PPEP TEC HIGH SCHOOL 2022-23 Enrollment Packet (English)

PPEP TEC HIGH SCHOOL

2022-2023 School Year
STUDENT ENROLLMENT FORMS
*Students must be between the ages of 14-21 and have an 8th grade diploma to be considered for enrollment.*
STUDENT'S NAME *
NAME OF PREVIOUS SCHOOL ATTENDED *
Location of PPEP TEC High School *
LIST OF REQUIRED DOCUMENTS
The FOLLOWING DOCUMENTS MUST BE SUBMITTED FOR ENROLLMENT IN PPEP TEC HIGH SCHOOL
FOR ENROLLMENT

1 ALL DOCUMENTS IN THIS ENROLLMENT PACKET MUST BE COMPLETED AND SIGNED BY PARENT/GUARDIAN/STUDENT AND SCHOOL OFFICIAL- - WHERE NOTED BIRTH CERTIFICATE, PASSPORT, BAPTISMAL CERTIFICATE. OR ANY OTHER LEGAL DOCUMENT SHOWING LOCATION OF BIRTH AND NAME DF PARENTS IMMUNIZATION RECORDS/EXEMPTION DOCUMENTATION-VERIFIED BY A MEDICAL OFFICIAL-THESE DOCUMENTS ARE REQUIRED TO ATTEND SCHOOL BUT ARE NOT A REQUIREMENT FOR ENROLLMENT
PROOF OF RESIDENCY: UTILITY Bill. COPY OF LEASE. NOTARIZED LETTER BY HOMEOWNER. GOVERNMENT ISSUED ID CARD. PROPERTY TAX BILL. BANK OR CREDIT CARD STATEMENT. PAYROLL STUB. CERTIFICATE OF TRIBAL ENROLLMENT. DOCUMENT FROM A STATE OR FEDERAL GOVERNMENT AGENCY
WITHDRAWAL FORM: FROM PREVIOUS HIGH SCHOOL -This Document Is A Requirement To Attend School. But Is Not A Requirement For Enrollment OFFICIAL TRANSCRIPTS-CERTIFIED "OFFICIAL" IN A SEALED ENVELOPE FROM PREVIOUS SCHOOL [] SPECIAL EDUCATION RECORDS-FROM PREVIOUS SCHOOL ATTENDED (IF APPLICABLE)
Birth Certificate Upload

Cancel of
Shot Record Upload

Cancel of
Proof of Arizona Address Upload

Cancel of
School Documents (Withdrawal form, transcripts, etc. )

Cancel of
NAME OF PARENT/GUARDIAN OR ADULT STUDENT SUBMITTING ENROLLMENT *
DATE *

Month Day Year
Date
(PHONE NUMBER) *
How did you hear about us? *
Who told you about PPEP TEC High School?
SY 2022-2023
PPEP TEC HIGH SCHOOL
STUDENT ENROLLMENT FORM
STUDENT INFORMATION
Name *

STUDENT'S FIRST NAME STUDENT'S LAST NAME
DATE OF BIRTH *

Month Day Year
Date
Address *

STREET ADDRESS

Street Address Line 2

City. STATE
ZIP CODE *
Is your mailing address different from your home address?

Yes No
MAILING ADDRESS (IF DIFFERENT FROM ABOVE)

Street Address Line 2

City.
STATE
ZIP CODE
CELL PHONE *
WORK PHONE
EMAIL ADDRESS *
example@example.com
Gender *

MALE FEMALE
ETHNICITY *

AMERICAN INDIAN/ALASKAN NATIVE BLACK HISPANIC WHITE ASIAN/PACIFIC ISLANDER
HAS THE STUDENT EVER BEEN ENROLLED IN A SPECIALEDUCATION PROGRAM? *

YES No
IS THE STUDENT A DEPENDENT OF A FULL TIME ACTIVE DUTY MEMBER OF THE ARMED FORCES?

ARMY NAVY MARINE CORPS Coast Guard NATIONAL GUARD AIR FORCE
Start Date

Month Day Year
Date
END DATE

Month Day Year
Date
*Please note: PPEP TEC is committed to praviding the best educational apportunity ta every student. We ask for the above information in order to ensure continuity of services, in keeping with that commitment.

I THE UNDERSIGNED HEREBY CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE AND BELIEF, THE

ANSWERS TO THE FOREGOING QUESTIONS AND

APPLICATION ARE COMPLETE AND ACCURATE.
PARENT/GUARDIAN/ADULT STUDENT SIGNATURE *

Clear
Date *

Month Day Year
Date
PARENT/GUARDIAN INFORMATION
WITH WHOM DOES THE CHILD CURRENTLY LIVE? *

MOTHER FATHER SELF
FOSTER PARENT/GROUP HOME
NAME *
Address

STREET ADDRESS

Street Address Line 2

City. STATE

ZIP CODE.
PHONE NUMBER
WORK PHONE
In What Language Do You Prefer To Receive Written Communication? *
In What Language Do You Prefer To Speak? *
EMERGENCY CONTACT INFORMATION
NAME *
RELATIONSHIP. *
CELL PHONE. *
WORK PHONE
HEALTHCARE INFORMATION
ALLERGIES
MEDICATIONS
SPECIAL MEDICAL CONDITIONS:
SERIOUS ILLNESSES OR DISABILITIES (SPECIFY)
DIETARY CONCERNS/RESTRICTIONS
I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND ACCURATE (Please print parent/guardian or adult student name) *
PARENT/GUARDIAN. / ADULT STUDENT SIGNATURE *

Clear
DATE *

Month Day Year
Date
GUIDELINES TO DETERMINE ELIGIBLE STUDENTS

THE DEPARTMENT OF EDUCATION PROVIDES THE FOLLOWING FY 2022 INCOME GUIDELINES FOR DETERMINING ELIGIBILITY INFORMATION FOR FEDERAL FUNDING ASSOCIATED WITH ARIZONA PROGRAMS FUNDED UNDER THE ELEMENTARY AND SECONDARY EDUCATION ACT (ESEA).

Is YOUR FAMILY AT OR BELDW THE CURRENT INCOME GUIDELLINES BASED ON THE FOLLOWING ESEA ELIGIBILITY GUIDELINES SCHEDULE?
DEFINITION OF INCOME: ALL ITEMS SUCH AS WAGES AND SALARIES BEFDRE ANY DEDUCTIONS, AND OTHER INCOME, SUCH AS SELF-EMPLOYMENT. WELFARE, SOCIAL SECURITY,RETIREMENT BENEFITS, UNEMPLOYMENT COMPENSATION, WORKERS COMPENSATION. AID FOR DEPENDENT CHILDREN, ALIMONY CHILD SUPPORT, PENSIONS, INSURANCE. OR ANNUITY PAYMENT.

Indicator 1 Indicator 2 No
Household Size Indicator1 (Yearly) Indicator 2 (Yearly)

1 $16,744 $23,828

2 $22,646 $32,277

3 $28,548 $40,626

4 $34,450 $49,025

5 $40,352 $57,424

6 $46,254 $65,823

7 $52,156 $74,222

8 $58,058 $82,621

*Each Additional Member Add: +$5,902 +$8,399
CHILD'S NAME, SCHOOL NAME, GRADE
I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND ACCURATE
PARENT/GUARDIAN / ADULT STUDENT SIGNATURE *

Clear
DATE *

Month Day Year
Date
Arizona Department of Education Office of English Language Acquisition Services

The responses to this Home Language Survey (HLS) are used by the school to provide the most appropriate instructional programs and services for the student. The answers below will determine if a student will take the Arizona English Language Learner Assessment (AZELLA) Please respond to each of the three questions as accurately as possible. If you need to correct any of your responses, this must be done before the student takes the AZELLA
1. What language do people speak in the home most of the time? *
2. What language does the student speak most of the time? *
3. What language did the student first speak or understand? *
Student Name *
District Student ID
Date of Birth *

Month Day Year
Date
SSID
Parent/Guardian Signature *

Clear
Date *

Month Day Year
Date
District or Charter
School
Please provide a copy of the Home Language Survey to the EL Coordinator/Main Contact on site. In AzEDS, please enter all three HLS responses. These HLS questions are in compliance with Arizona Administrative Code (R7-2-306(B1),(2a-c) (Revised 01-2020) Office of English Language Acquisition Services 1535 West Jefferson Street Phoenix, Arizona 85007 (602)542-0753 www.azed.gov/oelas
MCKINNEY VENTO PROGRAM INTAKE FORM
STUDENT'S FIRST AND LAST NAME *
SITE *
WHERE ARE YOU AND/OR YOUR FAMILY CURRENTLY LIVING?

RENT/OWN HOME
STOP: IF YOU HAVE MARKED THAT YOU RENT/OWN YOUR OWN HOME, SIGN AND DATE THE FORM BELOW. NOTHING ELSE IS REQUIRED. IF YOU DID NOT MARK THAT YOU RENT/OWN YOUR HOME, PLEASE CONTINUE TO THE NEXT SECTION
IS YOUR CURRENT ADDRESS A TEMPORARY LIVING ARRANGEMENT?

YES NO
IS YOUR TEMPORARY ADDRESS DUE TO LOSS OF HOUSING OR ECONOMIC HARDSHIP?

YES NO
IS THE STUDENT (FAMILY) CURRENTLY LIVING IN A SHELTER?

YES
IS THE STUDENT (FAMILY) DOUBLED UP? 1

YES
IS THE STUDENT (FAMILY) CURRENTLY LIVING IN A HOTEL/MOTEL?

YES
IS THE STUDENT (FAMILY) UNSHELTERED?

YES
IS THE STUDENT SEEKING ENROLLMENT WITHOUT PARENT OR LEGAL GUARDIAN?

YES
EXPLANATION LISTED BELOW:

1-DOUBLED UP-SHARING THE HOUSING OF OTHER PERSONS DUE TO LOSS OF HOUSING, ECONOMIC HARDSHIP, OR SIMILAR REASON

2-UNSHELTERED-LIVING IN A CAR, PARK, CAMPSITE, BUS/TRAIN STATION, ABANDONED BUILDING, OR OTHER LOCATIONS NOT ORDINARILY USED AS SLEEPING ACCOMMODATIONS.
PLEASE CHECK THE FOLLOWING SERVICES THAT ARE NEEDED/DESIRED

SCHOOL SUPPLIES CLOTHING GIFTED/TALENTED Other
I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND ACCURATE
PARENT/GUARDIAN /ADULT STUDENT SIGNATURE *

Clear
DATE *

Month Day Year
Date
Arizona Department of Education Arizona Residency Documentation Form
Student *
School
The Learning Center name (City)
School District or Charter Holder
PPEP TEC High School
Parent/Legal Guardian/Adult Student *
As the Parent/Legal Guardian of the Student, I attest* that I am a resident of the State of Arizona and submit in support of this attestation a copy of the following document that displays my name and residential address or physical description of the property where the student resides:
Please select proof of Arizona address

AZ Driver's license, identification card, motor vehicle registration Valid AZ address confidentiality program authorization card Real estate deed or mortgage docments Property tax bill
Please select proof of Arizona address cont.

Residential lease or rental agreement Water, electric, gas, cable, or phone bill Bank or credit card satement W-2 wage statement
Please select proof of Arizona address cont.

Payroll stub Certificate of tribal enrollment (506 fForm) or other identification issued by a recognized Indian tribe in Arizona. Documentation from a state, trival, federal government agency (Social Security Administration, Veteran's Administration, Arizona Department of Economic Security) Temporary on-base billeting facility (for military families)
Pease select proof of address cont.

Consular identification card issued by a foreign government as a valid form of identification if the foreign government uses biometric verification techniques in issuing the consular identification card I am currently unable to provide any of the foregoing documents. Therefore, I have provided an original affidavit signed and notarized by an Arizona resident who attests that I have established residence in Arizona with the person signing the affidavit.
Signature of Parent/Legal Guardian *

Clear
Date *

Month Day Year
Date
*For members of the armed services, the provision of verifiable documentation does not serve as a declaration of official residency for income tax or other legal purposes. Armed service members may utilize a temporary on-base billeting facility as the address for proof of residency.
State of Arizona

Affidavit of Shared Residence

*The following part is only if you cannot provide proof of an Arizona address*
Student Name
Parent/Legal Guardian Name
School Name
School District or Charter Holder
Name of Arizona Resident
I, (resident name) Arizona and that the persons listed below reside with me at my residence, described as follows:
I, (resident name)
swear or affirm that I am a resident of the State of Arizona and that the persons listed below reside with me at y residence, described as follows:
Persons who reside with me
Location of my residence
I submit in support of this attestation a copy of the following document that displays my name and current residence address or physical description of my property:
Proof of Arizona address

Valid Arizona driver's license, identification card or motor vehicle registration Valid Arizona address conficentiality program authorization card Real estate deed or mortgage documents Property tax bill
Proof of Arizona address cont.

Residential leas or rental agreement Water, electric, gas, cable, or phone bill Bank or credit card statement W-2 wage statement
Proof of Arizona address cont.

Payroll stub Certificate of tribal enrollment (506Form) or other identification issued by a recognized Indian tribe in Arizona Veteran's Administration, Arizona Department of Economic Security Type option 4
Printed Name of Affiant
Signature of Affiant

Clear
County of
The foregoing was acknowledged before me this day
Date

Month Day Year
Date
By
My Commission Expires
Notary Public
PPEP TEC High School DISCIPLINE POLICY
WE (PARENT/STUDENT) HAVE RECEIVED AND UNDERSTAND THE PPEP TEC HIGH SCHDOL PARENT/STUDENT HANDBOOK, INCLUDING DISCIPLINE POLICIES AND PROCEDURES. AND THE MISUSE OF COMPUTERS AND INTERNET. WE (PARENT/STUDENT) ALSO UNDERSTAND THE CONSEQUENCES SHOULD I (STUDENT) VIOLATE ANY OF THE PPEP TEC POLICIES.

THE SIGNATURES BELOW INDICATE AGREEMENT TO ABIDE BY THESE POLICIES AND PROCEDURES
PARENT/GUARDIAN NAME (PLEASE PRINT) *
PARENT/GUARDIAN SIGNATURE *

Clear
DATE *

Month Day Year
Date
STUDENT SIGNATURE *

Clear
DATE *

Month Day Year
Date
PARENT/STUDENT AFFIRMATION FORM CONCERNING LEGAL ACTION
WE (PARENT/STUDENT) HEREBY AFFIRM THAT THE STUDENT ENROLLING IN PPEP TEC HIGH SCHDOL Is CURRENTLY *

NOT ON PROBATION ON PROBATION
IF ON PROBATION, PLEASE PROVIDE THE FOLLOWING INFORMATION:
PROBATION START DATE

Month Day Year
Date
PROBATION END DATE

Month Day Year
Date
PROBATION OFFICER'S NAME
PROBATION OFFICER'S PHONE
IF ON PROBATION, I (PARENT/GUARDIAN) I GIVE/DO NOT GIVE (SELECT ONE) PPEP TEC HIGH SCHOOL PERMISSION TO RELEASE ACADEMIC, BEHAVIORAL, AND ATTENDANCE INFORMATION

GIVE DO NOT GIVE
THIS INFORMATION DOES NOT AFFECT ELIGIBILITY FOR ENROLLMENT. IT IS USED TO ENSURE COMPLIANCE WITH TERMS OF PROBATION ONLY.
PARENT/GUARDIAN / ADULT STUDENT SIGNATURE *

Clear
DATE *

Month Day Year
Date
MIGRANT AGRICULTURAL STUDENT IDENTIFICATION FORM
PPEP TEC LOCATION
STUDENT NAME *
GRADE
PARENT'S NAME *
Address *

ADDRESS

Street Address Line 2

CITY State

ZIP CODE
HAS YOUR FAMILY MOVED IN THE LAST 3 YEARS TO SEEK AGRICULTURAL WORK? *

YES NO
IS THE STUDENT A DEPENDENT OF AN AGRICULTURAL WORKER? *

YES NO
AGRICULTURAL WORK INCLUDES:
Agricultural activities such as the processing of:

Crops Dairy Poultry Livestock
Cultivation of fish or fish farms including:

Shellfish Catfish Eels Oysters or clams
Cultivation or harvesting of trees

Soil preparation Planting Tending
PPEP TEC HIGH SCHOOL PARENT PERMISSION FOR TITLE I INTERVENTION SERVICES
IT IS THE MISSION OF PPEP TEC HIGH SCHOOL TO EMPOWER EACH STUDENT TO ACHIEVE HIS OR HER FULLEST POTENTIAL TO BECOME A LIFELONG LEARNER AND RESPONSIBLE CITIZEN. WE ARE COMMITTED TO FOSTERING HIGH EXPECTATIONS AND PROMOTING ATTITUDES IN ORDER TO ACHIEVE EQUITY AND EXCELLENCE IN A SAFE AND NURTURING ENVIRONMENT.
IN KEEPING WITH THIS COMMITMENT, PPEP TEC HIGH SCHODL OFFERS THE FOLLOWING TITLE I INTERVENTION SERVICES TO ELIGIBLE STUDENTS ATTENDING PPEP TEC HIGH SCHOOLS WITH TITLE I PROGRAMS

READING AND MATH ACHIEVEMENT: TITLE I PARAPROFESSIONALS SUPPORT THE REGULAR EDUCATION ENGLISH AND MATH TEACHERS USING THE TITLE I PUSH-IN AND PULL OUT PROGRAM MODELS. THROUGH THESE MODELS, TITLE I PARAPROFESSIONALS PROVIDE SMALL GROUP AND ONE-ON-ONE INTERVENTION TO ELIGIBLE STUDENTS. AT SOME SCHOOLS, TITLE I PARAPRDFESSIONALS ARE ALSO AVAILABLE BEFORE AND AFTER SCHDOL FOR FURTHER INTERVENTION TO ELIGIBLE STUDENTS. EXTENDED LEARNING TIME: WHEN FUNDING PERMITS. PPEP TEC HIGH SCHOOL ALSO ALLOCATES FUNDING TO SUPPORT TITLE I SUMMER SCHODL PROGRAMS AT SCHOOLS WITH HIGH POPULATIONS OF ELIGIBLE STUDENTS WHO ARE PRIDRITY FOR TITLE I SERVICES. SUPPLEMENTAL EDUCATIONAL MATERIALS: PPEP TEC HIGH SCHOOL ALSO PROVIDES THE NECESSARY EDUCATIONAL MATERIALS TO SUPPORT TILTLE I PROGRAMS AT NO COST TO STUDENTS. EDUCATIONAL MATERIALS MAY INCLUDE, BUT ARE NOT LIMITED TO, WORKBOOKS, PENCILS, PENS, ERASERS, PAPER, GRAPHING PAPER, CALCULATORS, RULERS, GRAPHING CALCULATORS, BOOKS ON TAPE, REMEDIAL TEXTBOOKS AND WORKBOOKS, SOFTWARE PROGRAMS, AND LOWER READING LEVEL BOOKS AND NOVELS.
IN ORDER TO BE ELIGIBLE OR TITLE I SERVICES, STUDENTS MUST BE: (1) NOT OLDER THAN 21 WHO ARE ENTITLED TO FREE PUBLIC EDUCATION THROUGH GRADE 12; AND (2) NOT MET STATE STANDARDS ON ONE OR MORE AIMS/AZ MERIT TESTS (READING AND/OR MATH STUDENTS IN 12th GRADE WHO HAVE NOT MET STATE STANDARDS ON ONE OR MORE OF THE AIMS/AZ MERIT

TESTS ARE PRIORITY FOR TITLE | INTERVENTIONS SERVICES.

IF YOUR CHILD IS IDENTIFIED AND ELIGIBLE FOR ANY OF THE TITLE I INTERVENTION SERVICES MENTIONED ABOVE, YOU AGREE TO ENROLL YOUR CHILD INTO THE PPEP TEC HIGH Schoou TITLE I INTERVENTION PROGRAM BY SIGNING THIS FORM. You WILL BE NOTIFIED ABOUT THE TITLE I INTERVENTION SERVICES THAT YOUR CHILD IS RECEIVING, AS WELL AS YOUR CHILD'S PROGRESS AND

ACHIEVEMENTS. THRDUGH ANY OF THE FOLLOWING FORMS OF COMMUNICATION: TITLE I PROGRESS REPORTS; PARENT-TEACHER CONFERENCES. OR A LETTER OR PHONE CALL HOME.

IF YOU WOULD LIKE MDRE INFORMATION ABOUT THE PPEP TEC HIGH SCHOOL TITLE I INTERVENTION PROGRAM, PLEASE CONTACT THE LEAD TEACHER OF THE SCHDOL WHERE YOUR CHILD IS ENROLLED.

As MEMBERS OF THE PPEP TEC HIGH SCHODL EDUCATION COMMUNITY, WE ARE ALL PARTNERS IN YOUR CHILD'S EDUCATION. THANK YOU FDR ALLOWING PPEP TEC HIGH SCHOOL TO SERVE

THE EDUCATIONAL NEEDS OF YOUR CHILD.
PARENTAL CONSENT OF PARTICIPATION AND RELEASE OF INFORMATION
FOR SPECIAL EDUCATION STUDENTS ONLY
UNDER A RECENT CHANGE IN FEDERAL LAW, PPEP TEC HIGH SCHOOL WILL BE COLLABORATING WITH ARIZONA HEALTH CARE CONTAINMENT SYSTEM (AHCCCS) IN A PROGRAM THAT WILL ALLOW US TO BILL FOR MEDICALLY NECESSARY SERVICES RELATED TO THEIR SPECIAL EDUCATION PROGRAM. EXAMPLES OF THESE SERVICES ARE OCCUPATIONAL, PHYSICAL, OR SPEECH THERAPY, COUNSELING, SPECIALIZED TRANSPORTATION, NURSING SERVICES, OR AIDE ASSISTANCE WHICH ARE DETERMINED TO BE MEDICALLY/EDUCATIDNALLY NECESSARY BY THE IEP TEAM.

WHETHER OR NOT YOUR STUDENT IS CURRENTLY AHCCCS ELIGIBLE, WE ARE REQUESTING THAT YOU SIGN THE CONSENT FORM BELOW IN ORDER FOR US TO BILL FOR REIMBURSEMENT. IF APPROPRIATE, SIGNING AND RETURNING NOW WILL ALLOW US TO BE REIMBURSED IF YOUR CHILD IS CURRENTLY ELIGIBLE OR SHOULD EVER BECOME ELIGIBLE, THEREFORE WE ARE ATTEMPTING TO GATHER CONSENT FORMS FROM ALL PARENTS. IF YOUR STUDENT NEVER BECOMES AHCCCS ELIGIBLE, NO BILLING OR REIMBURSEMENT WILL BE PROCESSED.

PLEASE SIGN THIS LETTER ALLOWING US TO BILL AHCCCS FOR THESE SERVICES PROVIDED AT SCHOOL. THE MEDICAID REIMBURSEMENT PROGRAM WILL HELP PROVED IMPROVED QUALITY SERVICES FOR OUR STUDENTS. WE APPRECIATE YOUR COOPERATION - THANK YOU!

IF YOU HAVE QUESTIONS, PLEASE CONTACT THE DIRECTOR OF SPECIAL EDUCATION AT (520) 741-4393.
Students Name
Date of Birth

Month Day Year
Date
AHCCCS I.D. Number (if applicable)
If my child, whose name is listed above, is eligible, or should become eligible in the future, for Medicaid Health Coverage, PPEP TEC High School has my permission to release information from education records regarding special education and related services my child receives, to the Arizona Health Care Cost Containment System (AHCCCS) for billing purposes. I understand that the Charter may receive partial reimbursement for some of the special education or related services he/she receives. I also understand that I may revoke my permission at any time.

Please note: PPEP TEC is committed to providing the best educational opportunity to every student. We ask for the above information in order to ensure continuity of services, in keeping with that commitment.
SIGNATURE OF PARENT OR GUARDIAN

Clear
DATE

Month Day Year
Date
*Federal Law mandates that Special Education records be destroyed four years after the last fiscal year your child attended PPEP TEC High School. You will receive a copy of your child's records at every meeting and you may obtain additional copies at any time. You are encouraged to keep a copy of all your child's records as they may be of substantial value in social security issues or other educational experiences in the future. You will be notified at least one month prior to the destruction of the records and will have the opportunity to have them sent to you rather than be destroyed.
PARENT/STUDENT PERMISSION FOR INSTRUCTION ON AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES
*

YES -- I give permission for my son/daughter to receive instruction on AIDS and other sexually transmitted diseases. and understand that this is part of the PPEP TEC High School Health curriculum. I do not give permission for my son/daughter to receive instruction on AIDS and other sexually transmitted diseases, although I understand that this is part of the PPEP TEC High School Health curriculum. I am of the age of majority (18 years or older) and do not need parental permission to receive instruction on AIDS and other sexually transmitted diseases, and understand that this is part of the PPEP TEC High School Health curriculum.
STUDENT SIGNATURE *

Clear
DATE *

Month Day Year
Date
PARENT/GUARDIAN SIGNATURE *

Clear
DATE *

Month Day Year
Date
PPEP TEC High School Student Photo/Video Release

I hereby grant permission to PPEP TEC High School to use photographs/videos taken of my child on its web site, other official school printed material/publications, or released to the media without compensation. I also acknowledge that PTHS has the right to crop or treat the photographs/videos at its discretion. I also acknowledge that PTHS may choose not to use the photographs/videos at this time, but may do SD at its own discretion at a later date.
STUDENT NAME
DATE

Month Day Year
Date
SCHOOL SITE
DATE

Month Day Year
Date
PARENT OR GUARDIAN SIGNATURE

Clear
DATE

Month Day Year
Date
AZSCI / ACT
I/We understand that standardized testing, in the form of AzSCI and/or ACT. is required by the State of Arizona. I/We will assure PPEP TEC High School that I/my student will attend school on standardized testing dates.
PARENT OR GUARDIAN SIGNATURE *

Clear
DATE *

Month Day Year
Date
Parent/Student Affirmation Form Concerning Expulsion and Suspension

Please note: This information is not used to establish eligibility far enrollment. This information is important to the documentation of PPEP TEC High School's status as an Alternative School. However, according to ARS 15-84I(C) "a school district may refuse to admit any pupil who has been expelled from another educational institution or who is in the process of being expelled from another educational institution. Any enrollment decision may be appealed to the Superintendent.
| hereby affirm that I have / have not (select one) been expelled or am/am not in the process of being expelled from any other educational institution. *

I HAVE I HAVE NOT
| hereby affirm that I have / have not (select one) been suspended or am/not in the process of being suspended from any other educational institution. *

I HAVE I HAVE NOT
STUDENT SIGNATURE *

Clear
DATE *

Month Day Year
Date
PARENT OR GUARDIAN SIGNATURE *

Clear
DATE *

Month Day Year
Date
Student Internet Contract Parent & Guardian Internet Information

I understand and agree that by allowing me the use of the Internet, the school does not create a property right and that the school may revoke my access or for privilege any reason or no reason. I understand and will abide by the provisions and conditions of this contract. I understand that any violations of the previous provisions may result in automatic expulsion, the revoking of my user account, and appropriate legal action. I also agree to report any misuse of the information system to the Lead Teacher.

Students under the age of eighteen (18) must also have the signature of a parent or guardian who has read this contract.

As the parent or guardian of this student, I have read this contract and understand that the PPEP TEC High School technology and internet service is designed for educational purposes. I understand that it is impossible for the school to restrict access on the system to controversial or inappropriate materials and I will not hold the school responsible for materials acquired on the network. I also agree to report any misuse of the information system to the school administrator. Misuse can come in many forms, but can be viewed as any message sent or received that indicates or suggests pornography or obscenity, unethical or illegal solicitation or activities, racism, sexism, inappropriate language, and other issues described previously.
PARENT OR GUARDIAN SIGNATURE *

Clear
DATE *

Month Day Year
Date
STUDENT SIGNATURE *

Clear
Date *

Month Day Year
Date
PUBLIC NOTICE TO PARENTS

Recent legislation requires that PPEP TEC High School must notify all parents that teacher résumés are on file and available for review at the Administrative Offices located at 1840 E. Benson Highway, Tucson, Arizona. Should you wish to review a teacher's résumé, please contact the Administrative Office at (520)294-6997.
NOTICE OF PRIVACY PRACTICES

I have received a copy of teh PEP TEC High School "Notice of Privacy Practices", and understand that PPEP TEC High School's policy regarding the protection my son/daughter's health records.
PARENT OR GUARDIAN SIGNATURE *

Clear
DATE *

Month Day Year
Date
In partnership with the parents and the community, it is the mission of PPEP TEC High School to empower each student to achieve his or her fullest potential, and to become a lifelong learner and responsible citizen. We are committed to fostering high expectations and promoting positive attitudes in order to achieve equity and excellence in a safe and nuturing environment.

Community, Parents, School, and Student Partner in Each Child's Education

As a School, the staff of the _________Learning Center will strive to:
- believe that each child can learn;
- respect and value the uniqueness of each child and his or her own family;
- provide high quality curriculum and instruction;
- provide an effective and supportive learning environment that promotes active learning;
- enforce classroom rules and throughout the school in a fiar and consistent manner;
- document on-going assessment of each student's academic progress;
- maintain open lines of communicaiton with students adn parents to discuss this compact as it relates to achievement;
- demonstrate professional behavior and a positive attitude;
- provide opportunities for parents to volunteer and particpate in thier child's education; and
- find ways to involve parents in the school program.
As a parent/guardian, I _________, will strive to:
- belive my child can learn;
- show respect for my child, the staff and the school
- support my child's learning by seeing that they attend school regularly and on time;
- assist my child with homework and follow up to see that the assignments are completed in a timely manner;
- attend parent-teacher conferences;
- support the school in developing positive behaviors in my child;
- support my child's education by volunteering at teh school whenvever possible;
- support my child's learning by limiting access to non-school related activities (TV, video games, etc...) until school assignments are completed; and
- maintain on-going communicaiton with teh school and teachers by making regular calls and school visits to discus this compact as it relates to my child's achievement.
As a student, I _________, will strive to:
- belive that I can learn;
- show respect for myself, my school, and other people;
- obey PPEP TEC High School policies and procedures in the classroom and throughout the school;
- come to school prepared and ready to learn; and
- always try to do my bes in my work and my behavior.
As members of the PPEP TEC High School education community, we are partners in your child's educaiton as we uphold this compact.
Select your school
I, as the parent, (print parent/guardian name) blanks will strive to:
Student first and last name

First Name Last Name
Student first and last name

First Name Last Name
Student Signature

Clear
Parent Signature

Clear
STUDENT RECORDS REQUEST
Student Name *
Date of Birth *

Month Day Year
Date
Name of Previous School *
Should be Empty:

PPEP TEC HIGH SCHOOL

STUDENT ENROLLMENT FORMS

LIST OF REQUIRED DOCUMENTS

SY 2022-2023

PPEP TEC HIGH SCHOOL

STUDENT ENROLLMENT FORM

STUDENT INFORMATION

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT INFORMATION

HEALTHCARE INFORMATION

SPECIAL MEDICAL CONDITIONS:

I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND ACCURATE

PPEP TEC High School DISCIPLINE POLICY

PARENT/STUDENT AFFIRMATION FORM CONCERNING LEGAL ACTION

IF ON PROBATION, PLEASE PROVIDE THE FOLLOWING INFORMATION:

MIGRANT AGRICULTURAL STUDENT IDENTIFICATION FORM

AGRICULTURAL WORK INCLUDES:

PPEP TEC HIGH SCHOOL PARENT PERMISSION FOR TITLE I INTERVENTION SERVICES

PARENTAL CONSENT OF PARTICIPATION AND RELEASE OF INFORMATION

FOR SPECIAL EDUCATION STUDENTS ONLY

AZSCI / ACT

STUDENT RECORDS REQUEST