EASTHANOVERMIDDLE SCHOOL

477 RIDGEDALE AVENUE

EAST HANOVER, NJ07936

973-887-8810

FAX: 973-887-5079

MS. STACIE COSTELLO MR. MICHAEL CALOMINO

PRINCIPAL ASSISTANT PRINCIPAL

May 2015

Dear Parents/Guardians of all Students Entering Sixth Grade:

All 6th graders in East Hanover Township Schools require documentation of a current physical. Physicals must be received prior to the start of school. Please note that any student who wishes to try out for an athletic team at the Middle School needs to have the Athletic Pre-Participation Physical Examination Form completed by both the student’s parent/guardian and the student’s physician in order to participate.The physical must be current and performed within 365 days of the sport to be considered valid.Please refer to the Scholastic Student-Athlete Safety Act Information Fact Sheet for further information on completing the necessary forms for sports participation.

We have attached a copy of the Pre-participation Physical Evaluation form for you to bring to your doctor when you schedule your child’s next well visit. Additional copies may be obtained on the East Hanover School District website as well.

All 6th graders born on, or after, January 1, 1997, will also be required to have the following immunizations prior to the beginning of the school year:

  • One dose of Tdap (Tetanus, diphtheria, acellular pertussis) given no earlier than the 10th birthday. If your child received a Td booster within the last five years, they will not be required to have the Tdap at this time.

And

  • One dose of meningococcal-containing vaccine.

Completed paperwork must be submitted to East Hanover Middle School Main Office by August 24, 2015. Outstanding physicals and immunization documentation will delay your student’s entrance into 6th grade. Please submit all completed formsto Nurse Nancy Napolitano at East Hanover Middle School.

If you do not have a family physician or need further assistance, please contact me. Your cooperation is appreciated.

Nancy Napolitano

EastHanoverMiddle School Nurse

(973)887-8810 Option 2

EAST HANOVER TOWNSHIP SCHOOLS

EastHanoverMiddle School

477 RIDGEDALE AVENUE
EAST HANOVER, NEW JERSEY 07936
(973) 887 – 8810 Ext. 233
Fax (973) 887 – 5079 / Nancy Napolitano
School Nurse


Name of Student:

Date of Birth:

The above-named student has received the following immunizations which are required before the first day of school in September, 2015.

  • One dose of Tdap (Tetanus, diphtheria, acellular pertussis) given no earlier than the 10th birthday.

Date Vaccine administered

And

  • One dose of meningococcal-containing vaccine.

Date Vaccine administered

Physician’s SignatureDate

Physician’s Stamp