Parent Information Verification Sheet

2011-2012 School Year
Secondary Version

In an effort to streamline the myriad of information that comes home on the first day of school, please be sure to complete the following:

STEP 1: SIGN AND RETURN THE FOLLOWING MANDATORY FORMS:

Ø  Health Update Form

Ø  Student Emergency Information Form

STEP 2: SIGN AND RETURN ANY ADDITIONAL FORMS, IF APPLICABLE:

Ø  Free and Reduced Lunch Application

o  Families eligible for Free and Reduced lunch should also review the Comcast Internet Essentials or Verizon Link Up America programs, which make Internet access and computer ownership available to low income families. This information can be found on the QCSD website link referenced below or in each school office.

Ø  School Insurance Application (Mail directly to vendor)

QCSD INFORMATION / INITIAL
EACH BOX
1.  Acceptable Use of Internet Form
2.  Asbestos Notice
3.  Body Mass Index (BMI) Letter
4.  CHIP Insurance Information
5.  “Do Not Publish” Form
6.  Emergency Treatment Letter
7.  Integrated Pest Management (IPM) Notice
8.  Meal Pay Plus Information
9.  Medication During School Hours
10.  Standardized Assessment Letter
11.  Student Dress Code Policy
12.  Student Rights and Responsibilities
13.  Title One / NCLB Letter (Strayer, Options Academy only)

STEP 3: INITIAL THE FOLLOWING BOXES TO INDICATE THAT YOU HAVE READ AND UNDERSTAND THE LISTED FORMS. (Return any needed forms to the school building.)
(All information can be found under the “Schools” tab of the QCSD webpage, www.qcsd.org, or is available at each building’s main office.)

This sheet should be signed, each box initialed, and all necessary forms from Steps 1, 2, 3 returned on
Thursday, September 1, 2011.

STUDENT NAME: ______GRADE: ______

PARENT SIGNATURE: ______DATE: ______

FAMILY EMAIL ADDRESS: ______

Our family DOES NOT have access to the Internet in our home. (Check box if applicable)