WALNUT HIGH SCHOOL 400 N. Pierre Road Walnut, CA (909) ENROLLMENT PROCEDURES

Transcription

1 WALNUT HIGH SCHOOL 400 N. Pierre Road Walnut, CA (909) ENROLLMENT PROCEDURES The first day for new student enrollment for the school year will be Monday, APRIL 16 th and is by appointment only. Please contact the Registrar s Office. Elizabeth Lopez Cecille Ortiz Registrar Office Assistant x x FAX FAX elopez@wvusd.k12.ca.us cortiz@wvusd.k12.ca.us A PARENT OR LEGAL GUARDIAN MUST BE PRESENT DURING ENROLLMENT. Please be sure all Enrollment Forms have been completed prior to your appointment time. You will need to bring the following information with you for your appointment: If you are the homeowner or renter, please provide: 1. Monthly mortgage statement, close of escrow, OR current property tax bill OR rental/lease agreement. 2. A current utility bill (gas, electric, water only) with your name and address reflected. 3. California driver s license or California ID card with current address for parent. CA or US Student required information: Original Birth Certificate and Immunization Record. For an incoming freshman, 9 th an 8 th grade report card, attendance & discipline For 10 th, 11 th, or 12 th an unofficial transcript of the previous grade(s) completed, attendance and discipline. Student transferring from OUT OF THE COUNTRY, required information: Original Birth Certificate (officially translated into English) Valid Passport Immunization AERC TRANSCRIPTS or Receipt of AERC Evaluation will need to be provided for the last three (3) years of Education from (Please see the attached flyer with Evaluation instructions) In addition, please include the student s Enrollment dates and Educational Plan.

2 WALNUT VALLEY UNIFIED SCHOOL DISTRICT 880 South Lemon Avenue, Walnut, California (909) Verification of Residency Form I-A Student name (please print): Grade: Date of Birth (month, day, year): School: Year: Home Address: California law requires that students enroll in the school district of residence of the parent. Upon request, parent(s)/legal guardian(s) must provide verification of residency in order to enroll a student or to maintain enrollment. This form will assist in verifying your current residency. Please call if you have any questions. Please present one (1) item from each category listed below in the name of the parent(s)/legal guardian(s). It is necessary for you to personally submit this information to the Principal/District Representative. California Driver s license or California Id with current address, picture identification: California Driver s License California I.D. card Utility Billing addressed to you at your residence address within the last thirty(30) days from: Southern California Gas Company Southern California Edison Company Water Company Proof of Residence addressed to you at your residence address within the last thirty(30) days from: A current lease or rental agreement for a residence within the District. Mortgage Statement or Close of Escrow Instructions Current year property tax statement I am currently residing in a home that I own or rent within the boundaries of the Walnut Valley Unified School District. (If you are residing with another family who owns or rents the home/apartment/condominium, please complete form II-B attached). I certify under penalty of perjury that I am presently a resident of the Walnut Valley Unified School District, and that all information I have submitted is true, complete and accurate. I understand that my child may be withdrawn from his or her assigned school if incomplete, inaccurate or false information is provided. Signed under penalty of perjury this day of 20 _. Signature of Parent/Legal Guardian Signature of District Representative/Principal/Designee

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4 Walnut Valley Unified School District KIDS FIRST Every Student, Every Day 880 S. Lemon Avenue Walnut, California Tel. (909) Enrollment Record Student Number Office Use Only Area Res. Verification Birth Verification Student s LEGAL Name Birth Date / / Last First Middle Other Names (Also Known As) Male Female Grade Address City Home Phone Student s Birthplace Student is living with: Both Natural Parents Father Only Mother Only Step-Parent/Foster Parent/ Guardian Please specify name(s): Father s Full Name Work # ( ) - Cell # ( ) - Employer *Position/Job Title Mother s Full Name Work # ( ) - Cell # ( ) - Employer *Position/Job Title Father s Mother s *Parent(s) Level of Education: Some High School High School Graduate Some College College Graduate Advanced Degree Residence Student living in (Federally mandated by NCLB) please check appropriate area: In a single family permanent residence (house, apartment, condo, mobile home) Doubled-up (sharing housing with another family due to economic hardship or loss Hotel/Motel Unsheltered (car/campsite) Other (Specify) Ethnicity: Student is not Hispanic or Latino Student is Hispanic or Latino Select up to five categories: Chinese (201) Asian Indian (205) Other Asian (299) Tahitian (304) Japanese (202) Laotian (206) Hawaiian (301) Other Pacific Islander (399) Korean (203) Cambodian (207) Guamanian (302) Filipino (400) Vietnamese (204) Hmong (208) Samoan (303) African American or Black (600) American Indian or Alaskan Native (100) (Person having origins in any of the original people of North or South America including Central America) White (700) (Person having origins in any of the original peoples of Europe, North Africa, or the Middle East) *Language Spoken at home: English Other (Specify) Last School Attended Grade Date Left School District City State Has child been in any Special Program? (Check appropriate Area) Special Education RSP SDC Speech Gate Other (Name) Is the student expelled or pending expulsion? Yes No Parent/Guardian Signature Date *These items contain information required by the state Department of Education for group reporting purposes. Your assistance assures accuracy. Revised 1/15/2015

5 Walnut High School REGISTRATION FORM Expulsion/Suspension Status Student Name Date In keeping with California State Law (Ed. Code # ), Walnut High School must be informed by student and parent if the student is currently suspended or expelled from any school or district in or out of the State of California. Student IS NOT under suspension or expulsion from any school or district or currently waiting for a Board of Trustee s hearing on a potential expulsion in another district. Student signature Parent/Guardian Signature Student IS currently: (check) suspended expelled waiting for a Board of Trustee s hearing Name of school District Falsification of this document will result in student being automatically dropped from Walnut High School. Any student under expulsion from another school or district shall be referred to the WVUSD Office for further processing. ====================================================================== Residency HISTORY Previous Home address Previous Home phone number Schools previously attended in the last 3 years: Education HISTORY School Name City, State Year Attended ====================================================================== Additional Student Relatives in this Household (18 Years or Under) Name Birth Date Age Grade School City

6 Walnut Valley Unified School District 880 S. Lemon Avenue Walnut, CA Student Residency Form This form is intended to address the requirements mandated within the McKinney-Vento Assistance Act, U.S.C.A. 42 Section 11302(a). Your response will help determine services your child may be eligible to receive. Please read the following and check the box below if applicable. 1. If you choose not to complete this form or if your child has permanent housing (house, apartment, etc. owned or rented by the child's parents/ guardian) it is not necessary to complete this form. 2. Check this box if your child's current residence is temporary due to one of the following: loss of housing, economic hardship, domestic violence, homelessness or other similar reasons. Complete the information below, print and submit this form to your child's school. Child's/ Student's Name School Grade Child's/ Student's Address Printed name of person completing this form Relationship to Child/ Student Cell/ Home / Contact Number address Date Please contact Martha Arellano, Child Welfare and Attendance Worker, Walnut Valley Unified School District at ext if you have questions about this form. Office staff Forward this form immediately to Martha Arellano at Vejar ONLY IF the box above is checked.

7 Walnut Valley Unified School District KIDS FIRST Every Student, Every Day 880 S. Lemon Avenue Walnut, California Tel. (909) STUDENT HEALTH ASSESSMENT Your child s learning depends upon good health. Please complete the assessment if your child has health problems. If your child has NO HEALTH PROBLEMS, fill out the student information, sign and date the form on the bottom and check the box indicating NONE below your signature. Current health problems/conditions should also be listed on the student s emergency card. Name DOB / / Grade Last First Middle Parent/Guardian Name If no health problems, proceed to signature. Phone # ( ) - Does your child have: Allergies Yes No To drugs, food, pollen? Please list Has the allergy required emergency (911) action in the past? Yes No Comments: Bee sting allergy Yes No Describe reaction Difficulty breathing? Yes No Need emergency medication (911) Yes No Asthma Yes No Triggered by Treatment Diagnosed by doctor Date Diabetes Yes No Takes insulin? Yes No Date Diagnosed Endocrinologist Phone Epilepsy/Seizures Yes No Describe seizure Date of last seizure Medication Is student currently under a doctor s care for seizures? Yes No Neurologist Name Phone Heart Condition Yes No Describe Any physical restrictions? Medication Yes No Cardiologist name Phone Bone or joint problems Yes No Describe List physical restrictions/limitations Select the following regarding health concerns that required medical attention: Hearing Loss Yes No Explain Hearing aid Yes No Nosebleeds Eating disorder Sleeping Bladder Requires catheterization Respiratory Neurological Headaches Bowel Requires diapering Phobias ADD/ADHD Dental problems Skin Menstrual problems Blood disorder Blood pressure Other Does the student take daily medication(s) and reason for taking List serious illness or injuries Other health information or concerns Signature of Parent/Guardian NONE Date

8 The California Education Code requires schools to determine the language(s) spoken at home by each student. This information is essential in order for schools to provide meaningful instruction for all students. Please answer the following questions prior to enrollment. Year School Teacher Home Phone Number Cell Phone Number Residency cleared STATE OF CALIFORNIA DEPARTMENT OF EDUCATION WALNUT VALLEY UNIFIED SCHOOL DISTRICT HOME LANGUAGE SURVEY ENGLISH Name of Student: Last First Middle Grade Date of Birth Enter the country where your child was born: Enter the date your child first enrolled in USA Schools: Last public school attended in California: District: County: 1. Which language did your son or daughter learn when he or she first began to talk? * 2. What language does your son or daughter most frequently use at home? * 3. What language do you use most frequently to speak to your son or daughter? * 4. Name the language in the order most often spoken by the adults at home: * *Do not write CHINESE as the language. Please specify the dialect as Mandarin, Cantonese, Taiwanese, Shanghainese, etc. Signature of Parent or Guardian Date Address District Assessment Office: (909) , extensions: 31327, 31396, or Revised 11/2014

9 FOREIGN TRANSCRIPTS In order for Walnut High School to grant Official Credits by subject, we are requesting a DETAILED EVALUATION REPORT be provided to the Registrar at the time of Registration. Provided below is the company that Walnut Unified uses to transcribe your child s Official Original Foreign Transcripts. Please contact them directly. AMERICAN EDUCATION RESEARCH CORPORATION (AERC) (626) (OFFICE) 382 E. ROWLAND STREET (626) (FAX) COVINA, CA HOURS: MON FRI 9:00am 4:00pm You will need to provide the following to AERC: - Student s Original Official Foreign Transcript - AERC application (get from website or AERC office) Please have the Evaluation Report sent to: WALNUT HIGH SCHOOL Elizabeth Lopez, Registrar 400 N. Pierre Road Walnut, CA FOREIGN TRANSCRIPTS In order for Walnut High School to grant Official Credits by subject, we are requesting a DETAILED EVALUATION REPORT be provided to the Registrar at the time of Registration. Provided below is the company that Walnut Unified uses to transcribe your child s Official Original Foreign Transcripts. Please contact them directly. AMERICAN EDUCATION RESEARCH CORPORATION (AERC) (626) (OFFICE) 382 E. ROWLAND STREET (626) (FAX) COVINA, CA HOURS: MON FRI 9:00am 4:00pm You will need to provide the following to AERC: - Student s Original Official Foreign Transcript - AERC application (get from website or AERC office) Please have the Evaluation Report sent to: WALNUT HIGH SCHOOL Elizabeth Lopez, Registrar 400 N. Pierre Road Walnut, CA 91789

10 IMMUNIZATION RECORDS A STUDENT WILL NOT BE ENROLLED WITHOUT PROOF OF IMMUNIZATION It is the responsibility of the Parent/Guardian to provide Walnut High School with the student s immunization records. Contact the previous school your student attended or your Doctor if you do not have copies of the immunization records at home. All dates recorded must include month, day, and year. IMMUNIZATION REQUIREMENTS POLIO 4 doses required 4-dose requirement for ages 7-17 years if at least one was given on or after the 2nd birthday DTP 3 doses required for grades 9 12 One more if last dose was given (diphtheria, tetanus and pertussis) prior to 2 nd birthday TDap 1 dose required 7 th grade and up. MMR 2 doses required. First dose after 1 st birthday (measles, mumps & rubella) VARICELLA (Chickenpox) Effective 7/1/2001 HEP B 2 doses over 13 yrs old 3 doses L. A. COUNTY HEALTH DEPT. CLINIC HOURS Pomona Health Center Immunizations are given 750 S. Park Avenue Mon.-Fri. to school age children at Pomona, CA no cost. Shot record (Yellow Card) must be presented. CALL first as hours are subject change. STUDENTS ENTERING FROM A FOREIGN COUNTRY If the immunization records provided are from a foreign country, in a language other than English, the parents must provide a copy of the immunization record which has been translated into English by a certified Doctor. The translated copy should be written on the Doctor s letterhead or have the Doctor s office stamp on it, which shows the Doctor s address and telephone number.