de uno)
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Agencia de Educación de Texas – Marzo 2010
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A person standing in parental relation of a minor student residing in the district but whose parent,
guardian, or other person having lawful control under a court order does not reside in the district shall
present a Power of Attorney assigning responsibility for the student in all school-related matters to an
adult resident of the district. [FD(Local)]
The purpose of a Power of Attorney is to afford an adult resident of the school district power and
authority to act in all school-related matters for the parent of the named minor(s). The following are
specific acts and powers that are granted by this Power of Attorney:
1. To receive and discuss the student’s class work with appropriate District personnel.
2. To examine and receive copies of student’s records and report cards from the District.
3. To give parental permission for the student’s participation in various activities, such as, but not
limited to, field trips and travel for extracurricular activities.
4. To be notified concerning medical problems, if the parent cannot be contacted, to give consent for
the care and treatment of the student.
5. To be notified and consulted concerning the student’s attendance and tardiness.
6. To represent the student in any disciplinary action initiated by the District.
7. To give permission, if required, for disciplinary actions involving the student.
8. To perform any other duties, responsibilities, and privileges normally afforded to the parents of
students in the District, including those for a student referred to or served by the district’s
program for students with disabilities.
Forms to be completed:
1. Complete Eligibility and Admissions Requirements Form
2. Complete Application for Guardianship
3. Complete Circumstances Necessary for Guardianship Change
4. Complete statement establishing who is responsible for financial support, morals, discipline,
medical care, behavior at school, etc. of the student
5. Acceptance of Power of Attorney
The Eligibility and Admissions Requirements and the Acceptance of Power of Attorney forms (pages 3
and 8) must be notarized. The building principal must review the guardianship request before submitting
to the Student Services, Office of the Deputy Superintendent for approval.
The district is not required to admit a student under the Texas Education Code 25.001(b) (4) and (d) if the
student:
1. has engaged in conduct or misbehavior with in the preceding year that has resulted in :
a. removal to a disciplinary alternative education program
or
b. expulsion;
2. has engaged in delinquent conduct or conduct in need of supervision and is on probation or other
conditional release for that conduct; or
3. has been convicted of a criminal offense and is on other conditional release.
This applies only if a student is living in a different district than the student’s parent, legal guardian, or
other person with lawful control of the child under a court order.
Revised July 2013
Page 1 of 8
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CROWLEY, TEXAS 76036
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ACCEPTANCE OF POWER OF ATTORNEY
(Guardian)
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Principal’s Signature
Date
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Page 8 of 8
Exhibit A
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NOTICE TO PERSON ENROLLING STUDENT: A person who knowingly falsifies information on a form required for a
student’s enrollment in the District shall be liable to the District for tuition or other costs, as provided in Education Code
25.001(h), if the student is not eligible for enrollment but is enrolled on the basis of false information. In addition,
presenting false information or false records is a criminal offense under Penal Code 37.10.
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To be completed by the parent or guardian
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Page 1 of 5
Exhibit A
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,VKDOODVVXPHUHVSRQVLELOLW\IRUWKHVXSHUYLVLRQRIWKLVFKLOGIRUWKHSXUSRVHRISURYLGLQJDIWHUVFKRROFDUHDVGHVFULEHGLQ,WHP
DERYH
6LJQDWXUHRIJUDQGSDUHQW$IILDQW
STATE OF TEXAS
COUNTY OF TARRANT
68%6&5,%('$1'6:25172%()25(0(RQWKLVWKH
GD\RI
(Notary Seal)
6WXGHQW¶VQDPH
&DPSXV
$SSURYHG
'HQLHG
Campus Administrator’s Signature
Date
The Superintendent or designee may rescind a student’s intra-district transfer if the student does not comply with District and/or
campus policies, rules, and regulations. A student’s failure to abide by all the communicated federal, state, and local policies and
rules, including those found in the Student Code of Conduct and the Student Handbook, shall be grounds for the Superintendent
or designee to rescind the student’s transfer. A student’s withdrawal shall be grounds for the Superintendent or designee to
rescind the student’s transfer. Falsification of information shall cause the student’s transfer to be denied or rescinded during the
term of the transfer agreement.
Revised July 2013
Page 2 of 5
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,1)250$7,21 )25NON- RESIDENT 678'(17
,1$*5$1'3$5(176 $)7(56&+22/&$5(
NOTICE TO PERSON ENROLLING STUDENT: A person who knowingly falsifies information on a form required for a
student’s enrollment in the District shall be liable to the District for tuition or other costs, as provided in Education Code
25.001(h), if the student is not eligible for enrollment but is enrolled on the basis of false information. In addition,
presenting false information or false records is a criminal offense under Penal Code 37.10.
%()25(0(WKHXQGHUVLJQHGQRWDU\SXEOLFSHUVRQDOO\DSSHDUHG
DQG
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To be completed by the parent or guardian
,DPRYHU\HDUVRIDJHDQGDPOHJDOO\FRPSHWHQWWRWHVWLI\,KDYHSHUVRQDONQRZOHGJHRIWKHIDFWVVHWIRUWKKHUHLQDQGWKH\
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7KLVFKLOGDQG,UHVLGHDW
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,DXWKRUL]HWKHHPSOR\HHVRIWKH&URZOH\,QGHSHQGHQW6FKRRO'LVWULFWWRFRQWDFWWKHFKLOG¶VJUDQGSDUHQWLGHQWLILHGEHORZIRU
QRQHPHUJHQF\SXUSRVHVFRUUHVSRQGHQFHIURPFDPSXV± HJUHSRUWFDUGVSKRQHFDOOVDOHUWQRZWUDQVFULSWVQHZVOHWWHUVHWF
FRQWDFWIRUHPHUJHQF\SXUSRVHVVKDOOEHDV,KDYHLQGLFDWHGRQWKH'LVWULFW¶V(PHUJHQF\&RQWDFW,QIRUPDWLRQ&DUG
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68%6&5,%('$1'6:25172%()25(0(RQWKLVWKHBBBBBBBBBBGD\RI
6WXGHQW¶VQDPH
&DPSXV
SEE THE FOLLOWING PAGE FOR GRANDPARENT DOCUMENTATION
Revised July 2013
Page 3 of 5
([KLELW%
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DQGWKH\DUHWUXHDQGFRUUHFW
0\QDPHLV
,DPWKHJUDQGSDUHQWRIWKLVFKLOG
,UHVLGHDW
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,VKDOODVVXPHUHVSRQVLELOLW\IRUWKHVXSHUYLVLRQRIWKLVFKLOGIRUWKHSXUSRVHRISURYLGLQJDIWHUVFKRROFDUHDVGHVFULEHGLQ,WHP
DERYH
6LJQDWXUHRIJUDQGSDUHQW$IILDQW
STATE OF TEXAS
COUNTY OF TARRANT
68%6&5,%('$1'6:25172%()25(0(RQWKLVWKH
GD\RI
(Notary Seal)
6WXGHQW¶VQDPH
&DPSXV
$SSURYHG
'HQLHG
Campus Administrator’s Signature
Date
The Superintendent or designee may rescind a student’s interdistrict transfer if the student does not comply with District and/or
campus policies, rules, and regulations for the next school year. Transfers may also be rescinded if class size exceeds state
guidelines, facilities become overcrowded, or other reasons deemed to be in the best interest of the District or campus for the next
school year. A student’s failure to abide by all the communicated federal, state, and local policies and rules, including those found
in the Student Code of Conduct and the Student Handbook, shall be grounds for the Superintendent or designee to rescind the
student’s transfer for the next school year. A student’s withdrawal shall be grounds for the Superintendent or designee to rescind
the student’s transfer for the next school year. Falsification of information shall cause the student’s transfer to be denied or
rescinded during the term of the transfer agreement.
Revised July 2013
Page 4 of 5
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$)7(56&+22/&$5()25 NON-RESIDENT
127,&(723(5621(152//,1*678'(17$SHUVRQZKRNQRZLQJO\IDOVLILHVLQIRUPDWLRQRQDIRUPUHTXLUHGIRUD
VWXGHQW¶VHQUROOPHQWLQWKH'LVWULFWVKDOOEHOLDEOHWRWKH'LVWULFWIRUWXLWLRQRURWKHUFRVWVDVSURYLGHGLQ(GXFDWLRQ&RGH
K LI WKH VWXGHQW LV QRW HOLJLEOH IRU HQUROOPHQW EXW LV HQUROOHG RQ WKH EDVLV RI IDOVH LQIRUPDWLRQ ,Q DGGLWLRQ
SUHVHQWLQJIDOVHLQIRUPDWLRQRUIDOVHUHFRUGVLVDFULPLQDORIIHQVHXQGHU3HQDO&RGH
STATE OF TEXAS
COUNTY OF TARRANT
KNOW ALL BY THESE PRESENTS:
(parent), of
That I,
,
do
hereby
(name of attorney-in-fact), as my true and lawful attorney-in-fact for
appoint
me and in my name, place, and stead to take any and all actions and exercise any and all powers that I could take or exercise for the purpose of
(student), in attendance in
my child,
Crowley Independent School District as set forth below.
The following acts and powers are granted by this Power of Attorney:
1. To receive and discuss the student's class work with appropriate District employees.
2. To examine and receive copies of the student's Crowley Independent School District records and report cards.
3. To give permission for the student's participation in various activities such as, but not limited to, field trips and other student travel.
4. To be notified concerning medical problems and to give consent for the care and treatment of the student.
5. To be notified and consulted concerning the student's attendance and tardiness.
6. To give permission for any disciplinary actions involving the student by District employees.
7. To perform any other duties, responsibilities, and privileges normally afforded to the parents of students in the District.
I hereby ratify and confirm whatever such attorney-in-fact shall and may do on behalf of the student by virtue of this Power of Attorney. This
Power of Attorney may be voluntarily revoked in writing. A copy of any written revocation
will be delivered to Crowley Independent School District within five calendar days of revocation. I declare that all powers given to my
academic year, unless sooner revoked in writing.
attorney-in-fact shall be exercisable by my attorney-in-fact only for the
IN WITNESS WHEREOF, I have hereunto set my hand this the
day of
,
.
Parent
67$7(2)7(;$6
&2817<2)7$55$17
BEFORE ME, the undersigned authority, on this day personally appeared
, known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to
me that (he) (she) executed the same for the purposes therein expressed.
GIVEN under my hand and seal of office on this the
day of
,
.
Notary Public, State of Texas
(Notary Seal)
Revised July 2013
Page 5 of 5
Exhibit C
6+$5('5(6,'(1&< $&.12:/('*(0(17
127,&(723(5621(152//,1*678'(17$SHUVRQZKRNQRZLQJO\IDOVLILHVLQIRUPDWLRQRQDIRUPUHTXLUHGIRUDVWXGHQW¶VHQUROOPHQWLQWKH
'LVWULFWVKDOOEHOLDEOHWRWKH'LVWULFWIRUWXLWLRQRURWKHUFRVWVDVSURYLGHGLQ(GXFDWLRQ&RGHKLIWKHVWXGHQWLVQRWHOLJLEOH IRUHQUROOPHQWEXWLV
HQUROOHGRQWKHEDVLVRIIDOVHLQIRUPDWLRQ,QDGGLWLRQSUHVHQWLQJIDOVHLQIRUPDWLRQRUIDOVHUHFRUGVLVD FULPLQDORIIHQVHXQGHU3HQDO&RGH
Homeowner’s Name
Homeowner’s Address
(Street)
(City)
(State)
(Zip)
and his/her child/children,
1.
who wishes to attend (name of school),
2.
3.
reside with me and my family at the same address.
Reason
(Please use reverse side of this sheet for additional comments)
Parent’s/Guardian’s Previous Address:
Length of Time at Present Address:
Length of Time at Previous Address:
Check the box that best describes with whom the student resides
Parent(s)
Legal Guardians(s)
CISD Approved Guardianship or Grandparent After-School Caregiver
Homeowner’s relationship to student/parent:
Signature of Homeowner
Signature of Parent
:KHQWKHUHDUHFKLOGUHQUHTXHVWLQJDWWHQGDQFHDWPRUHWKDQRQHFDPSXVSOHDVHVXEPLWWKLVIRUPWRWKHROGHVWFKLOG¶VFDPSXVILUVW
State of Texas
County of Tarrant
Before me,
, a notary public, on this day personally appeared
____________________________________________, known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to
me that he/she executed the same for the purpose and consideration therein expressed.
Given under my hand and seal of office this __________ day of ____________________, 20________.
_________________________________________
Notary Public Signature
(Notary Seal)
&DPSXV$SSURYDO
Date
Date
Date
Revised July 2013
Approved
Not Approved
Approved
Not Approved
Approved
Not Approved
0F.LQQH\9HQWR+RPHOHVV$VVLVWDQFH$FW
:KRLVFRQVLGHUHGKRPHOHVV"
The USDE Federal McKinney-Vento Homeless Assistance Act says that children and youth who:
9 Lacks fixed, regular and adequate nighttime residences are homeless.
9 Have a primary nighttime residence not designed for ordinary use as regular sleeping accommodations
are homeless.
9 Live in substandard housing are homeless.
9 Is a part of a family living in doubled-up situations because they have lost their housing are homeless.
9 Live in hotels/motels are homeless.
9 Live in shelters are homeless.
9 Are abandoned in hospitals are homeless.
9 Are awaiting Foster care are homeless.
9 Live in abandoned buildings, parks, bus, and train stations, & other public places are homeless.
9 Live in cars or on the streets are homeless.
512 Peach Street Crowley Texas 76036-3119
817.297.5800 Phone
817.297.5805 Fax
z
z
z
z
z
Acknowledgment of Electronic Distribution of
Student Handbook and the Student Code of Conduct
My child and I have been offered the option to receive a paper copy of or to electronically
access at www.crowleyisdtx.org the Crowley Independent School District Student
Handbook and the Student Code of Conduct for 2016–2017 school year.
I have chosen to:
Receive a paper copy of the Student Handbook and the Student Code of Conduct.
Accept responsibility for accessing the Student Handbook and the Student Code of
Conduct by visiting the Web address listed above.
I understand that the handbook contains information that my child and I may need during the
school year and that all students will be held accountable for their behavior and will be subject
to the disciplinary consequences outlined in the Student Code of Conduct. If I have any
questions regarding this handbook or the Code of Conduct, I should direct those questions to
the principal.
Printed name of student:
Signature of student:
Signature of parent:
Date:
Please Print All Information
Exhibit C
2016-2017 Affidavit of Residency
One Student Per Form
Date:
School Name:
NOTICE TO PERSON ENROLLING STUDENT: A person who knowingly falsifies information on a form required for a student’s enrollment in the
District shall be liable to the District for tuition or other costs, as provided in Education Code 25.001(h), if the student is not eligible for enrollment but is
enrolled on the basis of false information. In addition, presenting false information or false records is a criminal offense under Penal Code 37.10.
Required Documentation:
a) Valid picture ID with new address; or
b) Mail or other documents (e.g. bank statement, payroll stub, government forms [Medicaid], etc.) with new address.
c) Homeowner’s utility bill (water, electric, and gas) with current address, disconnect notice will not be accepted.
d) Both parent and homeowner must be present.
e) If the residence is an apartment, student must be listed as an occupant on the lease.
Homeowner’s Name
Homeowner’s Address
(Street)
(City)
(State)
(Zip)
and his/her child/children,
reside with me and my family at the same address.
Reason
(Please use reverse side of this sheet for additional comments)
Parent’s/Guardian’s Previous Address:
Length of Time at Present Address:
Length of Time at Previous Address:
Check the box that best describes with whom the student resides.
Parent(s)
Legal Guardians(s)
CISD Approved Guardianship or Grandparent After-School Caregiver
Homeowner’s relationship to student/parent:
The signatures below reflect that every statement made on this document is true and reflect the full understanding and agreement with the following:
1. The parent is currently residing at the above stated address.
2. If the parent moves from the listed address, then school officials will be notified immediately.
3. In addition to the penalty provided by Section 37.10 of the Penal Code, a person who knowingly falsifies information is liable to the district if the
student is not eligible for enrollment into that district, but enrolled on the basis of false information. The Parent is liable, for the period which the
ineligible child is enrolled, for the full amount of tuition.
4. This form is valid for current school year only and must be renewed each year.
Signature of Homeowner
Signature of Parent
State of Texas
County of Tarrant
Before me,
, a notary public, on this day personally appeared
____________________________________________, known to me to be the person whose name is subscribed to the foregoing instrument and acknowledged to
me that he/she executed the same for the purpose and consideration therein expressed.
Given under my hand and seal of office this __________ day of ____________________, 20________.
_________________________________________
Notary Public Signature
(Notary Seal)
Campus Approval:
Approved
Revised June 2015
Not Approved
Date
Registration Personnel Initials
Please Print All Information
Exhibit C
2016-2017 Affidavit of Residency (Declaración de Residencia para 2016-2017)
One Student Per Form (Utilice un Formulario por estudiante)
Fecha:
Nombre de la escuela:
AVISO PARA LA PERSONA QUE VAYA A MATRICULAR AL ESTUDIANTE: La persona que a sabiendas falsifique información en un formulario
para matricular a un estudiante en distrito, será responsable ante el distrito por el importe de la matrícula u otros gastos, si el estudiante no fuera
elegible para ser matriculado en el Distrito y hubiera sido matriculado bajo información falsa, según lo dispuesto en el Código de Educación 25.001(h).
Además, presentar información falsa o documentos falsos es un delito bajo el Código Penal 37.10.
Documentos Obligatorios:
a) Identificación válida con fotografía, con la dirección nueva; o
b) Correo u otros documentos (p.ej., extracto bancario, recibo de la nómina, formularios del gobierno (Medicaid, etc.) con la dirección nueva.
c) Factura de las utilidades del propietario (agua, electricidad o del gas) con la dirección actual. El aviso de desconexión no será aceptado.
d) Ambos padres y el dueño de la casa deberán estar presentes.
e) Si la residencia fuera un apartamento, el estudiante deberá figurar en el contrato como inquilino.
Nombre del dueño de la casa
Dirección del dueño de la casa
(Calle)
(Ciudad)
(Estado)
(Código Postal)
y su hijo(s),
, los cuales desean asistir a (nombre de la escuela),
residen conmigo y mi familia en la misma dirección.
Razón
(Por favor, utilice el reverso de esta hoja para hacer comentarios adicionales)
Dirección previa de los padres o tutor:
¿Cuánto tiempo lleva residiendo en la dirección actual?
¿Cuánto tiempo estuvo residiendo en la dirección previa? _________________
Haga una marca en la casilla que describa mejor con quien está residiendo el estudiante:
Padres
Tutor legal
Tutor aprobado por CISD o con los abuelos después del horario escolar
¿Qué parentesco tiene el dueño de la casa con el estudiante o con los padres?:
Las firmas de la parte inferior indican que cada declaración hecha en este documento es verdadera y reflejan el entendimiento pleno y el acuerdo con lo siguiente:
1. Los padres residen actualmente en la dirección indicada en la parte superior.
2. Si los padres se mudaran de la dirección mencionada en la parte superior, los oficiales de la escuela serán notificados inmediatamente.
3. Además de la sección 37.10 del Código Penal, la persona que a sabiendas falsifique información es responsable ante el Distrito si el estudiante no fuera
elegible para ser matriculado en el mismo, pero hubiera sido matriculado bajo información falsa. Los padres serán responsables del importe total de la
matrícula si el estudiante no fuera elegible.
Firma del dueño de la casa
Firma del padre, madre o tutor
Estado de Texas
Condado de Tarrant
Ante mí,
, notary public, en este día se presentó personalmente
____________________________________________, según tuve conocimiento, que la persona cuyo nombre está suscrito en el instrumento anterior declaró ante
mí que él o ella firmó el documento con el propósito y la consideración aquí expresados.
Dado bajo mi firma y sello de esta oficina en el día __________ de 20________.
_________________________________________
Firma del Notary Public
(Notary Seal)
Campus Approval:
Approved
Revised June 2015
Not Approved
Date
Registration Personnel Initials
Notice Regarding Directory Information and
Parent’s Response Regarding Release of Student Information
State law requires the district to give you the following information:
Certain information about district students is considered directory information
and will be released to anyone who follows the procedures for requesting the
information unless the parent or guardian objects to the release of the directory
information about the student. If you do not want Crowley ISD to disclose
directory information from your child’s education records without your prior
written consent, you must notify the district in writing by within ten school days
of your child’s first day of instruction for this school year.
This means that the district must give certain personal information (called “directory
information”) about your child to any person who requests it, unless you have told the district
in writing not to do so. In addition, you have the right to tell the district that it may, or may not,
use certain personal information about your child for specific school-sponsored purposes. The
district is providing you this form so you can communicate your wishes about these issues. [See
Directory Information in the Student Handbook for more information.]
For the following school-sponsored purposes: Crowley ISD has designated the
following information as directory information:
x Student’s name
x Address
x Telephone listing
x E-mail address
x Photograph
x Date and place of birth
x Major field of study
x Degrees, honors, and awards received
x Dates of attendance
x Grade level
x Most recent school previously attended
x Participation in officially recognized activities and sports
x Weight and height, if a member of an athletic team
x Enrollment status
x Student identification numbers or identifiers that cannot be used alone to
gain access to electronic education records
Directory information identified only for limited school-sponsored purposes remains otherwise
confidential and will not be released to the public without the consent of the parent or eligible
student.
Parent: Please circle one of the choices below:
I, parent of ______________________________ (student’s name), (do give) (do not give) the
district permission to use the information in the above list for the specified school-sponsored
purposes.
Parent signature
Date
For all other purposes, Crowley ISD has designated the following information as
directory information:
x Student’s name
x Address
x Telephone listing
x E-mail address
x Photograph
x Date and place of birth
x Major field of study
x Degrees, honors, and awards received
x Dates of attendance
x Grade level
x Most recent school previously attended
x Participation in officially recognized activities and sports
x Weight and height, if a member of an athletic team
x Enrollment status
x Student identification numbers or identifiers that cannot be used alone to
gain access to electronic education records
Parent: Please circle one of the choices below:
I, parent of ______________________________ (student’s name), (do give) (do not give) the
district permission to release the information in this list in response to a request unrelated to
school-sponsored purposes.
Parent signature
Date
Parent’s Objection to the Release of Student Information to Military Recruiters
and Institutions of Higher Education
Parent’s Response Regarding Release of Student Information to Military
Recruiters and Institutions of Higher Education
Federal law requires that the district release to military recruiters and institutions of higher
education, upon request, the name, address, and phone number of secondary school students
enrolled in the district, unless the parent or eligible student directs the district not to release
information to these types of requestors without prior written consent. [See Release of
Student Information to Military Recruiters and Institutions of Higher Education in the Student
Handbook for more information.]
Parent: Please complete the following only if you do not want your child’s information released
to a military recruiter or an institution of higher education without your prior consent.
I, parent of ______________________________ (student’s name), request that the district not
release my child’s name, address, and telephone number to a military recruiter or institution of
higher education without my prior written consent.
Parent signature
Date
TO: Persons Enrolling Students Under 11 Years Enrolling For the First Time in Crowley ISD
Texas Criminal Code, Article 63.019, requires that when a student under 11 years of age enrolls for the first time at
a school, the person enrolling the child should provide the name of each previous school attended by the child.
Crowley ISD will request verification from each previous school of the child’s name, address, birth date, grades,
and dates attended.
In addition, Texas Criminal Code requires that the person enrolling the student provide:
(1) A copy of the child’s birth certificate; or
(2) Other legal proof of the child’s identity and age, and a signed statement explaining the person’s inability to
produce a copy of the birth certificate.
If the person enrolling the student does not provide the documentation required above within 30 days, the
school will notify the local police department. The police department will check the missing children’s
clearinghouse to determine if the child has been reported missing.
Please provide the following:
Student’s Legal Name___________________________________________________________
Student’s Date of Birth__________________________________________________________
No
Birth Certificate provided: Yes
or
Other legal proof of identity and age, and signed statement: Yes
No
Statement: I am not able to provide a birth certificate because:__________________________
____________________________________________________________________________
Schools in which student have previously been enrolled:
1. School Name____________________________________________________________
Address________________________________________________________________
2. School Name____________________________________________________________
Address________________________________________________________________
3. School Name____________________________________________________________
Address________________________________________________________________
Signature: ________________________________________
Date:____________________
Para: La persona que vaya a matricular a un estudiante menor de 11 años de edad Se está matriculando
por primera vez en Crowley ISD
El Código Penal de Texas, Artículo 63.019 exige que cuando se vaya a matricular en la escuela a un estudiante menor de 11
años de edad, la persona que vaya a matricular al niño(a) deberá proporcionar el nombre de las escuelas a las cuales el
estudiante haya asistido previamente. Crowley ISD solicitará de cada escuela previa el nombre del niño(a), la dirección, la
fecha de nacimiento, las calificaciones y las fechas de asistencia.
Además, el Código Penal de Texas exige que la persona que vaya a matricular al estudiante proporcione:
(3) Una copia de la partida de nacimiento del niño(a), u
(4) Otra prueba legal de la identidad del niño(a) y la edad, así como una declaración firmada que explique la razón por la
cual esta persona no puede presentar una copia de la partida de nacimiento del niño(a).
Si la persona que está matriculando al estudiante no proporcionara la documentación exigida dentro de un periodo de
30 días, la escuela notificará al departamento de policía local. El departamento de policía verificará la base de datos de los
niños desaparecidos para determinar si el niño(a) fue reportado como desaparecido.
Por favor, provea lo siguiente:
Nombre legal del estudiante______________________________________________________________
Fecha de nacimiento del niño(a) __________________________________________________________
¿Proporcionó la partida de nacimiento? Sí
No
o
No
¿Proporcionó otra prueba legal de la identidad, la edad y la declaración firmada? Sí
Declaración: No puedo proporcionar la partida de nacimiento porque: _____________________________
_____________________________________________________________________________________
Escuelas en las que estuvo previamente matriculado el estudiante:
4.
Dirección_______________________________________________________________________
5.
Dirección_______________________________________________________________________
6.
Dirección_______________________________________________________________________
Firma: ________________________________________
Fecha: ____________________

registration/enrollment information 2016 - 2017

Transcripción

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