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  • STUDENT ENROLLMENT APPLICATION FORM

    School Year 2021/2022
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  • Student's Name: *  *     Date of Birth: Pick a Date*   Age: *  Grade: *        

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  • PARENT INFORMATION

    Mother/Female Guardian Information
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  • PARENT INFORMATION Continued

    Father/Male Guardian Information
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  • EMERGENCY CONTACT INFORMATION

    In the event of an emergency, please contact the following in the order listed below
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  • 1       Relationship to Child:            Secondary Number:         

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  • 2       Relationship to Child:            Secondary Number:         

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  • 3       Relationship to Child:            Secondary Number:         

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  • 4       Relationship to Child:            Secondary Number:         

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  • 5       Relationship to Child:            Secondary Number:         

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  • Please note that individuals other than the parent will be required to provide a picture identification card before the student is released to them.  This is for safety and protection of your child.  If custody issues exist, we will require documentation to support this in the form of a court order, restraining order, etc. 

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  • TRANSPORTATION

    Pick-up/Drop-off information if needed. (Please Type N/A if not applicable)
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  • I verify that the information contained in this document is true and correct to the best of my knowledge. *   *   SIGNATURE: *   Pick a Date*   Relationship to Student: *.

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  • STUDENT IDENTIFICATION

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  • Student's Full Name:            

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  • Student's Place of Birth:

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  • Tribal Affiliation: Degree of Indian Blood          Dominant Language Spoken in the home:  

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  • FAMILY INFORMATION

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  • OTHER GUARDIAN INFORMATION

    If applies to student (Foster Parent(s), etc.)
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  •                                              

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  •                             

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  • PREVIOUS SCHOOL INFORMATION

    School(s) Previously Attended (if any)
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  • School Name:       Year(s) Attended:                         

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  •                     

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  • I am legally responsible for this student and hereby apply for his/her admission to this school. I understand that addition information may be requested by the school before the student is enrolled.      Pick a Date   

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  • STUDENT RESIDENCY VERIFICATION DOCUMENT

    This document is intended to address the McKinney-Vento Act. Your answers will help the school determine residency documents necessary for enrollment of this student.
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  • Signature of Parent/Legal Guardian:   *     Pick a Date*   

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  • This portion is for school use only

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  • If the parent has checked Section B above, completion of form is not required. For any choices in Section A, this form must be completed and provided to the School Registrar immediately after completion. Form will be kept separately from the Student's permanent Record for audit purposes during the school year.
    Name and phone number of a School Contact Person who may know of the family's situation:
                

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  • CONSENT FOR MEDICAL SERVICES

    Pueblo of Isleta Elementary School and the Pueblo of Isleta health Center
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  • The Pueblo of Isleta Elementary School is asking you to complete this form in order to arrange for or provide health care services and education for your child/children while attending school. This includes medical, dental care and especially emergency services.
    We understand that some children do not receive health care services from the Pueblo of Isleta Health Clinic. In the event of a medical emergency, the Pueblo of Isleta Emergency Medical Technicians are called and will administer first aid and possibly transport your child for medical care. In the event of an emergency, the parent or other emergency contact will be notified as soon as possible.
    The Isleta Diabetes Program provides nutrition awareness to our students and tracks their fitness level. The Pueblo of Isleta Community Health Nurse and Health Educator provide health education to our students in a variety of topics such as nutrition, healthy lifestyle choices and puberty education.
    Our Community Health Nurse also performs head lice checks routinely. Student immunization records are also reviewed to ensure that students are up to date with their shots. As a parent, you can specify exceptions or special instructions in the space provided below. This information is used for future promotion planning. The Pueblo of Isleta Health Clinic/Pueblo of Isleta Elementary School may provide the following services:

    1. Emergency Health Care fo accidents or illness.
    2. Transportation of the child to another health facility for these services.
    3. Health education such as diabetes awareness, head lice, nutrition,etc. 
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  • Student's Name:       Date of Birth:Pick a Date   Grade:       

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  • Parent/Guardian Signature:   *   Pick a Date*   

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  • MEDIA PERMISSION SLIP

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  • Grade:        

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  • Parent/Guardian Signature:      Pick a Date   

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  • WALKING PERMISSION SLIP

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  • Grade:         

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  • Parent/Guardian Signature:   *   Pick a Date*   

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  • INTERNET, ELECTRONIC MAIL AND COMPUTER PERMISSION FORM FOR PUEBLO OF ISLETA ELEMENTARY SCHOOL STUDENTS

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  • he Pueblo of Isleta Elementary School is pleased to offer students access to a computer network for electronic mail ( e-mail) and the Internet, all students must obtain parental permission as verified by the signature on the attach form.

    Pueblo of Isleta Elementary School Rules for Use of Computers, the Internet and Electronic (e-mail):

     

    1. DO NOT use a computer to harm other people or their work.
    2. DO NOT damage the computer or the network in any way. This includes not damaging the computer keyboard, mouse, mousepad or monitor. any student who damages computer equipment will lose the privilege to use school computers and will have to pay for repairs.
    3. DO NOT create, view, send or display offensive, inappropriate messages or pictures - Profane, abusive, or impolite language should not be used to communicate, nor should materials be accessed which are not in line with the rules of school behavior.
    4. DO NOT trespass in another's folder, work or files.
    5. NOTIFY an adult immediately if you or another student encounter inappropriate materials or language.
    6. BE PREPARED to be held accountable for your actions and for the loss of privileges if the Rule of Appropiate Use are violated.

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  • Parent Name:   *   *   
    Parent Signature:   *   Pick a Date*   

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  • HOME LANGUAGE SURVEY

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  • Grade:       

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  • Dear Parents and Guardians:

     

    In order to help your child, succeed in school, we ask that you please answer the following questions for each child in your family. Your answers will help us in creating the best possible educational program for your child's language development skills.

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  • The information in the below section is to be filled in by the person completing this form:

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  • Information was completed by:         
    Parent Signature:      Pick a Date   

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  • Relationship to child:    

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  • This Document will be kept in the student's file per Family Educational Rights and Privacy Act Regulations. If you have any questions, please contact the front office 505-869-2321.

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  • SCREENING CONSENT FORM

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  • I give permission for my child to participate in the free vision, dental, and hearing screening programs provided at the school.

     

    I understand the follwing regarding this program:

     

    I. There is no charge for my child to participate in these screening programs.


    II. The information obtained from this screening is preliminary only and does not constitute a diagnosis.


    III. I will be contacted by the school or by my child's teacher, school administrators, or directors should my child be referred for further evaluations.

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  • Name of Parent/Guardian:   *   *   
    Signature of Parent/Guardian:   *   Pick a Date*   

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  • LUNCH PROGRAM

    Information Regarding The Pueblo of Isleta Elementary School Free Lunch Program
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  • HEALTH PLAN/MEDICATION ADMINISTRATION

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  • Classroom:    

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  • PERMISSION TO ADMINISTER MEDICATION

     

    I hereby give permission to the Pueblo of Isleta Elementary School to administer medication as prescribed above.  I have administered at least one does of medication to my child without any adverse effects.

    Note:  If your child refuses medication, parents will be notified.  There is no medication disposal here at the Elementary School.  Should medication run out or expire, parents will be notified to pick up medication.

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  • Parent/Guardian Signature:      Pick a Date   Parent/Guardian Printed Name:                              

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  • Health Assistant Signature:      Pick a Date   

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  • Teaching Staff Signature(s):
       Pick a Date   
       Pick a Date   
       Pick a Date   

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  • FIELD TRIP MEDICATION RELEASE FORM

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