frequently asked question for the beginning of the school year forms/_2020-21 stud… · packing an...

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Frequently Asked Question for the Beginning of the School Year What does my student need for the 1 st day of school? Besides a 1 st day photo of your student … A roomy backpack is helpful to keep things together and to make sure things get to school from you and get home from us. Packing an extra set of clothes (pants, socks, underwear and shirt) is helpful for those unexpected “spilled-my-milk” days. Later, you can include rain gear and heavier clothing. Will I be getting a supply list for my student? No, we will be providing all the supplies necessary for learning. How will my student know where to go on the 1 st full day of school? Teachers be will be meeting and greeting the children as the buses arrive at school, and the School Staff is anxious and ready to welcome all the children every day, and most especially everyone is looking out for our Kindergarten and New Students. What about snacks? All classes have a snack time or break. A small healthy snack is appropriate and is much appreciated by your student, as the children have only a few minutes for a snack. In years past, our schools have been part of a Healthy Snacks Grant, through which fresh fruits and vegetables are provided to all students. We will send out a notification when this may be happening. Can my student buy breakfast and lunch on the 1 st day? As part of our Breakfast for Learning Program ALL STUDENTS will receive a FREE breakfast every day, if they would like. You will receive more detailed information during the first week from the school regarding the lunch program, prices and the monthly menu. Should my student wear anything special to school? Yes. We ask that every child wear closed-toe, comfortable shoes every day for safety on the playground and Gym. We go outside every day, so please be mindful of sending your child in weather and temperature appropriate clothing. PLEASE put your child’s First Name or Initials on everything! Most of us think that our children will recognize their own clothing, but sometimes they don’t OR another friend might have the same size, color and style clothing. But check the Lost & Found in your school, because it will be overflowing by October! Can we volunteer in school? Absolutely! We would love to have you! Volunteers support the students and their learning in many ways such as library work, field trips, special events, making materials and there are projects that can be done at home for those who are unable to come to school. After Teachers and the students get settled into a daily routine, Teachers will let you know about specific classroom work that might need volunteers. All volunteers are required to complete a volunteer form and undergo a background check. Can someone else pick my student up at school? Yes they can, but only with written permission or if you have named specific individuals on the “Student Information Form.” Please understand for safety reasons, if our Staff does not recognize the person picking up your child, he/she will be asked for identification. All students picked up prior to the regular dismissal time must be signed out at the office. 1

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Page 1: Frequently Asked Question for the Beginning of the School Year Forms/_2020-21 Stud… · Packing an extra set of clothes (pants, socks, underwear and shirt) is helpful for those unexpected

Frequently Asked Question for the Beginning of the School Year

What does my student need for the 1st day of school? Besides a 1st day photo of your student … A roomy backpack is helpful to keep things together and to make sure things get to school from you and get home from us. Packing an extra set of clothes (pants, socks, underwear and shirt) is helpful for those unexpected “spilled-my-milk” days. Later, you can include rain gear and heavier clothing.

Will I be getting a supply list for my student? No, we will be providing all the supplies necessary for learning.

How will my student know where to go on the 1st full day of school? Teachers be will be meeting and greeting the children as the buses arrive at school, and the School Staff is anxious and ready to welcome all the children every day, and most especially everyone is looking out for our Kindergarten and New Students.

What about snacks? All classes have a snack time or break. A small healthy snack is appropriate and is much appreciated by your student, as the children have only a few minutes for a snack. In years past, our schools have been part of a Healthy Snacks Grant, through which fresh fruits and vegetables are provided to all students. We will send out a notification when this may be happening.

Can my student buy breakfast and lunch on the 1st day? As part of our Breakfast for Learning Program ALL STUDENTS will receive a FREE breakfast every day, if they would like. You will receive more detailed information during the first week from the school regarding the lunch program, prices and the monthly menu.

Should my student wear anything special to school? Yes. We ask that every child wear closed-toe, comfortable shoes every day for safety on the playground and Gym. We go outside every day, so please be mindful of sending your child in weather and temperature appropriate clothing. PLEASE put your child’s First Name or Initials on everything! Most of us think that our children will recognize their own clothing, but sometimes they don’t OR another friend might have the same size, color and style clothing. But check the Lost & Found in your school, because it will be overflowing by October!

Can we volunteer in school? Absolutely! We would love to have you! Volunteers support the students and their learning in many ways such as library work, field trips, special events, making materials and there are projects that can be done at home for those who are unable to come to school. After Teachers and the students get settled into a daily routine, Teachers will let you know about specific classroom work that might need volunteers. All volunteers are required to complete a volunteer form and undergo a background check.

Can someone else pick my student up at school? Yes they can, but only with written permission or if you have named specific individuals on the “Student Information Form.” Please understand for safety reasons, if our Staff does not recognize the person picking up your child, he/she will be asked for identification. All students picked up prior to the regular dismissal time must be signed out at the office.

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Can my student go home with a friend on the bus? Your child can only travel on the bus/car assigned to them by GBSD and the Transportation Department. All bus/car questions can be directed to their transportation source or by contacting MECDHH/GBSD at 781-3165. K-12 Transportation: Safe Care, 542-3859 voice or text.

What if I want to pick up my student at the end of the day or take him/her out of school for an appointment? Please call the Main School Office (East End Community School at P/874-8228; Lyman Moore Middle School at P/874-8150, Portland High School at P/874-8250 and Portland Arts & Technology School (PATHS) at P/874-8166) and TRANSPORTATION to alert them to your request. If you come in early to pick up your child for an appointment, you will need to sign out your child, and the Main Office will call your child down to the Office to meet you.

Can I walk my student down to the classroom? For safety reasons, we ask that you drop off and pick up your student at the designated areas at the school or the Main Office. The beginning and end of the day are very busy for Teachers and Staff as they are greeting and dismissing students to get them to their destinations. If you want to communicate with Teachers, please email, text, call or leave a detailed message in the Main Office and the Teacher will get back to you.

Can I bring a special snack for my student’s birthday? Yes, but know that each class develops ways to make this a special day for your child. Please be aware that other students may have special dietary needs and/or restrictions.

Can my student hand out birthday party invitations? We ask that no invitations to parties be passed out at school. This helps prevent hurt feelings.

Can medications be given at school? There is a strict process for doing this. Please complete the “Medication Form” and you may also want to check in with the School Nurse as to how you would like them to handle your student’s medication. NO prescriptions or over-the-counter medication of any kind may be sent in with the student. This is a safety issue.

Any Emergency or Sick Days Please notify us at MECDHH/GBSD at 781-3165 or your Teacher, the Main Office, or Transportation as soon as possible if your student will be absent or away.

IMPORTANT: Please Notify Us Immediately if any of your information changes during the school year. It is extremely important that our records be kept up-to-date so we can contact you in case of sickness or other needs.

Thank you Parents and Guardians for your support, enthusiasm and interest in your student’s education. The importance of your support is immeasurable.

Please contact us with any additional questions.

Have a wonderful, fun-filled learning experience this year!

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Ten Ways to Get Ready for School this Fall

1) Create a routine over the summer or a least a couple of weeks before school starts. Give yourchild a set bedtime and stick to it.

2) Have your child practice writing their first name.

3) Use counting in your daily activities. Count how many steps it takes to get to the mailbox or thepark. Count out fruits, placemats and so forth.

4) Take your child with you to the grocery store, post office, library and other errands. Talk withthem about what they’re seeing, hearing and touching. It’s all part of learning!

5) Visit your local library and help your child get a free library card. Talk about the books you read.Ask questions like:

What was your favorite part of the story? Which character did you like? Halfway through, ask your child what they think will happen at the end.

6) Let your child practice their independence by allowing them to make certain choices (“Do youwant an apple or a banana?) and by encouraging them to try new things and problem solve.

7) Consider setting a limit to the amount of TV/Electronics your child uses. When possible, watch orplay with them and talk about what you see.

8) Prepare a “work spot” for your child and supply it with crayons, paper, scissors and other tools.Set aside a time each day for your child to draw there.

9) Help your child to know or be able to do the following before they go to school:

Know their name, address and phone number Use the bathroom on their own and button and zip their clothes Share toys and play with other children.

This will help them to adjust to their classroom setting.

10) Read! Read! Read! (in English or any native language)

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MECDHH/GBSD Student Information Form 2020/2021 School YearPlease notify GBSD immediately if any of your information changes during the school year. It

is extremely important that our records are up-to-date so we can contact you in case of sickness or other needs.

Student’s Name:________________________________________ Date Completed: _____________________

Full Middle Name (not initial – requirement of Dept. of Educ.):_______________________________________________

Birth date: ____________________________

Address: ________________________________________________________________________________________

Is the individual from one or more of the following races? (Circle at least one):

American Indian or Alaska Native Asian Black or African American

Hispanic/Latino Native Hawaiian or Other Pacific Islander White

Parent/Guardian Name: _____________________________________________ Cell Phone: ______________________

Primary Address: ____________________________________________ Home Phone: ___________________________

___________________________________________________________ Work Phone: ____________________________

Email Address: ______________________________________________________________________________________

**How would you like us to contact you? _______________________________________________________________

Parent/Guardian Name: _____________________________________________ Cell Phone: _______________________

Address: ___________________________________________________ Home Phone: ___________________________

___________________________________________________________ Work Phone: ____________________________

Email Address: ______________________________________________________________________________________

**How would you like us to contact you? _______________________________________________________________

With whom does the student live? ______________________________________________________________________

If applicable, who has legal custody? ____________________________________________________________________

If applicable, please provide MECDHH/GBSD or the School with a copy of the court custody order. Thank you.

IN AN EMERGENCY, PLEASE CALL (when a parent cannot be contacted):

1st Preference: _________________________________________________ Cell Phone: ___________________________

Relationship to Student: _____________________ Home P/ ___________________ Work P/ ____________________

2nd Preference: ________________________________________________ Cell Phone: ___________________________

Relationship to Student: _____________________ Home P/ ___________________ Work P/ ____________________

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MECDHH/GBSD Authorization to Release and Share Information Form, Primary Care Provider

2020-2021 School Year

Student’s Name:__________________________________________ DOB: _______________________

I authorize the Maine Educational Center for the Deaf and Hard of Hearing (MECDHH) to request and/or share information and records pertaining to my child with:

______________________________________________________________ _____________________________ Name of Primary Care Provider Phone Number

I understand that this Authorization permits MECDHH to:

• Communicate with the Provider listed above regarding coordination of early intervention/specialeducation and related services for my child

• Request from the Provider listed above: reports, evaluations, progress notes and recommendations• Share with the Provider listed above any information that is maintained in my child’s MECDHH file,

whether generated by persons employed by or contracted with MECDHH

Specific records/documents to be requested or shared:

□ Evaluation Reports□ Educational Plans□ Plans of Care/Treatment Plans□ Progress Notes□ Financial Resources Form□ Other (describe) ___________________________________________________________________________

This information will be used for the following purpose(s):

□ To assist in determining appropriate educational placement and/or programming□ To assist in determining the need for further educational/medical information□ To provide additional evaluation data□ For data collection/notification purposes at both the local and state level□ Other (describe) ____________________________________________________________________________

MECDHH applies the Family Educational Rights and Privacy Act (FERPA, see page 6) regarding confidentiality of client records. Information regarding my child:

• Will be maintained in a confidential file that is available for my review at the MECDHH office uponrequest.

• May be shared with persons employed by or contracted with MECDHH when relevant.

This authorization is effective for a period of no longer than twelve (12) months, will be reviewed annually, and may be revoked at any time. Revocation does not negate any requested and/or shared information obtained after the consent was given and before the consent was revoked.

______________________________________________________ Date:__________________________________ Signature of Parent/Guardian*

*The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature of such party andshall be effective to bind such party to this Agreement.

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MECDHH/GBSD Authorization to Release and Share Information Form, Agency/Agent

2020-2021 School Year

Student’s Name:__________________________________________ DOB: _______________________

I authorize the Maine Educational Center for the Deaf and Hard of Hearing (MECDHH) to request and/or share information and records pertaining to my child with:

______________________________________________________________ ____________________________ Name of Audiology Office (if applicable) Phone Number

I understand that this Authorization permits MECDHH to:

• Communicate with the Provider listed above regarding coordination of early intervention/specialeducation and related services for my child

• Request from the Provider listed above: reports, evaluations, progress notes and recommendations• Share with the Provider listed above any information that is maintained in my child’s MECDHH file,

whether generated by persons employed by or contracted with MECDHH

Specific records/documents to be requested or shared:

□ Evaluation Reports□ Educational Plans□ Plans of Care/Treatment Plans□ Progress Notes□ Financial Resources Form□ Other (describe) ___________________________________________________________________________

This information will be used for the following purpose(s):

□ To assist in determining appropriate educational placement and/or programming□ To assist in determining the need for further educational/medical information□ To provide additional evaluation data□ For data collection/notification purposes at both the local and state level□ Other (describe) ____________________________________________________________________________

MECDHH applies the Family Educational Rights and Privacy Act (FERPA, see page 6) regarding confidentiality of client records. Information regarding my child:

• Will be maintained in a confidential file that is available for my review at the MECDHH office uponrequest.

• May be shared with persons employed by or contracted with MECDHH when relevant.

This authorization is effective for a period of no longer than twelve (12) months, will be reviewed annually, and may be revoked at any time. Revocation does not negate any requested and/or shared information obtained after the consent was given and before the consent was revoked.

______________________________________________________ Date:__________________________________ Signature of Parent/Guardian*

*The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature of such party andshall be effective to bind such party to this Agreement.

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Family Educational Rights and Privacy Act (FERPA)

Family Policy Compliance Office (FPCO) Home

The Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g; 34 CFR Part 99) is a Federal law that protects the privacy of student education records. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education.

FERPA gives parents certain rights with respect to their children's education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level. Students to whom the rights have transferred are "eligible students."

• Parents or eligible students have the right to inspect and review the student's education recordsmaintained by the school. Schools are not required to provide copies of records unless, forreasons such as great distance, it is impossible for parents or eligible students to review therecords. Schools may charge a fee for copies.

• Parents or eligible students have the right to request that a school correct records which theybelieve to be inaccurate or misleading. If the school decides not to amend the record, the parent oreligible student then has the right to a formal hearing. After the hearing, if the school still decidesnot to amend the record, the parent or eligible student has the right to place a statement with therecord setting forth his or her view about the contested information.

• Generally, schools must have written permission from the parent or eligible student in order torelease any information from a student's education record. However, FERPA allows schools todisclose those records, without consent, to the following parties or under the following conditions(34 CFR § 99.31):

o School officials with legitimate educational interest;o Other schools to which a student is transferring;o Specified officials for audit or evaluation purposes;o Appropriate parties in connection with financial aid to a student;o Organizations conducting certain studies for or on behalf of the school;o Accrediting organizations;o To comply with a judicial order or lawfully issued subpoena;o Appropriate officials in cases of health and safety emergencies; ando State and local authorities, within a juvenile justice system, pursuant to specific State law.

Schools may disclose, without consent, "directory" information such as a student's name, address, telephone number, date and place of birth, honors and awards, and dates of attendance. However, schools must tell parents and eligible students about directory information and allow parents and eligible students a reasonable amount of time to request that the school not disclose directory information about them. Schools must notify parents and eligible students annually of their rights under FERPA. The actual means of notification (special letter, inclusion in a PTA bulletin, student handbook, or newspaper article) is left to the discretion of each school.

For additional information, you may call 1-800-USA-LEARN (1-800-872-5327) (voice). Individuals who use TDD may use the Federal Relay Service. Or you may contact us at the following address: Family Policy Compliance Office, U.S. Department of Education 400 Maryland Avenue, SW Washington, D.C. 20202-8520.

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MECDHH/GBSD Email Permission Form

2020-2021 School Year

Student’s Name:_______________________________________ Date Completed: _______________

MECDHH/GBSD would like to email Parents/Guardians educational information about their students. By signing below, you confirm that you have read and understand the following:

Under FERPA and corresponding Maine Laws, student’s educational records are protected from disclosure to third parties.

(For additional information, see the FERPA Information page 7.)

I understand that by sending my student’s education records via email that it may be accessible to someone other than myself and MECDHH/GBSD by virtue of the online environment.

My signature below confirms my consent to allow my student’s educational record to be emailed. I understand that by participating, information about my child will be emailed electronically. I

understand that I may ask for my email to be removed from obtaining this information at any time.

______ YES, I give permission for MECDHH/GBSD to email educational information about my child

______ NO, I DO NOT give permission for MECDHH/GBSD to email educational information about my child, but please mail their information to:

Student Name (Please Print)

___________________________________________________________________________________

Parent/Guardian Signature*

___________________________________________________________________________________

Preferred Email Address (Please Print)

____________________________________________________________________________________

*The parties agree that the electronic signature of a party to this Agreement shall be as valid asan original signature of such party and shall be effective to bind such party to this Agreement.

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MECDHH/GBSD Field Trip Permission Slip Form

2020-2021 School Year

Student’s Name:_________________________________ Date Completed: ______________

Dear Parents,

We are sending out this general permission form to be signed by you for your child to be able to participate in any/all field trips connected directly with classroom instruction for the duration of the school year. By having a general permission form we will not send forms home for each field trip. We will continue to send informational letters about each trip to keep you up to date as to where and what your child will be doing and learning.

Thank you, Administrative Office

Field Trip Permission Slip

My son/daughter _________________________________________has permission to participate in any/all field trips connected directly with classroom instruction for the duration of the school year.

________________________________________________________________________

Signature of Parent/Guardian*

*The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signatureof such party and shall be effective to bind such party to this Agreement.

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MECDHH / GBSD Media Release Form 2020-2021 School Year

Student’s Name:______________________________________ Date Completed: _______________________

Consent Information

MECDHH/GBSD has permission to release my child’s information in:

a.) MECDHH/GBSD’s website, Facebook page and Preschool Blog Yes____ No____

b.) Yearbook, newsletters, etc. Yes____ No____

c.) Media including TV, newspapers, (sports, awards, special events, Yes____ No____ and general coverage)

d.) Nationwide database for schools regarding assessment Yes____ No____

Please check which form of information MECDHH/GBSD has permission to share via the above opportunities:

*Child’s Full Name *Child’s Sign Name *Child’s Age *Child’s Photograph

__________________________________________________________________________________________ Signature of Parent/Guardian*

*The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature of such party and shall beeffective to bind such party to this Agreement.

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MECDHH / GBSD Home Language Survey Form

2020-2021 School Year

Student’s Name:_________________________________ Date Completed: _______________

The state requires the district to collect a Home Language Survey for every student. This information is used to count the students whose families speak a language other than English at home. It also helps to identify the students who need to be assessed for English language proficiency.

1. Is a language other than English spoken in your home?Yes No What language? ____________________________________

2. Does your child speak a language other than English?Yes No What language? ____________________________________

If the answer to either question is yes, please let us know, since the law requires the school to assess your child’s English language proficiency. Thank you.

______________________________________________________________________________ Signature of Parent/Guardian*

*The parties agree that the electronic signature of a party to this Agreement shall be as valid as anoriginal signature of such party and shall be effective to bind such party to this Agreement.

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MECDHH/GBSD For Preschool Only: Family Communication Preference Form

2020-2021 School Year

Student’s Name:_______________________________________ Date Completed: ______________________

1. The language we use at home is:❏ ASL❏ Spoken English❏ Combination of Spoken English and ASL

❏ We support our speech with signs❏ We have times when we talk and times when we sign

❏ Another Language: _____________________________________________

2. Our child is most comfortable understanding language right now through:❏ ASL❏ Spoken English❏ Combination of Spoken English and ASL

❏ Speech supported with signs to clarify❏ Other: __________________________________________________

3. Our child is most comfortable expressing himself/herself right now through:❏ ASL❏ Spoken English❏ Combination of Spoken English and ASL

❏ Speech supported with signs to clarify❏ Signs mixed with occasional words❏ Other: __________________________________________________

4. Our long-term goal for our child is to:❏ Be fluent in spoken English❏ Be fluent in ASL❏ Be fluent in both spoken English and ASL (bilingual)❏ Be fluent in spoken English and know some functional ASL❏ Be fluent in ASL and know some functional spoken English❏ Undecided

5. I would like for my child to spend instructional time (learning new concepts and vocabulary, direct teachingopportunities during structured and unstructured activities, circle time, etc.):❏ All in ASL❏ All in Spoken English❏ Combination ASL and Spoken English (bilingual/bimodel model)❏ Would there be any other information you’d like us to know about language use at home, your family,

or any questions you have:

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MECDHH / GBSD Health Form

2020-2021 School Year

Student’s Name______________________________________ Date Completed____________________

Before your child can start school, this form must be completed each year and returned by August 30 and attach any

additional sheets if necessary. Note: Please make a copy of your completed form and keep for your records. DATA

BASE To be completed by parent(s) or guardian. (Please Print)

Date of Birth________________ Sex M_________ F_________ Grade in September 2019________________________

Student resides with: Both Parents ____________ Father __________ Mother _______ Other ____________________

Parent/Guardian Name _______________________________Cell ________________ Alt. Phone __________________

Address __________________________________________________________________________________________

Parent/Guardian Name _______________________________Cell ________________ Alt. Phone __________________

Address __________________________________________________________________________________________

List two responsible adults, preferably in the area, to be contacted in case of emergency if parent/guardian is unavailable.

Name/Relationship _____________________________________ Cell ______________ Alt. Phone ________________

Name/Relationship_____________________________________ Cell ______________ Alt. Phone _________________

HEALTH INSURANCE MaineCare # __________________________________________________________________

Name of other insurance company ___________________________________________ Phone ____________________

Policy # ________________________________ I.D. # _________________ and/or Group # ________________________

Policy Holder’s Name: ________________________________________________________________________________

STUDENT PROFILE (Use space on back of form, or attach a separate document, to explain)

1. Any known allergies (include reaction to insect bites) Yes ______ No ______ If yes, list allergy and type of reaction _____________________________________________________________

2. Medications which student currently takes on a regular basis, both at home and at school. (Please complete theattached PERMISSION TO ADMINISTER MEDICATION AT SCHOOL form. Make copies as necessary to fill out oneform for EACH medication to be given at school.)__________________________________________________________________________________________

3. Pertinent medical histories (e.g. asthma, diabetes, seizures, etc.)

__________________________________________________________________________________________

4. Significant injury/illness since completion of last year’s form (e.g. chicken pox, broken bones, mono, etc.)

__________________________________________________________________________________________

5. Date of last physical exam __________________________ Date of last tetanus shot ______________________

6. Student’s Primary Care Physician Name ________________________ Phone ____________________________

Dentist _______________________ ___________________ Phone ________________AUTHORIZATION FOR TREATMENT: In the event I cannot be reached, I authorize that medical and/or surgical treatment be secured as may be deemed necessary or advisable for my child. I also authorize release of medical information to insurance companies for the purpose of payment and to health care providers who may treat my child.

Signature of Parent/Guardian* _______________________________________________________________________________________________________ *The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature of such party and shall be effective to bind such party to this Agreement.

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MECDHH/GBSD FIRST AID and Over-the-Counter Medication Form

2020-2021 School Year

Student’s Name:___________________________________ Date Completed: ______________________

We have first aid supplies and a few over-the-counter medications on hand for minor injuries and mild physical symptoms. Please indicate your preferences regarding the following treatments for your child:

OK to give Do Not Give Call First

Tylenol/acetaminophen (age appropriate dose)

Advil/ibuprofen (age appropriate dose)

Benadryl/diphenhydramine (for allergies)

Cortisone ointment (for skin itching)

Antibacterial ointment (for cuts/wounds)

Tums (for upset stomach)

_____________________________________________________________________________________

Signature of Parent/Guardian*

*The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature of such party andshall be effective to bind such party to this Agreement.

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MECDHH/GBSD Medication Form 2020-2021 School Year

Phone: 781-6215/Fax: 781-6246 **Print this form and fill out with your physician.**

Once completed email to: [email protected], fax to: 781-6246 or mail to: MaryJo York, MECDHH/GBSD, 1 Mackworth Island, Falmouth, ME 04105

Student’s Name: _____________________________________________DOB:___________________________

TO BE FILLED OUT BY PHYSICIAN: Physician’s Name (Please Print): _______________________________________________________________________ Reason for Medication: ______________________________________________________________________________ Name of Medication: ________________________________________________________________________________

Directions (include specific area of application if topical):

If PRN, frequency: ____________________________________________ Max dose in 24 hours: ___________________ Date of Discontinue: __________________________________________ (not to exceed school year) Side effects and action to be taken:

Student may carry inhaler with them throughout the school day I request and give my permission for school personnel, under the direction and at the discretion of the school

nurse, to administer this medication to the above-named student Student may self-administer this medication under the supervision of trained school personnel

Physician’s Signature __________________________________________________ Date: _________________________ Physician’s Tel. # ______________________________________________________Date: _________________________

TO BE SIGNED/DATED BY PARENT/GUARDIAN:

Student may carry inhaler with them throughout the school day I request and give my permission for school personnel, under the direction and at the discretion of the school nurse, to

administer this medication to the above-named student Student may self-administer this medication under the supervision of trained school personnel

Parent/Guardian Signature ________________________________________________ Date: ________________________

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MECDHH/GBSD Use of Computers and Internet Resources Form

2020-2021 School Year

Dear Parent(s)/Guardian(s):

Due to the nature of the Internet, it is neither practical nor possible for Maine Educational Center for the Deaf and Hard of Hearing (MECDHH) & the Governor Baxter School for the Deaf to enforce compliance with user rules at all times. Accordingly, parents and students must recognize that students will be required to make independent decisions and use good judgment in their use of the Internet. Therefore, parents must participate in the decision whether to allow their children access to the Internet and must communicate their own expectations to their children regarding its use.

As a Parent/Guardian of _______________________________, I have read and attached School Board policy, Students Use of Computers and Internet Resources, and the Administrative Procedures outlined in the Student Internet Access Agreement.

• I understand that Internet access is designed for educational purposes and that the school will attempt todiscourage access to objectionable material and communications. However, I recognize it is impossible forMECDHH & the Governor Baxter School for the Deaf to restrict access to all objectionable materials, and I willnot hold the school responsible for materials acquired or contacts made on the network.

• I understand that a variety of inappropriate and offensive materials are available over the Internet and that itmay be possible for my child to access these materials if she/he chooses to behave irresponsibly. I alsounderstand that it is possible for undesirable or ill-intended individuals to communicate with my child over theInternet, that there is no practical means for the school to prevent this from happening, and that my child musttake responsibility to avoid such communications if they are initiated. While I authorize the staff to monitor anycommunications to or from my child on the Internet, I recognize that it is not possible for the school to monitorall such communications. I have determined that the educational benefits of my child having access to theInternet outweigh the potential risks.

• I understand that any inappropriate conduct by my child that is in conflict with these responsibilities may resultin termination of access and possible disciplinary action.

• I have reviewed these responsibilities with my child, and I hereby grant permission to the school to provideInternet access.

Student Internet Access Agreement

I agree to abide by MECDHH & the Governor Baxter School for the Deaf Administrative Procedures for acceptable use of the Internet as stated in this agreement. I understand the use of the Internet is a privilege, not a right.

I agree:

• To use the Internet network for appropriate educational purposes and research• To be considerate of other users on the network and follow network etiquette rules• To not intentionally degrade or disrupt Internet network services or equipment - this includes but is not limited

to tampering with the computer hardware or software, vandalizing data, invoking computer viruses, attemptingto gain access to restricted or unauthorized network services or violating copyright laws

• To immediately report any security problems or use violations to the person responsible for the school network

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Page 17: Frequently Asked Question for the Beginning of the School Year Forms/_2020-21 Stud… · Packing an extra set of clothes (pants, socks, underwear and shirt) is helpful for those unexpected

I understand that I have no guarantee to privacy when I use the school Internet network, and I consent to the monitoring of my communications.

I also understand that any conduct that is inappropriate may result in termination of my school Internet access and possible disciplinary action.

Student’s Name: (please print) ____________________________________________________________

Student’s Signature*: ____________________________________________ Date: __________________

Parent/Guardian Name(s): (please print) ____________________________________________________

Parent/Guardian Signature*: ______________________________________ Date: __________________

*The parties agree that the electronic signature of a party to this Agreement shall be as valid as an original signature ofsuch party and shall be effective to bind such party to this Agreement.

STUDENTS’ USE OF COMPUTERS AND INTERNET RESOURCES (POLICY)

The MECDHH & the Governor Baxter School for the Deaf School Board; hereinafter, referred to as the “Board,” believed that the use of the computers in instructional programs is an educational tool which facilitates communication, innovation, resource-sharing and access to information. Due to the complex nature of accessible networks and magnitude of potential information available to students utilizing computers and the Internet, the Board believes strict guidelines in the form of administrative procedures are warranted in order to reduce or limit potential negatives effect. The global and fluid nature of the Internet networks’ contents makes it impossible for the Board to completely regulate and monitor the information available to students. Although students will be under teacher supervision while on the network, it is impossible to constantly monitor all individual students and the information that students may retrieve via the Internet.

Students utilizing computers and the Internet shall comply with the administrative procedures regarding computers and Internet use. The Board, via its administrators, reserves the right to monitor all computer and Internet activity by students. Privacy is not guaranteed. The school administration will establish procedures that will ensure no unreasonable restriction of student communication with parents/guardians.

In addition, use of computers and the Internet is a privilege, not a right. As such, students violating this Board’s policy administrative procedures shall be subject to revocation of privileges and potential disciplinary and/or appropriate legal action.

The MECDHH & the Governor Baxter School for the Deaf make no assurances of any kind, whether expressed or implied, regarding any Internet services provided. The school will not be responsible for any damages the user suffers. Use of any information obtained via the Internet is at the user’s own risk. The school specifically denies any responsibility for the accuracy or quality of information or software obtained through its services. This agreement must be signed and renewed each year and kept on file at school.

In consideration of my child being permitted access to the Internet on Governor Baxter School for the Deaf computers, I/we agree to assume all risk of injury, harm or damage to his/her person, whether physical or emotional, property, including harm caused by negligence of the GBSD, its School Board, its employees and agents arising out of his/her use of the school’s Internet access. This agreement must be signed and renewed each year and kept on the file at school.

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