PPEP TEC HIGH SCHOOL

*Students must be between the ages of 14-21 and have an 8th grade diploma to be considered for enrollment.*

The FOLLOWING DOCUMENTS MUST BE SUBMITTED FOR ENROLLMENT IN PPEP TEC HIGH SCHOOL

*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.

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?

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

 

      

I CERTIFY THAT THE INFORMATION PROVIDED IS TRUE AND ACCURATE

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

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

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

Arizona Department of Education Arizona Residency Documentation Form

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:

*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.

I, (resident name) Arizona and that the persons listed below reside with me at my residence, described as follows:

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:

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:

The foregoing was acknowledged before me this day

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

 

THIS INFORMATION DOES NOT AFFECT ELIGIBILITY FOR ENROLLMENT. IT IS USED TO ENSURE COMPLIANCE WITH TERMS OF PROBATION ONLY.

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 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.

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.

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.

*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

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.

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/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.

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.

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.

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.