2018 - 2019Teacher: Phillip Kirk

AP Student and Assigned Materials Information Sheet

Name ______Student ID#______Birth Date ______(Last, First MI)

Home #______Cell #______Work #______

Address______

Parent(s) and/or Guardian(s) Name(s) and Phone Numbers

______Home ______Cell ______Work ______

______Home ______Cell ______Work ______

Do you wear contacts?______If yes, do you have a pair of glasses that you can wear? ______

I would also like to remind you that contact lenses should not be worn in the chemistry laboratory. OSHA, the American National Standards Institute and the American Chemical Society all agree that contact lenses can hold foreign materials against the cornea, are difficult to remove in case of a splash and can absorb and retain chemical vapors. Even though students are required to wear chemical splash goggles when working with chemicals, it is a good policy to avoid contact lenses on lab days. There will be lab days on which contacts are prohibited.

1) Sign onto the Online Homework Site by Logging In and creating a UT EID and Password.

Register for this class (AP Chem 12 Fall 2018).

I have checked in and my id is: ______

2) Sign onto the Notes & Lab ScreenCasts Site.

I have checked in and my id is: ______

Text Book Number: ______General Book Condition: ______

Outside: Front Cover & Back Cover

Spine & Corners

Inside: Pages

Solutions Manual Number: ______General Book Condition: ______

Outside: Front Cover & Back Cover

Spine Corners

Inside: Pages

2018 - 2019Teacher: Phillip Kirk

AP Student and Assigned Materials Information Sheet

Name ______Student ID#______

(Last, First MI)

Take Home Text Book Number: ______General Book Condition: ______

Outside: Front Cover & Back Cover

Spine & Corners

Inside: Pages

Take Home Solutions Manual Number: ______General Book Condition: ______

Outside: Front Cover & Back Cover

Spine & Corners

Inside: Pages

2 CD’s Number: ______General CD Condition: ______

Jewel Case:

Appearance:

Functionality:

2 Purple Practice

Test Books Number: ______General Condition of Books: ______

Outside: Front Cover & Back Cover

Spine Corners

Inside:Pages

Students are asked to record the current condition of the materials they are assigned in the areas above. Any damages to those materials that are found and that were not recorded could be charged to you and your son or daughter at the end of the year.

Please look over the Information Sheet to ensure that there will not be any unidentified damages and fees charged at the end of the year.

Lab Safety & Classroom Regulations Contract

(TO BE SIGNED AND RETURNED)

I (student)______have read and agree to abide by the safety regulations as set forth above and also any additional instructions provided by the teacher and/or district.

I further agree to follow all other written and verbal instructions given in class. I have read and agree to abide by theClassroom Management and Classroom Discipline Policy as set forth by those sheets included inmynotebook and also any additional instructions provided by the teacher and/or district. I understand and agree with all regulations, policies and procedures.

Any loss or injury to either myself or others caused by my failure to follow thepolicies and the procedures as set forth by this district, school and my teacher cannot and will not be held against this district, school and my teacher.

I can be held financially accountable for damages that I cause due to my failure to follow the policies and the procedures as set forth by this district, school and my teacher.Furthermore, I have viewed and inventoried the condition of the assigned text book.

I and my parents accept the financial obligation which may arise either if any unlisted damage occurs in the course of the year or if said text is lost.

Student Signature______Date______

Guardian Signature______Date______

If you have any questions or comments, then please contact Mr. Kirk directly as soon as possible. This sheet should be signed and returned by the following date: 8/31/2018

Parent Contact Information:

Reason For Contact / Date Of Contact / Manner Of Contact / Response / Action