Warner High School 2017-18 Enrollment Packet
Grades 7-12
Any student that will be enrolling for the first time in the Warner Public School System will need to bring the following items:
1. Birth Certificate
2. Social Security Card
3. CDIB Card- if applicable (Blue Card from Cherokee Nation Members)
4. Up-to-date shot/immunization record (students may not enroll until all immunizations are current)
5. 7th Grade students must have TDAP immunization (may not enroll until immunized)
6. Up-to-date transcript
7. Withdrawal Grades-- If students is enrolling during school year
8. Freshman must have college preparatory curriculum SB 982 or state graduation requirements form checked and signed
9. Proof of residence—utility bill or lease agreement with physical address (no post office box) to show proof of residency in district
10. E-mail Contact for Parent/Guardians
(New Students Only)
Request for Records from Previous School
Name of studentGrade
Former School
Address
Phone # / Fax #
Does your student have an IEP? Yes No
Parents/Guardians:
Attached is your enrollment packet. Thank you for helping us keep all information current for student information, parent contacts, and Oklahoma State Department of Education Reporting.
1. Student Enrollment Form: All information is needed for student demographics and state department coding and reports. Please ensure accuracy in all fields.
2. Medical Information: Include all medical information for your student. This information enables us to properly assist your student in the event of an emergency. Please mark your student’s name on the medicine container so it may be locked in our high school vault. Information from this form will be used when your student is on activity trips or in need of care.
3. Bus Form/ Image Release: Bus form is for all students in our school system. We occasionally transport students to various activities during the school day, activity trips, competitions, or regular route bus students. The image release is to allow us to use your student’s image on publications, including printed literature, our website, or other forms of media.
4. Home Language Survey: State Department of Education Survey Form. Required for all students in Oklahoma Public Schools.
5. 506 Form-- Indian Education Program: Student Eligibility Certification Form to meet requirements set forth under the elementary and Secondary Education Act, Title VII, Part A. If your child does not qualify, please list name of child and N/A across this form.
6. Title I- Parent Compact Form
7. Impact Aid Documentation- Any patron who is employed by the federal government, live on federal land, military employees or VA employees. If you live in a home that is on Indian Land, please return the documentation.
8. Child Nutrition Form-- Check front and back of all sheets: If you feel that you DO NOT qualify for free/reduced meals, please go to “Attachment C” and list your child’s name, grade, N/A, and sign the form.
Yearbooks will be available for purchase during enrollment.
JOM supplies will be distributed for students in grades 7-12 only. We will not serve elementary students at this time.
All students will be presented with a Student Handbook during the first week of school. Students are encouraged to take this home with them to share with their parents/guardians.
Netbook cost will be $20. All students will need a netbook or personal computer.
17-18 Warner High School Student Enrollment Form- Please Print All Information
Date / SSN # / Parent/Guardian E-mailGrade / Secondary E-mail
Student’s Full Legal Name
First Middle Last
Race and Ethnicity Data-- Please Circle One or More
1. African American 4. Asian
2. American Indian 5. Pacific Islander
3. Unlisted 6. White Caucasian
Name of Tribe / Roll #Are you of Hispanic/Latino culture or origin? Yes No (please circle one)
Gender: (please circle one) Male Female
Date of Birth / AgeBirth Place
City County State/Country
Is either parent active in the military service? (please circle one) Yes No
Does either parent work on federally owned land? (please circle one) Yes No
Do you reside in Cherokee housing? (please circle one) Yes No
Does student live on a bus route? (please circle one) Yes No
Which route does student live on? (please circle one) Blue Green Red Purple
Who has legal custody of student?Please include copy of most recent documentation if not already on file
Relationship Coding- Circle one code for the person listed as the #1 parent/legal guardian.
1. Father, foster / 2. Father, natural / 3. Father, step / 4. Mother, foster / 5. Mother, natural / 6. Mother, step7. Adoptive parents / 8. Court Appointed Guardian / Please define other circumstances: ie
Grandparents, aunt/uncle, friend, etc / 9.
Parent/Guardian 1
Parent/Legal Guardian NameHome Mailing Address
Cell Phone / Alt. Phone #
Parent/Guardian 2
Parent/Legal Guardian NameHome Mailing Address
Cell Phone / Alt. Phone #
Emergency Contact Other Than Parent/Legal Guardian
Name / Relationship / Cell Phone # / Home Phone # / Work Phone #Warner Public Schools Student Medical Information (must be on file for all students)
Please list any facts concerning the student’s medical history including allergies, medications being taken and any physical impairment in which a physician should be alerted.
Insurance Company / Phone #Policy Holder / ID #
Employer / Plan #
Family Doctor / Phone #
Hospital: / Phone:
Contact Person (s)
Parent/Legal Guardian/Other / Cell Phone / Home Phone / Work PhoneConsent for Treatment of a Minor
DateI, / X / Being the parent/legal guardian of / (minor’s name)
Give my consent for emergency medical and surgical treatment of this minor in the event that such treatment becomes necessary. I grant my permission for treatment in a licensed hospital and/or clinic by a licensed physician, physician’s assistant or designee, including such hospital personnel as the physician may deem necessary. I understand that hospital personnel will make reasonable attempts to contact me before initiating treatment. The minor named in this consent form may receive all treatment provided according to generally accepted standards of medical practice.
Please list any restrictions to the above statement:
Initial here: X
This consent will remain effective while student is in attendance at Warner Public Schools.
Signature of Parent/Legal Guardian: X
DateREFUSAL TO CONSENT
I/We do not give consent for emergency medical treatment of (minor’s name) in the event of illness or injury requiring emergency treatment. I/We wish the school authorities to take no action.
Signature of Parent/Legal Guardian: Date:
The office will not be dispensing Aspirins, Tylenol, Cough Drops, etc. All prescription medicine that needs to be taken at school must be given to the office, must be in original container and must have complete, written instructions. It is advisable to send only the amount of medicine required for administration while at school.
Bus Policy 17-18
Parents:
Appropriate behavior on the school bus is vitally important for your child’s safety. You can imagine how difficult it is to concentrate on driving with 66 to 80 children behind you who are loud and disruptive. Because a distraction can cause a tragedy with injuries or death, we insist on good bus behavior.
RIDING THE BUS IS A PRIVILEGE, NOT A RIGHT!!! BELOW ARE THE BUS RULES, PLEASE GO OVER THEM WITH YOUR CHILD.
● Stand back from the street while waiting for the bus.
● Check the bus number (color) to make sure that you get on the right bus.
● Do not push or shove other students while waiting for the bus.
● If you drop something around the bus, leave it along and tell the bus driver. Stay away from the bus wheels, as they are very dangerous.
● Obey the bus driver.
● Do not fight, push or trip other students.
● Talk quietly (unless the bus driver says no talking at all).
● Do not be rude, discourteous or annoying to others / ● Always stay seated. Do not stand.
● Do not use profane language or obscene gestures.
● Do not hang out of the windows.
● Enter and leave the bus properly.
● No nuisance items.
● Do not destroy property.
● Do not tamper with bus equipment.
● Do not spit, litter, eat or drink on the bus.
● Behave in a safe, respectful way with consideration for the well being of others – on the bus and at the bus stop
CONSEQUENCES FOR NOT FOLLOWING BUS RULES:
● 1st Bus Conduct Report- Warning
● 2nd Bus Conduct Report- Off for 3 days
● 3rd Bus Conduct Report- Off for 10 days
● 4th Bus Conduct Report- Off for the rest of the school year
● Fighting can/will result in being off the bus immediately.
Students who ride school transportation to and/or from school, and/or activity trips must be enrolled on the bus through the office. Each student must follow the Bus Policy that outlines the rules for behavior while on school transportation. We encourage each rider and his/her parents to read the Bus Policy and follow the rules closely. Students who consistently fail to follow bus rules will face disciplinary action which includes the loss of riding privileges.
All buses are equipped with cameras.
Steps in discipline plan may be skipped, depending on severity of student’s actions.
Please sign and return this letter acknowledging receipt and review of bus policies.
X Student Name / Parent/Guardian SignatureConsent for Release of Photograph
Student photographs are taken for use in newspapers, yearbooks, websites, and other publications to recognize accomplishments, awards, participation, etc.
Please check one: Consent for use of photography of your student
Refuse consent for use of photography of your student. Refuse permission.
X Signature of Parent/Guardian / DateName of Student / Grade