SY 2023-24 Tucson-Enrollment Packet-English

PPEP TEC HIGH SCHOOL

Celestino Fernandez LC-Tucson
STUDENT ENROLLMENT PACKET
STUDENT'S NAME*
NAME OF PREVIOUS School ATTENDED*
Location of PPEP TEC High School Site*
LIST OF REQUIRED DOCUMENTS
THE FOLLOWING DOCUMENTS MUST BE SUBMITTED For ENROLLMENT IN PPEP TEC HIGH School
- 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 Or PARENT(S)
- IMMUNIZATION RECORDS/ExEMPTION DOCUMENTATION-VERIFIED BY AMEDICAL OFFIDAL-THESE DOCUMENTS ARE REDUIRED To Attend SCHOOL But ARE Not A REQUIREMENT
- PRODF OF RESIDENCY: Unitity Bill. Copy OF LEASE. NOTARIZED LETTER BY HOMEDWNER. GOVERNMENT ISSUED ID CARD. PROPERTY TAX Bill. BANK OR CREDIT CARD STATEMENT. PAYROLL STUB.CERTIFICATE Or TRIBAL ENROLLMENT. DOCUMENT FROM ASTATE 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 TRANSCRIPIST-CERTIFIED "OFFICIAL" IN A SEALED ENVELOPE FROM PREVIOUS SCHOOL
- SPECIAL EDUCATION RECORDS-FROM PREVIOUS SCHOOL ATTENDED (if applicable)
Birth Certificate

Cancelof
Shot Records

Cancelof
Proof Address

Cancelof
School Documents

Cancelof
Additional Documents

Cancelof
(NAME OF PARENT/GUARDIAN SUSMITTING ENROLLMENT)
(DATE)*

MonthDayYear
Date
PHONE NUMBER
"Students must be between the ages of 14-2Yand have an 8th grade promotion certificate or a letter from the parent to be considered for enrollment.
How did you hear about us?*
SY 2023-2024
PPEP TEC HIGH SCHOOL
STUDENT ENROLLMENT FORM
STUDENT INFORMATION
Last Name, First Name*

STUSENT'S LAST NAMESTUDENT'S FIRST NAME
DATE OF BIRTH*

MonthDayYear
Date
Street address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing address if different

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell phone/WhatsApp
Please enter a valid phone number.
Work phone
Please enter a valid phone number.
Email Address
example@example.com
Gender on the student's birth certificate*

MaleFemale
Ethnicity*

American Indian/Alaskan NativeBlackHispanicWhiteAsian/Pacific Islander
Has the student been enrolled in a Special Education Program?*

YesNo
Is the student a dependent of a full time active duty member of the armed forces?

ArmyNavyAir ForceMarine CorpsCoast GuardNational Guard
Start Date

MonthDayYear
Date
END DATE

MonthDayYear
Date
"Please Note: PPEP TEC is committed to providing the best educational oppartunity to every student. We ask for the above information in order to ensure continuity of services, in heeping with that commitment.

- I THE UNDERSIONID HEREBY CERTIFY THAT, TO THE BEST OF MY KNOWLEDGE AND BELIEFE, THE ANSWERS TO THE FOREGOING QUESTIONS AND STATEMENTS MADE BY ME IN THES APPLICATION ARE COMPLETE AND ACCURATE.
Parent/Guardian/Adult Student Signature*

Clear
Date*

MonthDayYear
Date
Parent Guardian Information
With whom does the student currently live?*

MotherFatherSelfFoster Parent/Group HomeOther
Name of Group Home
Name of person with whom the student currently lives:

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone/WhatsApp
Please enter a valid phone number.
Work phone
Please enter a valid phone number.
Email
example@example.com
In what language do you prefer to receive communication?*
In what language do you prefer to speak?*
Emergency Contact

Who do we contact? (if you do not have a contact add the school's information)
Name*

First NameLast Name
Relationship
Cell phone/WhatsApp
Please enter a valid phone number.
Work phone
Please enter a valid phone number.
Healthcare Information
Allergies
Medications
Special Medical Conditions
Serious Illness or Disabilities (Specify)
Dietary Concerns/Restrictions
Parent/Guardia/Adult Student Signature*

Clear
Date*

MonthDayYear
Date
Guidelines to Determine Eligible Students
The Arizona Department of Education Provides the Following FY 2023 Income Guidelines for Determining Elegibility Information for Federal Funding Associated with Programs Funded Under the Elementary and Secondary Educatino Act (ESEA).

Is your family at of Below the Current Income Guidelines Based on the Following ESEA Eligibility Guidelines Schedule?

Definition of Income: All Items Such as Wages and Salaries Before any Deductions, and other Income, Such as Self-Employment, Wefare, Social Security, Retirement Benefits, Unemployment Compensation, Workers Compensation, and for Dependent Children, Alimony, Child Support, Pensions, Insurance, or Annuity Payment.

Household Size Indicator 1 Indicator 2 No

1 $17,667 $25,142 Income is over the limit

2 $23,803 $33,874   Income is over the limit

3 $29,939 $42,606   Income is over the limit

4 $36,075 $51,338   Income is over the limit

5 $42,211 $60,070   Income is over the limit

6 $48,347 $68,802   Income is over the limit

7 $54,483 $77,534 Income is over the limit

8 $60,619 $86,266 Income is over the limit

*Each additional member add:

+$6,136 +$8,732
Income Eligibility*

Indicator 1Indicator 2No-Income is over the limit
List All Children in the Household Child's Name Name of School Grade/Age
Parent/Guardian/Adult Student's Signature*

Clear
DATE*

MonthDayYear
Date
Home Language Survey

Arizona Department of Education Office of English Language Acquisition Services
The responses to the Home Language Survey (HLS) are used by the school to provide the most appropriate instructional programs an dservices 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 teh student takes the AZELLA Placement Test.
What language do people speak in the home most of the time?*
What language does the student speak most of the time?*
What language did the student first speak or understand?*
Student's Name*

First NameLast Name
Date of birth*

MonthDayYear
Date
Parent/Guardian/Adult Student's Signature*

Clear
Date*

MonthDayYear
Date
PPEP TEC High School Campus*
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 Jeffeason Sucet Phoenix, Arizona 85007 (602)542-0753 . www.azed.gov/pelas
Student Residency Questionnaire
Information contained on this form is confidential and used to determine whether a child or youth meets the definition of homeless under the McKinney-Vento Act. The Education for Homeless Children and Youth (EHCY) program as authorized under Title VII-B of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11431 et seq.) Please note, false claims about living situations may affect enrollment.
Section A
Date*

MonthDayYear
Date
Name of individual completing this form:*

First NameLast Name
Your Phone Number
Please enter a valid phone number.
Your Email
example@example.com
Student's Name*

First NameLast Name
Last School Attended*
Student's Current Grade*
Birth Date*

MonthDayYear
Date
Do you have additional children attending school in our district?*

YesNo
Do you have children of the preschool age?*

YesNo
Please provide information about additional children attending school in our district or of preschool age. Last Name First Name Grade School District
Address where the student slept last night:*
Is this address based on a temporary living arrangement? (Examples: hotel, shelter, transitional housing, sharing the housing of others due to loss of housing, economic hardship, or similar reason, car, park, campsite)*

YesNo
Section B *If you answered NO above stop here*

Student Residency Questionnaire
Name of the parent/guardian/adult caring for the student:

First NameLast Name
Relationship
If the address you provided in section A is based on a temporary living arrangement, is it due to loss of housing or economic hardship?

YesNo
Select the living arrangement that fits best below, you may choose more than one.

In a place that does not have windows, doors, running water, heat, electricity, or overcrowdedStaying with a friend or relative becaue of loss of housing, economic hardship, or similar reason. (examples: evection, foreclosure, fire, flood, lost job, divorce, domestic violence, kicked out by parents, ran away from home)
What date did you start staying with the friend or relative?

MonthDayYear
Date
In a shelter/transitional housing program
Name of the agency
What date did you begin staying here?

MonthDayYear
Date
Unsheltered (examples: tent, vehicle, abondoned building, streets, campground, park, bus/train station, or similar place)
Provide the main cross streets of this unsheltered location:
In a hotel/motel
Name/address of the hotel or motel
Date you began staying here:

MonthDayYear
Date
With an adult that is not a parent or court appointed legal guardianAlone, not in the care of a parent or court appointed legal guardian
None of the above, please explain
Signature of person providing information, Parent/Legal Guardian, *

Clear
Date*

MonthDayYear
Date
Caregiver's Authorization Affidavit-*For students NOT in the care of their parent or legal guardian*

This form is not a legal document and is solely for school contact only.
(This form is not a legal document and is solely for school contact only

The information on this form is required to meet the Education for Homeless Children and Youth (EHCY) program, authorized under Title VII-B of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 11431 et seq) There are situations when a child or youth who is homeless may not be able to reside with their parent or guardian; however, this fact does not nuilify the child's or youth's right to receive a free, appropriate public education. In this situation, the child may be considered an unaccompanied youth. The term unaccompanied youth includes a youth not in the physical custody of a parent or guardian. [42 U.S.C. $11434A(6)] The adult "caregiver" requesting enrollment for a minor student shall complete this form. The caregiver is defined as the adult presenting him/herself for enrollment and educational services while not in the physical custody of a parent or legal guardian.

By signing below, I acknowledge the following:
- I am 18 years of age or older and have agreed to fulfill the role of caregiver for the minor student named below, who is unaccompanied by a parent or legal guardian
- I agree to make a good faith effort to encourage the minor student named below to attend school.
- I will attempt to contact the school office if become aware that the minor student named below will not be attending school on that day(s) and share whether the absence is with or without my approval.
- I have provided the school district with proof of my residence and personal identification I understand that signing this document does not make me the legal guardian of the minor student listed below or make me financially responsible for the minor student, even if I am providing financial support to the student.
- I understand that I may choose to make educational decisions on behalf of the minor and in all other ways stand in for the authorizing party with respect to federal, state and district educational policy. including, but not limited to, accessing the minor's educational records, representing the minor in enrollment, disciplinary, curricular, special education or other matters, signing permission slips for school activities, and any other decision that facilitates the minor's educational experience.
Name of student

First NameLast Name
Date of birth

MonthDayYear
Date
Last school or school district the student attended:
Caregiver's Name

First NameLast Name
Caregiver's date of birth:

MonthDayYear
Date
Caregiver's home address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Caregiver's cell phone number/WhatsApp
Please enter a valid phone number.
Caregiver's email address
example@example.com
I am the student's

Relative (grandparent, aunt, uncle, sibling)I am related to the student
General Information

The student is staying at my home address, as listed aboveThe student is staying at the following location:
Location of the student
Please select any that apply:

While I am currently helping with the care of a student, I DO NOT wish to assist school officials with making education-related decisions.I have notified the parent(s) or other person(s) having legal guardianship of the minor of my intent to assist school officials with making education-related decisions in the best interest of the student and have received NO objection.I am unable to contact the parent(s) or legal guardian(s)
Name of the parent(s) or legal guardian(s) if you have been able to contact them.
Caregiver's Signature

Clear
Date

MonthDayYear
Date
Arizona Department of Education

Arizona Residency Documentation Form
Student's Name*

First NameLast Name
Name of School*
Name of Parent/Legal Guardian

First NameLast Name
As the Parent/Legal Guardian of the Student, I attest* that I am a resident of the State of Arizona and submitin 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:
Select the documents that you are providing

Valid Arizona driver's license, Arizona identification card or motor vehicle registrationValid Arizona Address Confidentiality Program authorization cardReal estate deed or mortgage documentsProperty tax bilResidential lease or rental agreementWater, electric, gas, cable, or phone billW-2 wage statementPayroll stubBank or credit card statement
Select the documents that you are providing cont.

Certificate of tribal enrollment (506 Form) or other identification issued by a recognized Indian tribe in ArizonaDocumentation from a state, tribal or federal government agency (Social Security Administration, Veteran's administration, Arizona Department of Economic SecurityTemporary on-base billeting facility (form malitary families)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 cardI 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*

Clear
Date*

MonthDayYear
Date
State of Arizona

Affidavit of Shared Residence
Name of student

First NameLast Name
Name of Parent/Legal Guardian

First NameLast Name
Name of school
Name of Arizona Resident

First NameLast Name
I, (resident name) blanks swear of affirm that I am a resident of the State of Arizona and that the persons listed below reside with me at my residence, described as follows:
Persons who reside with me:
My address
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:

Valid Arizona driver's license, Arizona identification card or motor vehicle registrationValid Arizona Address Confidentiality Program authorization cardReal estate deed or mortgage documentsProperty tax billResidential lease or rental agreementWater, electric, gas, cable, or phone billBank or credit card statementW-2 wage statement
Support documents cont.

Payroll stubCertificate of tribal enrollment (506 Form) or other identification issued by a recognized Indian tribe in ArizonaDocumentation from a state, tribal or federal government agency )Social Security Administration, Veteran's Administration, Arizona Department of Economic Security)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
Printed Name of the Affiant:

First NameLast Name
Signature of the Affiant:

Clear
DISCIPLINE POLICY
WE (PARENT/STUDENT) HAVE RECEIVED AND UNDERSTAND THE PPEP TEC HIGH SCHODL PARENT/STUDENT HANDBOOK INCLUDING DISCIPLINE POLICIES AND PROCEDURES, AND THE MISUSE OF COMPUTERS AND INTERNET. WE (PARENT/STUDENT) ALSO UNDERSTAND THE CONSEQUENCES SHOULD (Student) VIOLATE ANY OF THE PPEP TEC POLICIES.

THE SIGNATURES BELOW INDICATE AGREEMENT TO ABIDE BY THESE POLICIES AND PROCEDURES.
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Student Signature*

Clear
Date*

MonthDayYear
Date
PARENT/STUDENT AFFIRMATION FORM CONCERNING LEGAL ACTION
WE (PARENT/STUDENT) HEREBY AFFIRM THAT THE STUDENT IS CURRENTLY:
Please Select One:*

Not on probationOn probation
IF ON PROBATION, PLEASE PROVIDE THE FOLLOWING INFORMATION:
Probation start date:

MonthDayYear
Date
Probation end date:

MonthDayYear
Date
Probation Officer's Name

First NameLast Name
Probation Officer's Phone Number
Please enter a valid phone number.
*If on probation, I (parent/guardian) give/don't give PPEP TEC High School permission to release academic, Behavioral and attendance information to the enrolling student's probation officer.

Give PPEP TEC High School permission to release records to the probation officerDo not give PPEP TEC High School perission to release records to the probation officer
Parent/Guardian/Adult Student Signature*

Clear
Date*

MonthDayYear
Date
PPEP TEC HIGH SCHOOL

PARENT PERMISSION FOR TITLE 1 INTERVENTION SERVICES

IT IS THE MISSION OF PPEP TEC HIGH SCHOOL TO EMPOWER EACH STUDENT TO ACHIEVE HIS OR HER FULLEST POTENTIAL TO BEVOME 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 NUTURING ENVIORNMENT.

IN KEEPING WITH THE COMMITMENT, PPEP TEC HIGH SCHOOL OFFERS THE FOLLOWING TITLE 1 INTERVENTION SERVICES TO ELIGIBLE STUDENTS ATTENDING PPEP TEC HIGH SCHOOLS WITH TITLE 1 PROGRAMS:
- READING ADN MATH ACHIEVEMENT-TITLE 1 PARAPROFESSIONALS TO SUPPORT THE REGULAR EDUCATION ENGLISH AND MATH TEACHERS USING THE TITLE 1 PUSH-IN AND PULL-OUT PROGRAM MODELS. THROUGH THESE MODELS, TITLE 1 PARAPROFESSIONALS PROVIDE SMALL GROUP AND ONE-ON-ONE INTERVENTION TO ELIGIBLE STUDENTS. AT SOME SCHOOLS, TITLE 1 PARAPROFESSIONALS ARE ALSO AVAILABLE BEFORE AND AFTER SCHOOL FOR FURTHER INTERVENTION TO ELIGIBLE STUDENTS.
- EXTENDED LEARNING TIME-WHEN FUNDING PERMITS, PPEP TEC HIGH SCHOOL ALSO ALLOCATES FUNDING TO SUPPORT TITLE 1 SUMMER SCHOOL PROGRAMS AT SHOOLS WITH HIGH POPULATIONS OF ELIGIBLE STUDENTS WHO ARE PRIORITY FOR TITLE 1 SERVICES.
- SUPPLEMENTAL EDUCATIOAL MATERIALS-PPEP TEC HIGH SCHOOL ALSO PROVIDES THE NECESSARY EDUCATINAL MATERIALS TO SUPPORT TITE 1 PROGRAMS AT NO COST TO STUDENTS. EDUCATINAL MATERIALS MAY INCLUDE, BUT ARE NOT LIMITED TO, WORKBOOKS, SOFTWARE PROGRAMS, AND LOWER READING LEVEL BOOKS AND NOVELS.
IN ORDER TO BE ELIGIBLE FOR TITLE 1 SERVICES, STUDENTS MUST NOT BE OLDER THAN 21 WHO ARE ENTITLED TO FREE PUBLIC EDUCATION THROUGH GRADE 12, AND NOT MET STATE STANDARDS ON ONE OR MORE REQUIRED STATE STANDARDIZED TEST IN READING OR MATH. STUDENTS IN 12TH GRADE WHO HAVE NOT MET STATE STANDARDS ON ONE OR MORE OF THE TESTS ARE PRIORITY FOR TITLE 1 INTERVENTION SERVICES.

IF YOU CHILD IS IDENTIFIED AND ELIGIBLE FOR ANY OF THE TITLE 1 INTERVENTION SERVICES MENTIONED ABOVIE, YOU AGREE TO ENROLL YOUR CHILD INTO THE PPEP TEC HIGH SCHOOL TITLE 1 INTERVENTION PROGRAMBY SIGNING THIS FORM. YOU WILL BE NOTIFIED ABOUT THE TITLE 1 INTERVENTION SERVICES THAT YOUR CHILD IS RECEIVING, AS WELL AS YOUR CHILD'S PROGRESS AND ACHIEVEMENTS THROUGH ANY OF THE FOLLOWING FORMS OF COMMUNICATION: TITLE 1 PROGRESS REPORTS; PARENT-TEACHER CONFERENCES, OR A LETTER OR PHONE CALL HOME.

IF YOU WOULD LIKE MORE INFORMATION ABOUT THE PPEP TEC HIGH SCHOOL TITLE 1 INTERVENTION PROGRAM, PLEASE CONTACT THE LEAD TEACHER OF THE SCHOOL WHEN YOUR CHILD IS ENROLLED.

AS MEMBERS OF THE PPEP TEC HIGH SCHOOL EDUCATION COMMUNITY, WE ARE ALL PARTNERS IN YOUR CHILD'S EDUCATION. THANK YOU FOR ALLOWING PPE TEC HIGH SCHOOL TO SERVE THE EDUCATIONAL NEEDS OF YOUR CHILD.
Parent/Guardian/Adult Student Signature*

Clear
Date*

MonthDayYear
Date
PARENTAL CONSENT OF PARTICIPATION AND RELEASE OF INFORMATION

For Special Education Students only
UNDER A RECENT CHANGE IN FEDERAL LAW, PPEPTEC HIGH SCHOOL WILL BE COLLABORATING WITH ARZONA HEALH CARE CONTAINMENT SYSTEM (AHCCCS) IN A PROGRAM THAT WILL ALLOW US T0 BILL FOR MEDICALLY NECESSARY SERVICES RELATED TO THEIR SPEDIAL 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/EDUCATIONALLY 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 RETURING NOW WILL ALOOW US TO BE REIMBURSED IF YOUR CHLD IS CURRENTLY ELIGIBLE OR SHOULD EVER BECOME ELIGIBLE. THEREFORE, WE ARE ATTEMPTING TO GAHER CONSENT FROMS FROM ALL PARENTS. IF YOUR STUDENT NEVER BECOMES AHCCCS ELIGIBLE, NO BILLING OR REIMBURSMEMENT WILL BE PROCESSED.

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

IF YOU HAYE QUESTIONS PLEASE CONTACT THE DIRECTOR OF SPECIAL EDUCATION AT (520) 741-4393.
Student's Name

First NameLast Name
Date

MonthDayYear
Date
AHCCCS I.D. Number (If applicable)
Signature of Parent/Guardian

Clear
Date

MonthDayYear
Date
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 copes 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 pror 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
Please select one:*

Yes, I give permission to my student to receive instruction on AIDS and other sexually transmitted diseases and understand that this is part of the PPEP TEC High School curriculum.No, I do not give permission for my student 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 maturity (18 years or older) and DO NOT NEED parental permission to receive instruction on AIDS and sexually transmitted diseases, and understand that this is part of the PPEP TEC High School curriculum.
Student Signature*

Clear
Date*

MonthDayYear
Date
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
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 website, other official school printed materials/publications, or released tot he media without compensation. I also acknowledge that PTHS has the right to crop of treat the photographs/videos at its discretion. I also acknowledge that PTHS may choose to use the photographs/videos at this time, but may do so at its own discretion at a later date.
Student's Name*

First NameLast Name
Date*

MonthDayYear
Date
School Site*
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date
AZSCI / ACT

Required State Assessments
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 l/my student will attend school on standardized testing dates.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Parent/Student Affirmation Form Concerning Expulsion and Suspension
Please Select One Regarding Expulsion*

I hereby affirm that I HAVE been expelled or AM in the process of being expelled from any other educational institution.I hereby affirm that I HAVE NOT been expelled or AM NOT in the process of being expelled from any other educational instution.
Please Select One Regarding Suspension*

I hereby affirm that I HAVE been suspended or AM in the process of being suspended from any other educational institution.I hereby affirm that I HAVE NOT been suspended or AM NOT in the process of being suspended from any other educational instutution.
Please note: This information is not used to establish eligibility for enrollment. This information is important to the documentation of PPEP TEC High School's status as an Alternative School However, according to A.R.S. 15-841(C), "a school district may refuse to admit any pupil who has been expelled from anather educational institution or wito is in the process of being expelled from another educational institution." Any decision may be appealed to the Superintendent.
Student Signature*

Clear
Date*

MonthDayYear
Date
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
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 privilege for 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 eighten (18) must also have the signature of a parant 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 previsusly.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Student Signature*

Clear
Date*

MonthDayYear
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 Private Practices
I have received a copy of teh PPEP TEC High School "Notice of Privacy Practices," and I understand PPEP TEC High School's policy regarding the protection of my son/daughter's health records.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
In partnership with parents and the community, it is the mission of PPEP TEC High School to empower each student to achieve his or her full 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 nurturing environment.

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

As a school, the staff of theLearning Center will strive to: believe that each child can learn; respect and value the uniqueness of each child and his or her 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 fair and consistent manner; document on-going assessment of each student's academic progress: maintain open lines of communication with students and parents to discuss this compact as it relates to student achievement; demonstrate professional behavior and a positive attitude; provide opportunities for parents to volunteer and participate in their child's education; and find ways to involve parents in the school program.

As parent/guardian, 1,will strive to: believe 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 assignments are completed in a timely manner;
As a school the ____________ Learning Center will strive to:*
- believe that each child can learn;
- respect and value the uniqueness of each child and his or her 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 and parent to discuss the compact as it relates to student achievement;
- demonstrate professional behavior and participate in their child's education; and
- find ways to involve parents in the school program.
Parent's Name*

First NameLast Name
As a parent/guardian I will strive to:
- believe 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 assignments are completed in a timely manner;
- attend parent-teacher conferences;
- support my child's education by volunteering at teh school whenever possible;
- support my child's learning by participating in decision-making whenever possible;support my child's learning by limiting access to non-school related activities (TV, video games, etc.) until his/her school assignments are completed; and
- maintain on-going communication with the school and teachers by making regular calls and school visits to discuss this compact as it relates to my child's achievement.
Student's Name*

First NameLast Name
As a student at PPEP TEC High School, I will strive to:
- believe 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 througbout the school;
- come to school prepared to learn; and always try to do my best in my work and my behavior.
As members of the PPEP TEC High School education community, we are partners in your child's education as we uphold this compact.
Student's Name*

First NameLast Name
Student's Signature*

Clear
Parent/Guardian Signature*

Clear
Migrant Agricultural Student Identification Form
PPEP TEC Site:*
Student's Name*
Grade*
Parent's Name*

First NameLast Name
WhatsApp Contact
Please enter a valid phone number.
Has your family moved in the last 3 years to seek agricultural work?*

YESNO
Is the student a dependent of an agricultural worker?*

YESNO
Agricultural Work Includes:

Agricultural activities as the processing of:
- Crops
- Dairy production
- Poultry
- Livestock
Cultivaiton of fish or fish farms including:
- Shellfish
- Catfish
- Ells Oysters
- Clams
Cultivaiton or Harvesting of trees:
- Soil preperation
- Planting
- Tending
Student Records Request

From previous school
Student's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Name of Previous School*
Address of school; please complete what you can.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

PPEP TEC HIGH SCHOOL

STUDENT ENROLLMENT PACKET

LIST OF REQUIRED DOCUMENTS

SY 2023-2024

PPEP TEC HIGH SCHOOL

STUDENT ENROLLMENT FORM

STUDENT INFORMATION

Parent Guardian Information

Emergency Contact

Healthcare Information

Guidelines to Determine Eligible Students

Home Language Survey

Student Residency Questionnaire

Section A

Section B If you answered NO above stop here

Caregiver's Authorization Affidavit-For students NOT in the care of their parent or legal guardian

Arizona Department of Education

State of Arizona

DISCIPLINE POLICY

PARENT/STUDENT AFFIRMATION FORM CONCERNING LEGAL ACTION

PARENTAL CONSENT OF PARTICIPATION AND RELEASE OF INFORMATION

Parent/Student Permission for Instruction on AIDS and other Sexually Transmitted Diseases

PPEP TEC High School Student Photo/Video Release

AZSCI / ACT

Parent/Student Affirmation Form Concerning Expulsion and Suspension

Student Internet Contract

Public Notice to Parents

Notice of Private Practices

Migrant Agricultural Student Identification Form

Student Records Request

PPEP TEC HIGH SCHOOL

STUDENT ENROLLMENT PACKET

LIST OF REQUIRED DOCUMENTS

SY 2023-2024

PPEP TEC HIGH SCHOOL

STUDENT ENROLLMENT FORM

STUDENT INFORMATION

Parent Guardian Information

Emergency Contact

Healthcare Information

Guidelines to Determine Eligible Students

Home Language Survey

Student Residency Questionnaire

Section A

Section B *If you answered NO above stop here*

Caregiver's Authorization Affidavit-*For students NOT in the care of their parent or legal guardian*

Arizona Department of Education

State of Arizona

DISCIPLINE POLICY

PARENT/STUDENT AFFIRMATION FORM CONCERNING LEGAL ACTION

PARENTAL CONSENT OF PARTICIPATION AND RELEASE OF INFORMATION

Parent/Student Permission for Instruction on AIDS and other Sexually Transmitted Diseases

PPEP TEC High School Student Photo/Video Release

AZSCI / ACT

Parent/Student Affirmation Form Concerning Expulsion and Suspension

Student Internet Contract

Public Notice to Parents

Notice of Private Practices

Migrant Agricultural Student Identification Form

Student Records Request

Section B If you answered NO above stop here

Caregiver's Authorization Affidavit-For students NOT in the care of their parent or legal guardian