Buses leave the school around 4:45 pm. If a child is on the bus list (if you selected “My child will be riding home on the bus" below), a signed note from the parent/guardian must be provided each time they will NOT be riding the bus home. BUS STUDENTS MAY NOT WALK OR CAR RIDE WITHOUT WRITTEN PERMISSION FROM PARENT/GUARDIAN.
If your child will be riding the bus home, what bus number do they normally ride? blanks Where is their bus stop? blank
"Funding is provided by the United States Department of Education's Nita M. Lowey 21st Century Community Learning Center Program."
West Virginia’s 21st CCLC Program Focus Group Informed Consent Form for Parents or Guardians
I understand that my child, will be participating in a focus group of students at their 21st Century Community. Learning Center site. The West Virginia Department of Education (WVDE) is seeking feedback as part of the program monitoring system. Names and identifying characteristics will not be used in any publication of findings. Individual Information provided from the focus groups will be held in strictest confidence, and I understand that I am free to withdraw permission for my child’s participation at any time by notifying the staff at my child’s before or after school program, and that there will be no negative consequences from WVDE or from the program as a result of this withdrawal. My signature on this consent form indicates my understanding of the focus group. The program staff member’s signature indicates that he or she has explained the purpose of the focus group and to inform my child that he or she may withdraw from participation at any time with no negative consequences. If you would like a copy of this form for your records, please contact your Program Director. If you have any questions about the program, you may contact the before/after school program staff member named below or Sherry Swint, 21st CCLC Coordinator, at the West Virginia Department of Education (304-558-7805 Ext: 3138).