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Soaring to Excellence ADAPT Alvin Disciplinary Alternative Placement Teaching Student Handbook “Where Change Begins”

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Soaring to Excellence

ADAPT Alvin Disciplinary Alternative Placement Teaching

Student

Handbook

“Where Change Begins”

DAEP laws: http://ritter.tea.state.tx.us/rules/tac/chapter103/ch103cc.html

§103.1201. Standards for the Operation of School District Disciplinary Alternative Education Programs.

The Alvin Disciplinary Alternative Placement Campus is a disciplinary alternative education program (DAEP) established

in conformance with the Texas Education Code (TEC), §37.008, and this section is defined as an educational and self-

discipline alternative instructional program, adopted by local policy, for students in elementary through high school

grades who are removed from their regular classes for mandatory or discretionary disciplinary reasons and placed in a

DAEP.

Because of the disciplinary measures, videotaping is a means of safety for our students and staff. Classrooms and

common areas are equipped with cameras and may be accessed by authorized personnel only.

Updated August 2014

Contact Information

ADAPT Campus

701 Second Street

Alvin, Texas 77511

(281) 245-2681 Fax: (281) 245-2044

Administrator - Lisa Almendariz

[email protected]

Secretary - Tammy Riddle

[email protected]

Counselor- Tracy Elam

[email protected]

Teachers:

Anneke Wiiliams –Special Education David Williams—Science/Compass

[email protected] [email protected]

Elliot Moutra—High School Math Jeffrey Hummel—High School Social Studies

[email protected] [email protected]

Kevin Baker —High School Science Carol Hooker—High School English

[email protected] [email protected]

Lauren Taylor – Jr. High Core Subjects

[email protected]

Staff:

Lead Drill Instructor - Judi Walker Drill Instructor—LaWanda Daniels

[email protected] [email protected]

Drill Instructor – Nathan Wolfe Drill Instructor — TBD

[email protected]

Computer Lab Aide – Kristin Garland

[email protected]

ADAPT Campus Purpose Statement:

The purpose of the Alvin Disciplinary Alternative Placement Teaching Campus (ADAPT) is to equip students with the

tools needed to be successful in learning environments and life. While enrolled at the ADAPT Campus students will be

exposed to an environment of care as well as challenged academically, mentally and physically.

Vision Statement

The ADAPT Campus will create an environment that empowers our students to make appropriate decisions

when faced with challenges and become productive citizens in society.

ADAPT Campus Motto: “Soaring to Excellence”

ADAPT Campus Philosophy: Where Change Begins

We believe that education is the key to every student’s success and all students have the right to be educated.

It is our responsibility to leave a legacy of empowerment through education and to reach our students, so they

may empower themselves and others.

ADAPT Campus Five Core Values:

1. You have the right to be a student. 2. You have the right to learn.

3. You will be given the tools to help you learn to make good choices.

4. In the midst of distraction you will remain focused.

5. You will understand consequences.

ADAPT Campus Behavior Model:

o Social Skills Curriculum

o Teacher Interaction—Proactive teaching, corrective teaching, and crisis teaching

o Administrative Intervention—Consistent and supportive response to serious discipline

problems

o Motivation System—Positive motivation and empowerment

ADAPT Campus Physical Training (PT): Physical Training is a required element of the ADAPT Campus program. The ADAPT Campus physical training

promotes physical fitness, problem solving, self-confidence, endurance, and self-esteem. It is designed to

challenge the individual physically, cognitively, emotionally, and socially. The students are not required to be

of great athletic ability; however, they must show commitment and desire for change.

A student must have a doctor’s note with specific instructions and specific dates to be followed in order to

be excused from any activity. Without a doctor’s note, the student will be required to participate in PT.

PT will be held on the field next to the ADAPT building. During bad/cold weather, the students will be moved

into the cafeteria or inside.

PT Schedule:

May include but is not limited to circuit training, cardio, weights, and aerobic-exercises during the week.

PT is a part of the student’s schedule. He/She earns PE credit; there as, it must be completed daily. Failure

to complete PT will result in a failing grade, loss of credit, additional days added to placement, loss of levels,

and/or suspension. Students will PT in their daily uniform and have the option to remove their white shirt

and PT in their grey undershirt. No other clothes are permitted.

ADAPT Campus Searches:

All students assigned to Alvin ISD’s DAEP (ADAPT) will be searched every morning upon arrival. Students will

arrive with their white button up shirt, belt, and tie in hand in preparation for searches. Socks and shoes will

be removed at the time of search.

A drill instructor will search all clothing (including socks and shoes), any items that are in student’s possession

(i.e. books, binders, school supplies), and then pat search the student.

Any non-allowed item found during searches will be confiscated. Any student refusing to relinquish

contraband will be escorted to the office, parents will be contacted, and student may be suspended for up to 3

days and have up to 15 days added to his/her ADAPT assignments.

Tardy students will remain in the office until they can be searched by a drill instructor. Parents/Guardians

must wait with their student until after he/she has been searched before they may leave.

Students may be searched randomly throughout the day and metal detectors may be used at any time.

ADAPT Campus Expected Behaviors:

Students are required to be accompanied by a parent/guardian at check-in every morning. The

parent/guardian must wait in their car until after the student has been checked for 100% compliance

with ADAPT dress code and receive approval from a Drill Instructor to leave.

Students will adhere to the ADAPT Campus dress code at all times.

Students will have their black binder with them at all times with paper, pencils, and their written

Student Expectations visible on the outside of the binder.

Students will carry pencils and earphones in their binder only. They are not allowed in pockets, behind

the ear, or around the neck.

Students may not communicate with others verbally or non-verbally at any time without permission.

Students must walk to the right of the hallway at all times.

Students must walk to their designated class in a silent and timely manner.

Students will follow instructions the first time given without hesitation.

Students will be respectful to staff and peers at all times.

Students are expected to go to the restroom during their assigned restroom break times.

Students will follow each teacher’s classroom rules/expected behaviors.

Students may not bring any non-allowed items on campus. (Including but not limited to: money, make-

up, candy, pens, mechanical pencils, backpacks, jackets, jewelry, purses, or any item that would be a

violation of the law or that would jeopardize the safety of others.)

Hallway Rules and Procedures: No talking or whistling in the hallway! It should remain silent at all times.

Keep your hands behind your back. If carrying a binder or book, the left hand should be carrying the

item at your side while the right hand is behind your back.

Walk on the right side of the hallway and in a single file line at all times.

When you arrive to your classroom, line up outside the door behind the red line and wait for

permission from the teacher to enter.

Do not stop at other classrooms to speak to a teacher/student. Anything other than walking directly to

your assigned classroom will be considered truancy.

Do not stop at the restroom. All students will be given restroom breaks at predetermined times during

the day.

Parent/Guardian Expectations:

o Contact office when student will be absent and provide documentation for the absence upon

the child’s return.

o Wait until DI has checked your student in each morning before leaving and in cases where

he/she is tardy you will need to wait in the office with your child until after they have been

searched by a drill instructor.

o Review and sign any paperwork given by staff.

o Pick up your child with-in a reasonable time following dismissal (3:40pm). Your child is your

responsibility.

o When your child is suspended you MUST provide transportation for them with-in 30 minutes or

they will be released to walk.

o It is your responsibility for your child to attend school and be on time.

o Provide transportation for your child.

*ADAPT Campus Exit Requirements: Before students can be considered to exit the ADAPT Campus program, they must complete the required

amount of:

Days according to their placement

F.L.I.T.E./CIS Services

Reach the required number of points and be passing all classes.

Once the above are met and the student has consistently proven to have good behavior, he/she will

then be required to write a self-reflective speech to recite.

Students must be passing all classes in order to move up levels. Grades will be checked weekly. Teachers will

contact parents of any student not making academic progress.

The following pages outline the Levels and privileges along with a sample of the point cards used.

*Any student who is returned to the ADAPT campus in the same school year must meet a student-specific set

of exiting standards.

ADAPT Level System

Level Privileges

Level 2

1 – RR Passes

1 – Modified Dress Code Pass

Level 3

2—RR Passes

2—PT/Leave Passes

2—Modified Dress Code Passes

Level 4

5—RR Passes

5 – PT/Leave Passes

5 – Modified Dress Code Passes

Modified dress code passes must be presented to the DI’s in the mornings at drop off or students will

be considered out of dress code and not allowed to stay. If passes were left in the ADAPT building the

previous day, students will not be allowed to retrieve them during this time. Passes are required to be in

the student’s possession at all times. Students must take these passes home with them daily and are

responsible for them. Lost, stolen, or destroyed passes will not be replaced. Passes may not be given to

another student to use. They may only be used by the student who earned them. Upon exiting the ADAPT

program, any unused passes should be turned into the office.

When using a modified dress code pass, students may wear:

an Alvin ISD spirit shirt, college shirt, white polo, or white button up shirt

Khaki, black, or blue denim (no skinny or cargo) or khaki, black, or blue slacks (no skinny or cargo)

*All other dress code items and procedures are still required to be followed when using a modified dress code

pass (i.e. undershirt, belt, socks, shoes, hair/headband). Shirts longer than the student’s wrist will be required to

be tucked in.

Level Infractions

Level Downs

Persistent Sleeping

Insubordination

Consecutive Zeros (not turning in work)

Office Referral

Dress Code Violation

3 Tardies

Back to Level 1

Fighting

Vandalism

Verbal Assault

Disrespect to Teacher/ DI/ Staff

Profanity Directed toward Staff

*If you are dropped to Level One you will lose ALL of your points.

*If you are dropped a Level (Level Down) you will lose the points and start back at the value of your new Level and the student forfeits the use of

the level passes.

*All Students MUST be on Level 4 in order to be released from the ADAPT Program

Name

Level 1 1st Period

Date:

Period Monday Tuesday Wednesday Thursday Friday

Breakfast

1st 1

hallway 0

2nd 1

hallway 0

3rd 1

Hallway 1

Lunch 0

4th 1

Hallway 1

5th 1

Hallway 1

6th 1

Hallway 1

7th/PT 3

Hallway/Dismiss 1

Total Points 14 0 0 0 0

Total Points

for week

Week 1 Week 7

Week 2 Week 8

Week 3 Week 9

Week 4 Week 10

Week 5 Week 11

Week 6 Week 12

Point Balance 14

ADAPT Campus Procedures:

Clinic

Students are only taken to the AHS clinic in case of an emergency or if they have been hurt.

Parent/Guardians must pick up students with fever or vomiting.

Medicine

A trained staff member will administer prescription medicine. MEDICINE MUST BE BROUGHT BY

THE PARENT (NOT THE STUDENT) IN THE ORIGINAL PRESCRIPTION BOTTLE WITH LABEL. The

medicine administration form must be on file.

Attendance

Arrival: 6:45am – 7:10am

*Parents MUST wait in their cars until they get approval to leave from the Drill Instructor. The

student MUST be in dress code in order to stay, if not they will be counted tardy and sent home

and must return by 8:00am. If they do not come back, they will be counted absent. Students who

are sent home for dress code issues will not be added to the breakfast list, unless they are back

prior to the 7:10 cut off.

Any student who arrives after this time (7:10am) will not receive breakfast, as the list will be

turned in by this time. If a student is tardy, a parent will need to escort them into the office, sign

them in with the secretary, and wait with them until after they have been searched by a drill

instructor.

Tardy Policy

1st Tardy – loss of 10 points

2nd and 3rd Tardy – loss of 20 points

4th Tardy – loss of 50 points and assigned after school PT

5th Tardy – loss of 50 points, mandatory parent meeting, and no early release

Continued tardiness will result in further disciplinary actions.

Dismissal: 3:40pm

*Students not picked up by 4:00 will be considered walkers and will be released at that time. Please be here by

3:40. Your child is your responsibility.

When a student is absent, the parent is required to call the ADAPT office to report the absence.

Parents must also provide written documentation of the absences within three days in

accordance with district policy. Notes will not be accepted after three days and the student will

lose any points associated with an unexcused absence. Truancy will be filed on any student who

is out of compliance with the district attendance policy.

Transportation

It is the parent’s responsibility to provide transportation for their child to and from the ADAPT

Campus. Students are not allowed to walk, ride the bus or drive themselves to the ADAPT

Campus.

*Parents who are unable to provide transportation to the ADAPT Campus may submit a request in writing to the

campus principal to evaluate the transportation need of the child. The campus principal will have the final say on

whether or not a student may walk. Once/If walking access is permitted; ANY infraction of the rules (tardy, dress

code, behavior) will result in the privilege being revoked.

Trespassing

ADAPT Campus students are allowed on the ADAPT Campus only. Students may not be on any

other ALVIN ISD campus for any reason. This rule applies to the formal school day as well as to

after school functions such as dances and sporting events. Students in violation risk disciplinary

action including tickets and/or fines and suspension.

A student placed in a disciplinary AEP may not participate in or attend ANY school-sponsored or

school-related extracurricular or co-curricular activities during the period of placement.

*See Criminal Trespass Warning

ADAPT Dress Code:

The ADAPT dress code is to be followed at all times. Our goal is to establish a manner of dress

that will reflect excellence and self-respect. The following dress code is intended to accomplish a

standardized school dress without having to order from a specific uniform company or catalog.

Any student who arrives out of dress code will be returned to his/her parent and have the

opportunity to correct the infraction prior to the start of the school day. Students are expected

to return to school in dress code, if returned to parent. If a student walks to campus, a staff

member will contact a parent or other contact, the student will be sent home and their walking

privilege will be revoked.

Daily Uniform:

White long sleeve button-up dress shirt with functioning top button

Solid grey t-shirt undershirt

Black “Docker-pant” style pants (for females too)

Black tie

Solid White or solid black socks

Solid black leather-type belt (NO BELT BUCKLES WITH DESIGNS)

Solid black tennis shoes with no accents

Black 3 ring binder with paper, pencils, and other supplies

A sports bra is recommended for young ladies.

Students may wear solid black sweatshirt (no hoodies) over regular dress if needed.

Shirts

Shirts are to be tucked in and buttoned all the way to the top of the shirt at all times. If the top

button breaks, it is the responsibility of the student to return the next day with it fixed. No

undershirts with writing will be allowed. No tank tops (A-shirts) will be allowed as undershirts.

STUDENTS MUST HAVE A GREY UNDERSHIRT. This will be the shirt students PT in. There will be

NO PT clothes.

Pants

Pants must be a “Docker-pant” style and material, with or without pleats, without cuffs. This is

the same expectation for females. Females who show up with ANY PANTS (such as but not

limited to skinny, tight, stretchy/yoga) other than the Docker style, will be considered out of

dress code and sent home.

NO “five-pocket” jean style, cargo pants style, denim material, stretch fabric (YOGA PANTS),

hip-huggers, “skinny” or corduroy pants. THE PANTS MUST NOT BE TIGHT FITTING IN ANY

WAY. DISCRETION WILL BE UP TO THE STAFF.

Pants are to be worn at the waist. They must be fitted at the waist and in the crotch before being

belted. Any student who is unable to keep his/her pants at the waist will be given the

opportunity to tighten his/her belt or a zip tie will be used to assist in keeping pants at the proper

fit and we will attempt to notify parents in each case. Persistent offenders may be leveled down

and subject to suspension. Students may not roll up their pant legs into tight cuffs. Slacks must

be hemmed at appropriate length; no frays, slits or tears. Tight or baggy fitting pants are not

permitted at any time. No athletic shorts are to be worn under the pants.

Belts

Belts are to be worn at all times and are to be leather or plastic and must be solid black with no

decorative designs. Belt Buckles must be plain without design. Students may not wear cloth belts

or shoe laces for belts at any time.

Shoes

Shoes must be tennis shoes, athletic shoes, or Van styled shoes only. Shoes must be solid black,

including the sole of the tennis shoe, with no accent colors. The shoe laces must also be black.

Shoes must be worn at all times.

Socks

All white/black socks will be worn. Students who violate this rule will be required to remove

their socks.

This is an example of the proper dress code. This is for males and females.

Hair

Hair color must be a natural/ standard color.

Eyebrows must be free of shaved and dyed designs (students with slashes in eyebrows will need

to shave the brow(s) from the slash to the end of the eyebrow OR color the eyebrow in with a

black marker).

Males: Young men’s hair will not exceed 1/8 inch in length and must be cut prior to enrolling in

the ADAPT Campus. Hair must be kept at this length or shorter. A verbal warning will be given to

the student if hair begins to exceed the required length and a letter may be sent home with the

student, but it is the student’s and parent’s responsibility to maintain the length. Students will be

sent home if hair is in violation and should return with the appropriate cut.

Haircuts may not have designs or parts cut into the hair (students with designs in their hair will

shave their entire head on site or be sent home). Sideburns shall not be below the earlobes and

shall not be flared. No braids or corn rows allowed.

No facial hair is permitted: no mustaches, beards, or goatees will be allowed at any time.

Students violating this rule will be required to shave on site or be sent home if repeated

violations.

Females: While enrolled in the ADAPT Campus, young ladies must wear their hair in a tight bun

using a black cloth “bungee tie”. It will not go beyond the top of the shoulders when wrapped in

the bun hair style. All young ladies are required to wear a black elastic head band in order to

keep all hair pulled away from their face. No bangs or loose hair around the face. Failure to

comply may result in being sent home until in compliance, loss of points, or suspension.

Below are examples of how hair should look when students arrive.

Tattoos

All tattoos, writing, or markings of any kind must be covered at all times, including during PT. If it

cannot be covered with clothing, it must be covered with bandages and be done prior to arrival.

Students who have visible tattoos and/or markings at arrival will be sent home with parents, and

expected to return once covered. Students who have tattoos and/or markings that may be visible

during PT will need to have a long sleeve solid grey undershirt, wear their long sleeve white

button up shirt, or have the necessary bandages to completely cover the tattoos and/or markings

during the PT scheduled time. Student must provide these items.

No cologne/perfume of any kind is permitted.

Accessories

Jewelry: No jewelry of any kind will be permitted. Students may not wear any form of decorative

item (such as but not limited to: watches, earrings, necklaces, facial piercing items, chains,

rubber bracelets, finger rings, rubber bands, ankle bracelets). Any items confiscated will be

returned to the parent upon student’s release of the ADAPT program (NOT AT THE END OF THE

SCHOOL DAY). If these items are not picked up, they will be disposed of accordingly.

Grills: Grills are non-permanent dental appliances for decorative purposes. These decorative

appliances will not be permitted at any time.

Fingernails: No fake fingernails/tips or fingernail polish will be allowed. Fingernails for males and

females should be kept trimmed (no longer than the end of the fingertip).

Make-up: Students will not wear make-up of any kind to school or related ADAPT Campus

functions (including, but not limited to, foundation, powder, eyeliner, lip gloss, mascara, etc.).

Make-up wipes will be provided and any refusal to remove may result in suspension and

additional days added.

Any failure to comply with the dress code will result in a student being sent back to their

vehicle and afforded an opportunity to correct the infraction and return to school by 8:00

without being counted absent. Students may lose points or have after school PT for arriving out

of dress code. Failure to return to school by 8:00 will result in a student being marked

unexcused. This may result in truancy issues and add additional time to their ADAPT

placement.

Cell Phones: Cell phones are not allowed.

If confiscated the phone will be turned over to the ADAPT principal and there will be a

$15.00 fee to retrieve the phone; student will receive a disciplinary write-up.

Breakfast/Lunch Money: Students are only allowed to bring money for their breakfast/lunch. It

should be brought enclosed in an envelope labeled “Lunch money,” with the amount enclosed

and the name of the student listed. Any money found on a student will be considered lunch

money and will be deposited into his/her lunch account.

Misc: No backpacks, purses, make-up bags, make-up, sun-glasses, lanyards, gloves, hair clips, hair

brushes, rat-tail combs, picks, caps, hats, bandanas, hair nets, or wave caps will be allowed. If

confiscated, they will be discarded/thrown away immediately.

No radios, cameras, beepers/pagers or video games, are allowed. If confiscated, the cell phone

procedure/fines will be followed.

No gum or candy is allowed at any time on campus. This will be disposed of immediately. Any

non-approved item will be returned to parents upon students release from ADAPT. Any student

refusing to relinquish items will be suspended for up to 3 days and have up to 15 days added to

his/her ADAPT assignments.

ALL confiscated items will be returned to the parent upon students release from the

ADAPT program (NOT AT THE END OF THE SCHOOL DAY). At the end of the school year,

any item not collected by a parent/guardian will be thrown away.

ADAPT Supply List

Any student entering ADAPT must provide the listed supplies at Intake.

These supplies will need to be brought to Intake-Orientation when the student reports to ADAPT.

Please do not label the supplies. These items will not be returned. We understand that school

supplies might have been purchased earlier but these items will be needed while serving

his/her ADAPT placement.

24 – #2 Pencils (no mechanical pencils allowed)

4 – Spiral notebooks (1 subject)

1 – Pack of loose leaf paper 100 sheet count

1 – 2 inch 3 ring solid black binder

1 – Box of tissues

2 – Pump bottles of Germ-X

Students must bring one pair of headphones/earbuds. Headphones/earbuds will remain with the

student throughout the day and be kept in their binders when not in use. Headphones/earbuds

should not be left in any classroom or anywhere else on the ADAPT campus. Alvin ISD or ADAPT

staff are not responsible for loss or theft.

Male students:

1 – Pack of disposable razors

1 – Can of shaving cream

Female students:

1 – Pack of black hair bands

1- Pack of facial wipes

Feminine products labeled with the student’s name

No pens of any kind or color are allowed.

Students may only bring what is on this supply list. Any other items will be considered

contraband, confiscated and not returned (i.e. pictures, drawings, photos).

If a student has an issue obtaining these supplies please contact the office.

Alvin Independent School District

ADAPT CAMPUS PARENT/STUDENT CONTRACT

STUDENT: _____________________________________ ID#: ________________

HOME CAMPUS: _____________________________________ GRADE: _________

This receipt is to verify that I and my student have received a copy of the

GENERAL STUDENT RULES of the District ADAPT Program, which informs us of

our responsibilities throughout the ADAPT assignment. My signature below

indicates that I understand the rules and regulation of the ADAPT program.

I have read and understand the rules and regulations before me as binding. I

understand that not meeting the guidelines and expectations of the ADAPT

program may result in myself and/or my child incurring penalties which may

include court, tickets, fines, ISS, or JJAEP. I understand that during my orientation

at ADAPT, I have received specific information regarding dress code, leveling

system, and ADAPT procedures. As the parent/guardian I agree to support the

ADAPT program and all of its initiatives. I also understand that failure to meet

parental requirements will result in my child remaining in the program until all

requirements are satisfied.

Signature of Parent/Guardian Date Signed

I understand the rules and regulations of the ADAPT program and agree to comply

and follow all rules at all times. I also agree to comply and follow the student dress

code, student code of conduct, and write a self-reflective speech prior to my

scheduled exit release date.

Signature of Student Date Signed

I (Parent/Guardian): _________________________________________________

have read all sections of the ADAPT Campus Student Handbook, including the

highlighted sections below. By initialing below I verify that I have read all

sections of the ADAPT Campus Student Handbook and attended the orientation

where I could ask questions about policies and procedures governing the ADAPT

Campus.

__________ADAPT Campus Contact Sheet

__________ADAPT Physical Training (PT)

__________ADAPT Campus Searches

__________ADAPT Exit Requirements

__________ADAPT Level System

__________Expected Behaviors

__________Attendance

__________Tardy Policy

__________Transportation

__________Trespassing (Including Criminal Trespass Warning)

__________Clinic

__________Medicine

__________ADAPT dress code is to be followed at all times.

__________Hair Policies (for male and female)

__________Cell Phones

__________Money

__________ADAPT School Supplies

ALVIN ISD ADAPT

Student Information Form Student Name: _____________________________________________ Grade: _____________

Student ID Number: _______________________Home Campus: ___________________________

Address: ________________________________________________________________________ City: ___________________________Zip: __________Home Phone: ________________________ Student lives with: _______________________________ Relationship to student: _______________ Address: ___________________________________________ Phone: _____________________ Place of Employment: _____________________________ Work phone:______________________ E-Mail:_________________________________________ Cell Phone: _______________________ Contact Person #2:_______________________________ Relationship to student: ______________ Place of Employment: _____________________________ Work phone:_______________________ E-Mail:_________________________________________ Cell Phone: ________________________ Students must be dropped off each morning but have the option of walking home. How will your student get home each afternoon? Car rider _____________ Walker _______________ Parents/guardians must send an email or a note with contact information by 3:00, if afternoon transportation changes. Students listed as car riders, will remain in the office until after 4:30 if no contact has been made.

Emergency Information: If contact #1 or #2 cannot be reached, please provide three additional names and numbers for persons who may pick up or drop off your student. Name: Number: __________________________________________ _______________________________ __________________________________________ ________________________________ __________________________________________ ________________________________ In case of a medical emergency please provide the name and number of your family doctor: __________________________________________ _______________________________ Known allergies? _____________________ Currently taking any medication? ________________ If student will need to take medication at school, please contact the office for medication forms you must complete. Any physical limitations documented by doctor? ______________________________________ Any physical injuries? _______________Dietary restrictions? ____________If yes, please contact office. Other Information: Free lunch? Yes: _______ No:_______ Lunch PIN number: ___________________ Parents/guardians understand they are responsible for keeping their student’s cafeteria account current. If a student does not have money in his/her account, the cafeteria will not allow him/her to charge items and the student will not receive breakfast or lunch. Is student on probation? _________________ If yes, how long? ________________ Probation Officer Contact Information: ________________________________________ __________________________________ name number

ALVIN INDEPENDENT SCHOOL DISTRICT

Criminal Trespass Warning

Pursuant to Section 30.05(b)(2) of the Texas Penal Code, ______________________________________ Last Name First Name M.I. ___________________________________________________________________________________ Street Address City State Zip Code Telephone No. ___________________________________________________________________________________ Date of Birth Height Weight Color Hair/Eyes D.L. No. State has been warned and ordered not to return to property under the control of the Alvin Independent School

District.

This warning is given on the __________day of___________________20_____at_________A.M./P.M.

If the above named student returns to any property under the control of the Alvin Independent School District

with the exception of the ADAPT center without the proper authorization, the student is subject to criminal

prosecution for Criminal Trespassing. Proper authorization is a written permission slip giving the student

authorization to be on school district property and is signed by the school principal or the principal’s

designee. This trespass warning is in effect until the student completes his/her assigned days in ADAPT.

_____________________________________________________________________________________ Signature of Parent Date

___________________________________________________________________________________ Signature of Student Date ___________________________________________________________________________________ Signature of School Authority Date