putnam county high school dr. andrew cooper...putnam county high school 300 war eagle drive,...
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Putnam county high school 300 War Eagle Drive, Eatonton, GA 31024 (O) (706) 485-9971 (F) (706) 485-3128
Dr. Andrew Cooper Principal
Melanie McLemore
Assistant Principal
Web: https://pchs.putnam.k12.ga.us Facebook: PCHSWarEagles
Welcome to Putnam County High School where we are #Putnamunited #Allin! I am Mrs. Roberts, the data specialist/registrar, for the high school. This letter outlines the registration process here at Putnam County High School. Attached to this letter is our registration packet, the packet includes a registration checklist, a records request form, and registration form. All students registered by a noncustodial parent must provide guardianship documentation (this documentation must be a legal document filed with the court) and/or sign a Kinship Caregiver’s Affidavit. This affidavit is available upon request and requires the signature and stamp or notary. Please review the registration checklist attached. Before enrolling students and/or receiving a schedule, you are required to present documents one thru eight. If you are new to the state of Georgia, you will need to have your student’s immunization certifications transferred to a Georgia’s Immunization Form (GA Form 3231) and will need a Hearing, Dental, and Vison Form (GA Form 3300). The local health department may complete this documentation for you (fees may apply; 706-485-8591). Proof of residency must be within thirty days (30; this month and /or last month bill only). Mortgage documents, rental/lease agreements, and utility bills (no cellphone bills) are all acceptable proofs of residence. If you recently moved, a new service connection print out from Georgia Power or Tri-County is acceptable. If you are living in with someone else, a Residence Affidavit is available upon request (affidavit requires the signature and stamp of a notary). Once this is completed, you must bring the affidavit and a proof of residence (this must be within the guidelines stated above) in the person’s name who sign the affidavit stating that you lived in their home. Complete the top portion of this document and sign the bottom portion of the Request to Release Records. This document is a fax and/or emailed to you student’s transferring school so they can transfer all educational records. There is a 24 to 48 hour turn around on records (with a 48 to 72 hour turn around if your student has an IEP). Transferring schools are only responsible and are only required to provide educational records and all non-educational records not sent by the transferring school will be the responsibility of the registering parent to provide. NO STUDENT WILL RECEIVE A SCHEDULE WITHOUT ALL RECORDS; EDUCATION AND NONEDUCATIONAL. Our Registration Form is front and back. On the back portion please, complete emergency. If the contact is pick up only, you do not have to include a phone number. If the student has a sibling in the district (Putnam), include them on the bottom of the form. You may submit all documentations two ways - by email, [email protected], or in person every Thursday between the hours of 10am to 2pm.
Putnam County High School
300 War Eagle Drive, Eatonton, GA 31024 (O) (706) 485-9971 (F) (706) 485-3128
Dr. Andrew Cooper Principal
Melanie McLemore
Assistant Principal
Student Registration for Putnam County Schools
The following registration documentation must be completed before enrolling a student into Putnam
County Charter Schools. We will not accept registration packets if all documents are not completed at
the time of registration.
1. Withdrawal Form: from previous school or institution.
2. Birth Certificate: State issued, certified copy, (hospital certificate is not accepted)
3. Social Security Card
4. Immunization Certificate: Georgia Department of Human Resources (DHR) immunization
certificate form 3231
5. Hearing, Dental, & Vision Certificate: Georgia form 3300
6. If relevant, Custody Papers: If parents are divorced they must provide a copy of custody
papers. Legal guardian(s) will also have to provide a copy of custody papers. Custodial
parent(s)/guardian(s) must live in the district.
7. State ID or Driver’s License: Must be current (not expired)
8. Proofs of Residence:
a. The current utility bill must be within 30 days of current bill. (Water, Gas, Electric,
Lease Agreement) or Residency Affidavit with Attached Bill).
b. Apartment of home lease and/with receipt (receipt must show address)
The above documents are requirements and must be presented at the time of
registration.
9. Authorization for release of IEP and / Or Records
• If student is receiving Special Education or Gifted services, if IEP and/or eligibility for
services is not presented at the time of registration, services will be delayed until
records are received by the school.
10. Emergency Contact Information
• This must be on file by student’s first day of school.
Request to Release Student Educational Records
Student Name: Date:
Grade: Date of Birth: Enrollment Date: Pending receipt ofrecords
Previous School Information School Name:
City: State: District:
Phone Number: Fax Number: *Note: Federal Law 99.21 states, “No parent signature is required for educational records to be sent to another education agency.”
Forward Records to the Enrolling School as Indicated:
o Putnam County Primary School, 162 Old Glenwood Springs Road, Eatonton, GA 31024; Tracy Surmelino Phone: (706) 485-5141; Fax: (706) 485-4147; Email: [email protected]
o Putnam County Elementary School, 314 S. Washington Avenue, Eatonton, GA 31024, Nichole Crawfordo Phone: (706) 485-5312; Fax: (706) 923-2808; Email: [email protected]
Putnam County Middle School, 140 Sparta Highway, Eatonton, GA 31024, Tanja Moreland Phone: (706) 485-8547; Fax: (706) 485-7090; Email: [email protected]
o Putnam County High School, 300 War Eagle Drive, Eatonton, GA 31024, Allain Mouo Phone: (706) 485-9971; Fax: (706) 485-3128; Email: [email protected]
Please forward the following student information: Birth Certificate Social Security Card Immunization Card Hearing-Dental-Vision Certificate Current/End of the Year Report Card Standardized Test Scores Attendance Records Discipline Records Gifted Records 504 Records ESOL Records Date entered 9th grade: _________High School Only
If student receive any of the following Special Education Services, please send the most current information: IEP Psychological Eligibility Evaluation (parent consent, testing data, &
parent Notices of IEP meetings) Eligibility and Placement Documents Speech Records
______________________________________ _______________________________________ Parent/Guardian Signature Date
For Office Use Only: Date of Record Request: __________1st Attempt; __________2nd Attempt; __________3rd Attempt; __________4th Attempt
Revised 01/19
Office Use ONLY Please PRINT
Putnam County Charter School System Registration Form
Last Name ______________________ First Name _____________________ Middle Name ________________________
Address Physical________________________________________________________________ PO Box ______________
Mailing Address if different from physical address: ________________________________________________________________
City: ___________________________________________ State: ________________________ Zip: ________________
SS#: _________________/or wavier __________________________ Date of Birth: __/__/__ Gender: __Male __Female Is the student of Hispanic or Latino ethnicity? __Yes __No If yes, select one or more races from the five racial categories. If no, please check the student’s race below.
Student lives with: ___Both Parents __Mother __Father __Guardian __Foster Parent __Other Housing: ___Rent/Own ___Friend/Relative ___Motel/Hotel ___Shelter ___RV/Campground Transportation: ___Bus/# ___ ___Car Rider
Email Address: ______________________________________________________________________________________ Mother: ___________________________________Home PH#: _______________________Cell#: __________________ Work Place: ________________________________Work PH#: _______________________________________________ Father: ____________________________________Home PH#: _________________________Cell#: ________________ Work Place: ________________________________Work PH#: _______________________________________________ Are you an Active Military or Military Reserve? _____ Yes _____No; If so, which parent? _____ Mother; _____Father Legal Guardian: _____________________________________________________________________________________ (if not same as above) Legal Guardian Relationship: ______________________________________Cell PH#: _____________________________ Emergency Contact Name: ________________________________________Home PH#: __________________________ Emergency Contact Relationship: ___________________________________Cell PH#: ____________________________ Last School Attended: ____________________________________________________________Grade Level: _________ City: ___________________State: _________________ Pre-K School/City/State: ______________________________________________________________________________ Withdrawal Date: __/__/__ At last school, was student receiving services? ___ Gifted ___Speech ___SST/RTI ___504
___ Sp. Ed. ___ ESOL ___Other_________ Is the student currently suspended? __Yes __ No Has student ever been enrolled in Putnam County Schools? __No __Yes If yes, which school? _____________________ In which country was student born? _____________ Month/Year Student Entered US School______/______(mm/yyyy) What language did the student speak first? _____________________ What language is spoken at home? ____________ What language does the student speak most often? _________________________________ Written Communication Preference: ________________________________________________
I, ___________________________________, affirm that the above information is true and correct on ______________. Parent/Legal Guardian Signature Date
Entry Date___/___/20__ Entry Code ______ Grade Level___________ School Name_________________________ HR Teacher___________________ Student ID#_________________________ Entered 9th Grade___/___/20__ (HS Only) Records Requested___/___/20__ Records Received: Immunization□ EED□ Birth Cert.□ SS Card □ SPED□ Transcript□ HS□ MS □
___American Indian or Alaska Native ___Black or African American ___White Asian Native Hawaiian or other Pacific Islander
Parent/Guardian Contact Information
PUTNAM COUNTY CHARTER SCHOOL SYSTEM REGISTRATION
2020 - 2021
PERSON AUTHORIZED TO PICK UP YOU CHILD AND/OR EMERGENCY CONTACTS
Only the names of the persons listed above under “Persons Authorized and Emergency Contact” are authorized to pick up my child. Signature: __________________________________________________
Siblings Under Age 18 attending schools in the Putnam County Charter School System Name: (Last Name, First Name) Birth Date/Gender Age/Grade Attends Which School?
Name Phone Numbers Relationship to Student Home Number Cell Number Work Number