Forms Repository

For all field trips, please read policies: BP 6153 School-Sponsored Trips AR 6153 School-Sponsored Trips BP 3541.1 School-Related Trips AR 3541.1 School-Related Trips For field trips which include a Special Needs student: AR 6153.1 School-Sponsored Trips/Special Medical Needs Field Trip Requi

  Employee Accident & Workers CompensationRisk Management InstructionsOccupational Injury Illness InstructionsOn the Job Injury or Illness Flow ChartFORMSMandatoryReport of Occupational Injury or Illness (Workers' Comp Form) with State instructionsEmployee Injury Illness Report (Risk Management)Supplementary Temporary Prescription Services IDPhysicians Return to

1 AVTEC (ALASKA VOCATIONAL TECHNICAL CENTER) SCHOLARSHIP APPLICATION Sponsored by the Kenai Peninsula Borough School District Career & Technical Education 2010-1011 One 2011/2012 full-year tuition waiver This application form is intended to aid in the Career & Technical Education scholarship review process. If you wish

1 KENAI PENINSULA COLLEGE SCHOLARSHIP APPLICATION Sponsored by the Kenai Peninsula Borough School District Career & Technical Education 2010-2011 One 2011/2012 full-year tuition waiver This application form is intended to aid in the Career & Technical Education scholarship review process. If you wish to be considered f

www.kenaipeninsulabuilders.com KENAI PENINSULA BUILDERS ASSOCIATION SHELBY JOHNSON MEMORIAL SCHOLARSHIP Three $1,000.00 SCHOLARSHIPS Any member of the Kenai Peninsula School District 2011 Senior Class, or High School Graduate residing on the Kenai Peninsula who plans to pursue a career in a building-related field, and

www.kenaipeninsulabuilders.com KENAI PENINSULA BUILDERS ASSOCIATION SHELBY JOHNSON MEMORIAL SCHOLARSHIP Three $1,000.00 SCHOLARSHIPS Any member of the Kenai Peninsula School District 2012 Senior Class, or current juniors that will graduate in 2013 who plans to pursue a career in a building-related field, and who will a

Transportation nss 9/24/01 Emergency Contacts Medical Facilities Anchorage Alaska Native Medical Center 4315 Diplomacy Drive (Off Tudor) 563-2662 Emergency Room 729-1729 Anchorage Alaska Regional Hospital 2801 DeBarr Road 276-1131 Emergency Room 264-1222 Anchorage Providence Alaska Medical Center 3200 Providence Drive

KENAI PENINSULA SCHOOL DISTRICT AFTER SCHOOL ACADEMY PARENT/GAURDIAN AUTHORIZATION TO PARTICIPATE The Kenai Peninsula Borough School District has been awarded a grant through the State of Alaska to provide basic training to interested high school stu dents. The program is free of charge and is conducted b

SB-20647-0509 KENAI PENINSULA BOROUGH SCHOOL DISTRICT SECTION 125 ANNUAL ELECTION FORM American Fidelity Assurance <PLAN YEAR 7-1-11 TO 6-30-12> Name of Employee:___________________________________________ E# or Social Security Number:_____________________ Employee Address:______________________________________________

AR 6162.71 Instruction INTERNET USE AGREEMENT General Provisions Authorized Members It is a general policy of the District to promote the use of computers in a manner that is responsible, legal and appropriate. KPBSD-Net is intended for the use of authorized members only. Any person using

AVTEC (ALASKA VOCATIONAL TECHNICAL CENTER) SCHOLARSHIP APPLICATION Sponsored by the Kenai Peninsula Borough School District Career & Technical Education 2011-1012 One 2012/2013 full-year tuition waiver This application form is intended to aid in the Career & Technical Education scholarship review proces

KENAI PENINSULA BOROUGH SCHOOL DISTRICT PROFESSIONAL DEVELOPMENT BROKERED COURSE GUIDE I. Overview Brokered Course: The Kenai Peninsula Borough School District (KPBSD) and Kenai Peninsula College (KPC) have established a partnership where KPBSD employe es can enroll in upper division 500-level professional

This evaluation handbook, including the process and instruments, were developed during the 1995-96 and 1996-97 school years with direction from the school board. The final stages of development were meant to align the process with the mandates of House Bill 465, which ultimately became SLA 96, Chapter 31. A committee m

Chart of Accounts – Cheat Sheet CODE STRUCTURE: Fund Location Function Program Object xxx xx xxxx xxxx xxxx For purposes of budget building, the "100 School Operating (General Fund)” is used. FUND CODES 100 School Operating (General Fund) 260 Title III-A, English Lang. Acquisit. 289 Governors Drug Prevention 201 State

APPLICATION Developing K-3 Assessment Tools for Report Cards (Grades K-3) September 12, 2008 Application Deadline Committee membership is open to community members, parents, teachers, and students interested in developing the district s K-3 Assessment T ools for Report Cards. Persons interested in working

APPLICATION Social Studies Curriculum Review Committee (Grades K-12) September 12, 2008 Application Deadline Committee membership is open to community members, parents, teachers, and students interested in reviewing and developing the district s Social Studies curriculum. Persons interested in working on

APPLICATION World Language Curriculum Review Committee (Grades K-12) September 12, 2008 Application Deadline Committee membership is open to community members, parents, teachers, and students interested in reviewing and developing the district s World L anguage curriculum. Persons interested in working on

KENAI PENINSULA BOROUGH SCHOOL DISTRICT COOP EDUCATION TRAINING AGREEMENT The work station will permit (student name) to be employed in their business for the purpose of gaining knowledge and experience in the occupation of _____ from , 200 , to , 200 . The training will be provided in accordance with the following

ls 7/17/09 KENAI PENINSULA BOROUGH SCHOOL DISTRICT 148 N.BINKLEY SOLDOTNA, AK 99669 COURSE APPROVAL FOR SALARY ADVANCEMENT NAME ____________________________ SCHOOL ___________________________ GRADE/SUBJECT_________________ COLLEGE/UNIVERSITY _______________________________ DATES ATTENDED ______________________

Sheet3Sheet2Sheet1Check1Check2Kenai Peninsula Borough School DistrictPAYROLL DIRECT DEPOSIT AUTHORIZATIONI,Name (please print)Social Security NumberWork LocationI hereby authorize the KPBSD to make net payroll deposits to my account as indicated below:Payroll remittance to:Financial InstitutionFinancial Institution

DOING BUSINESS WITH KENAI PENINSULA BOROUGH SCHOOL DISTRICT 148 NORTH BINKLEY SOLDOTNA, AK 99669 (907)714-8888 FAX (907)262-9645 Website: www.kpbsd.k12.ak.us Created: August 2010 Superintendent Dr. Steve Atwater Assistant Superintendent, Instructional Support Dave Jones Director of Finance Laurie Olson Director of Plan

Transportation nss 10/15/01 Kenai Peninsula Borough School District Drivers Report of Accident All accidents must be reported immediately to your supervisor and the District Transportation Coordinator (Nan Spooner 262-8549 W, 283-3235 H). Do not discuss accident with anyone except your supervisor, the Borough Risk

E 0420Kenai Peninsula Borough School DistrictSite Council Annual Evaluation FormDue to Superintendent by June 1.School:Meeting dates and approximate attendance for this school year:What steps did the council take towards achieving the school goal(s)? Which topic discussed/acted upon by your council led most

E 0420(b) KPBSD SITE-BASED IMPROVEMENT COUNCILS Dedicated to the Continued Delivery of Quality Education for all Students Date: ________________________ Concern: _______________________________________________________ _______________________________________________________ Explanation:

VOLUNTEER QUESTIONNAIREYou are a recipient of unconditional love, you are a volunteer!PERSONALNamePhone #AddressCityZipI am available to be at school the following days:¤ Monday ¤ Tuesday ¤ Wednesday ¤ Thursday ¤ FridayEMPLOYMENTI am presently: ¤ working full time¤ working part time¤ homemaker¤

August 2003 Instruction/ma Kenai Peninsula Borough School District Request for Reconsideration of Instructional Materials Title, Author, Other Description of Material: Text Reader Library Book Periodical Pamphlet Type: Film Recording Other (describe): 1. Statement of objection (Please be specific: cite page, concepts,

E1312a Community Relations Public Complaints Concerning the Schools When problems, concerns or complaints arise regarding the School District, its practices or personnel, there are processes in place to help facilitate the resolution of those issues.  Policy 1312.1 Public Complaints Concerning School Perso

E 1312Kenai Peninsula Borough School DistrictComplaint FormDate:Time:Phone Number:Name:SchoolMailingAddress:Grade level of Student: School Board Policy 1312 (Community Relations)In order to promote fair and constructive communications, this form shall govern the resolution of complaints. Complaints concerning school

E 1321(a)GUIDELINES FOR GAMING RAFFLESAll raffles must be pre approved by the Assistant Superintendent.Do not raise funds using another organization's gaming permit.Do not allow other organizations to raise funds with your raffle permit.Only raffles and bingo are allowed no pull

Kenai Peninsula Borough School District Gaming / Raffle Pre-Approval Name of School Name of Class / Club / Activity Sponsoring Raffle Name of Adult in Charge Title (Teacher, Parent, etc.) Address Phone How Will Raffle Funds be Used? D ates Tickets Will be Sold Beginning Date Ending Da

KENAI PENINSULA BOROUGH SCHOOL DISTRICT E 1330(a) Room/Building Use Application School Room Name, No., Etc. Date(s) of Activity Age(s) of group Admission will, will not, be charged. (Day of Week) From: to Approximate n

E 2250 Administration Absence from Buildings If the administrator is sick, the school secretary should notify the superintendent via e-mail (copy the superintendent’s secretary). If the administrator is on other leave, s/he must send the superintendent an e-mail leave form prior to the absence.  When

E 3310(a) KENAI PENINSULA BOROUGH SCHOOL DISTRICT p-CARD USE AGREEMENT AGREEMENT made this __ day of ____, 20 __, between the Board of Education of the Kenai Peninsula Borough School District, and ______________, residing at ______________, City/State/Zip ____________, (hereinafter the “Staff Memb

E 3316 Kenai Peninsula Borough School District REQUEST TO DO BUSINESS WITH THE KENAI PENINSULA BOROUGH SCHOOL DISTRICT TO BE SUBMITTED TO SUPERINTENDENTS OFFICE ________________________________________ ________________________ Name Date Submitted ________________________________________ ________________________

ACTIVE LIST TAX SHELTER ANNUITY COMPANIES January, 2006 E 3342(b) AAL Capital Management Co 4321 N Ballard Rd. Contact: Ruth Lewis, Soldotna 907-260-3320 Appleton, WI 54915-0003 Contact: Al Basler, Anchorage American Fidelity 2000 N Classen Blvd. Contact: Darcy Carter 800-450-3506 ext. 6155 Oklahoma City, OK 73106

Elective Deferral and Vendor Election Form Plan Name: Kenai Peninsula Borough School District 403(b) Plan Ref. No. 105821 To Enroll: Complete All Sections To Change Contribution Amount: Complete Sections A, B and D To Change Vendors: Complete Sections A, C and D To Change Contract/Account Number:

Sheet1STATEMENT OF EXPENSESNameAddressRECEIPTS MUST BE ATTACHEDFOR EXPENSES IN CONNECTION WITH:Purpose of MeetingMeeting atDates TRANSPORTATION:SunMonTueWedThuFri Sat OTHER EXPENSES:Please listTOTALDateAccount numberEmployee Signatureand accordingly make claim for reimbursement.I certify the above is a true statement

Sheet1KENAI PENINSULA BOROUGH SCHOOL DISTRICTSTATEMENT OF MILEAGE EXPENSESBoard Members and District EmployeesNameAddressMonthDateFromTo PurposeActual MilesTOTAL REIMBURSEMENT REQUESTEDI hereby certify that the above is a true statement of expenses incurred by me in connection with the activity notedand accordingly

E3530c Kenai Peninsula Borough and Kenai Peninsula Borough School District Employee Injury/Illness Report System ID # Employee Report: This report should be filled out regardless of the extent of injury. If your injury/illness requires medical attention other than first aid or causes you to miss your next scheduled

Keywords: field trip KENAI PENINSULA BOROUGH SCHOOL DISTRICT E 3541.1(a) SCHOOL DRIVER REGISTRATION FORM DRIVER (check one) Employee Parent Volunteer Student Name Date of Birth Address Driver's License No. Expiration Date Telephone No. VEHICLE Name of Owner Year Address Make License Plate No. Registration Expires Seating Capacity must

Keywords: field trip KENAI PENINSULA BOROUGH SCHOOL DISTRICT 3541.1(b) Private Vehicle Transport Safety Check The following is to be completed by school personnel for any person driving a private vehicle transporting KPBSD students to a District sanctioned event. The Principal or designee is responsible for reviewing this form with the

Keywords: field trip KENAI PENINSULA BOROUGH SCHOOL DISTRICT E 3541.1(c) Booster Seat Safety Check The following is to be completed by any person driving a private or school district owned vehicle transporting KPBSD students to a District sanctioned event. The Principal or designee is responsible for reviewing this form with the drive

KPBSD Policy ManualE 3543Sign and return to Operations and Business Management by October 31. SCHOOL BUS SAFETY INSTRUCTION FORMBy state regulation, each school district is to “provide instruction on safe boarding, riding, exiting and emergency procedures to school children transported to or from a public school by

KPBSD Policy Manual E 4020DRUG AND ALCOHOL-FREE WORKPLACE NOTICE TO EMPLOYEESYOU ARE HEREBY NOTIFIED that it is a violation of Board policy for any employee at a School District workplace to unlawfully manufacture, distribute, dispense, possess, use, or be under the influence of any alcoholic beverage, drug, or

KPBSD Policy Manual E 4030EMPLOYEE NOTICEPROTECTION FOR WHISTLE BLOWERS Any employee of the school District may, in good faith, report to a public official or a public body, or testify before a public body about a matter of public concern. A matter of public concern means a violation of federal, state, or local law

KPBSD Policy Manual E 4119.21 4219.21 4319.21 20 AAC 10.020 CODE OF ETHICS AND TEACHING STANDARDS Professional Teaching Practices Commission (a) The following code of ethical and professional standards governs all members of the teaching profession. A violation of this section is grounds for discipline as provided in

KPBSD Policy ManualE 4119.42 4219.42 4319.42 KENAI PENINSULA BOROUGH SCHOOL DISTRICT 148 North Binkley Street – Soldotna , AK 99669-7598 – Phone 907-714-8888 – FAX 907-262-9645 HEPATITIS B VACCINATION DECLINATION FORM I understand that due to my occupational exposure to blood or other potentially infectious materials,

E 4119.43 4219.43 4319.43 Safe Glove Removal To avoid self-contamination, use the following method when removing gloves. Step Procedure Illustration Step 1 To remove the first glove, pinch the glove near the top edge. Graphic showing a person with latex gloves on both hands pinching one glove near the top edge. Step 2

KPBSD Policy ManualE 4154 4254 4354Health Benefits Responsibility Timeline Plan Administrator Provide written notice to all employees of coverage under COBRA At commencement of coverage District Notify Plan Administrator of employee death, termination, retirement, Medicare eligibility or reduction in hours Within 30

E 5111(a) EARLY ENTRANCE SCREENING Childs Name Age Birthdate Date of Screening Parent/guardians Name Address Telephone number (day time) The purpose of this screening tool is to provide information in helping to determine the most appropriate placement for a child being considered for early entrance into kindergarten.

E 5111(b)Early EntryParent QuestionnaireChilds NameAge:Birthdate:Parent/GuardianAddressDate:Circle the number of each item, which applies to your child. Add pertinent information to each as applicable.1.Started to walk and talk before most other children you know about.2.Is at least a little taller, heavier and

E 5116(a) KENAI PENINSULA BOROUGH SCHOOL DISTRICT OUT-OF-AREA ATTENDANCE REQUEST I. TO BE COMPLETED BY PARENT: STUDENT NAME GRADE ADDRESS Box/Street Address City Zip Code Phone PLEASE DESCRIBE EXACTLY WHERE YOU LIVE IF NOT SPECIFIED IN YOUR ADDRESS: WHICH BUS SERVICE AREA DO YOU LIVE? WHY DO YOU MAKE THIS REQUEST? BE

E 5123Kenai Peninsula Borough School DistrictRetention/AccelerationSchoolTeacherGradeDateStudent NameAcademic Abilities (Read/Math/Lang. Arts)*InterventionParent Notifieda, b, c, Dated, e, f, g*Interventions:(a) Motivation Strategies(e) Teacher Change(b) Intervention Team(f) Tutor/Special Services(c) Parent

E 5125.1 Kenai Peninsula Borough School District Directory Information Parent Opt-Out Form I request that my student be exempted from release of student directory information including students name, address, telephone number, electronic mail address, photograph, date and place of birth, major field of study,

E 5125(a) Kenai Peninsula Borough School District For Students Age 18 and Older Disclosure to Parents of Dependent Students and Consent Form To: Registrar, ____________________________________ ____________________ School Student ID From: ____________________________________________ ___

E 5134 EXPRESS ASSUMPTION OF RISK ASSOCIATED WITH THE PURCHASE OF STUDENT MANUFACTURED PRODUCTS AND STUDENT SERVICES I, __ ____ do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with the purchase of student manufactured products and services conducted by or

E 5141.21(a) SHORT-TERM MEDICATION REQUEST --PRESCRIPTION--School personnel will administer currently prescribed medicines for a period not to exceed two weeks. Medications must be delivered to the school in labeled prescription containers marked with the students name. All information requested below must be

E 5141.21(b) KENAI PENINSULA SCHOOL DISTRICT STUDENT MEDICATION RECORD SHORT-TERM PRESCRIPTION SCHOOL Special Instructions/Precautions Student: Medication: Dosage: Time Ordered: Date Time Initial Date Time Initial PERSON GIVING MEDICATION Initial Signature Initial Signature NP 101 Rev. 10/04

E 5141.21(c) OVER-THE-COUNTER MEDICATION REQUEST --NON-PRESCRIPTION--School District personnel may administer, at the nurses discretion, over-the-counter/nonprescrriptio medications for a limited period of time. Medications must be delivered to the school in the original containers marked with the students name. All

E 5141.21(d) KENAI PENINSULA SCHOOL DISTRICT STUDENT MEDICATION RECORD NON-PRESCRIPTION OTC STUDENT MEDICATION SCHOOL DOSAGE/TIME SPECIAL INSTRUCTIONS/PRECAUTIONS Date Time Initial Date Time Initial Date Time Initial PERSON GIVING MEDICATION Initial Signature Initial Signature NP 102 Rev. 1/04

E 5141.21(e) LONG TERM MEDICATION REQUEST School personnel may agree to honor parent requests for the administration of prescribed medication to students. Any medication sent to school without proper identification will not be given. Medication must be in the most current prescription container that indicates: student

SCHOOL_________________________________ KENAI PENINSULA SCHOOL DISTRICT Med Count q Month NP 106 Rev. 10/04 SPECIAL INSTRUCTIONS ______________________________ ______________________________ ____________________________________ STUDENT _____________________________________ ______________________________ MEDICATION

E 5141.23 Students PRECAUTIONS FOR INFECTIOUS DISEASE PREVENTION Hand washing is the single most important technique for preventing the spread of casually transmitted diseases. Liquid soap is preferable to bar soap. Hands should be washed thoroughly for 15 to 30 seconds with soap and warm running water, rinsed

E 5141.6 Students STUDENT NUTRITION AND PHYSICAL ACTIVITY Section 204 of PL 109-265 – June 30, 2004 Child Nutrition and WIC Reauthorization Act of 2004 (a) IN GENERAL - Not later than the first day of the school year beginning after June 30, 2006 , each local education agency participating in a

E 5141.4(a)KENAI PENINSULA BOROUGH SCHOOL DISTRICTREFERRAL FOR SUSPECTED CHILD ABUSE OR NEGLECTWithin 24 Hours, Mail To:HomerOffice of Childrens Services3670 Lake Street, Suite 100Homer, AK 99603 (235-7114)Fax (235-2484)Kenai/SoldotnaOffice of Childrens Services145 Main Street Loop, #100Kenai, AK 99611(283-3136)Fax

E5141.4(b) STATE OF ALASKA SARAH PALIN, GOVERNOR DEPARTMENT OF HEALTH AND SOCIAL SERVICES OFFICE OF CHILDRENS SERVICESKenai Field Office145 Main Street Loop Suite 100Kenai AK 99611O: (907) 283-3136F: (907) 283-9093TO:_________________________________________DATE:

Keywords: discipline E 5144.1 Students LONG-TERM SUSPENSION/EXPULSION PROCESS Be familiar with the following District Policies and Regulations: 5131.6 (if related to substance abuse) 5145.12 (if related to search and seizure) 5144.2 and 5144.11 (due process) 5144.1 (if related to expulsion) Contact the following:

Keywords: suspension, discipline E 5144.1(b)StudentsOrder of Hearings SUSPENSION HEARINGS  Hearing Type Description AppealInformalBy Principal or designee when there is cause to believe student has violated law, policy, regulation or school rules. Meeting requires no prior notice.Suspensions of 10 days for less may not be appealed. Suspensions

7/1/03* E 5144.11 (a) REQUEST FOR RECONSIDERATION STUDENT/PARENT DISCIPLINE APPEAL (Form must be filed within 5 school days of the alleged violation) NAME OF STUDENT: NAME OF PARENT/GUARDIAN: ADDRESS: PHONE(DAYTIME): EVENING: PLEASE SPECIFY THE DISCIPLINARY ACTION YOU WISH TO APPEAL: WHAT SPECIFIC RULE, POLICY, ACTION

Keywords: discipline E 5144.11(b) Students HEARING PROCEDURE HEARING PROCEDURE-LEVEL ONE ( by Hearing Officer) Indicate that the session will be taped and summarize the procedure for those in attendance. Turn on the recorder and state the date, time and place of the hearing. Identify yourself as the hearing officer. Read,

Keywords: expulsion, discipline E 5144.11 (c) Kenai Peninsula Borough School District Procedure for Student Hearings (by the School Board) Opening Statements 5 minutes(Student) Opening Statements 5 minutes(District) Presentations 20 minutes(Student) Presentations 20 minutes(District) Closing Remarks 5 minutes(Student) Closing Remarks 5 minutes(District)

Keywords: discipline Expulsion Recommendation ProcessE 5144.1(c)Violations and Informal HearingPrincipal places student on suspension with recommendation for expulsionSuperintendent conducts Level I hearingSuperintendent conducts administrative reviewNo AppealAppealAppealNo AppealBoard conducts expulsion reviewDecision renderedBoard conduc

E 6141 (a) CURRICULUM DEVELOPMENT PROCESS K -12 BELIEFS DISTRICT MISSION STATEMENT GOALS FOR STUDENT LEARNING DISTRICT ASSESSMENT POLICY PROGRAM STANDARDS AND ASSESSMENT CURRICULUM (COURSE STANDARDS: Algebra, Chemistry, etc.) UNIT STANDARDS LESSON STANDARDS

E 6141 (b) Curriculum Review Cycle 2006-2007 2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 Science (K-12) Health (K-12) Social Studies (K-12) World Language (K-12) Fine Arts (K-12) Physical Education (K-12) Vocational Education (K-12) Language Arts (K-12) Language Arts (7-12) Mathematics (K-12) Phases of

E 6145.5(a) SUBCHAPTER VIII -THE EQUAL ACCESS ACT 4071. Denial of Equal Access Prohibited (a) Restriction of limited open forum on basis of religious, political, philosophical or other speech content prohibited It shall be unlawful for any public secondary school which receives Federal financial assistance and which

E 6146.1 KENAI PENINSULA BOROUGH SCHOOL DISTRICT Physical Education Waiver Request To Be Completed By Student Name Date Athletic Activity Name of Coach/Instructor/Supervisor Students who participate in a vigorous athletic activity that is sponsored by the District, that is supervised by a certified teacher or an

E 6146.11 KENAI PENINSULA BOROUGH SCHOOL DISTRICT EARLY GRADUATION PROCEDURES The purpose of the four-year high school program is to provide students with a combination of academic, vocational and social experiences that will prepare him/her for entry into the world of work, further training and/or continued academic

E 6146.51(a-1) KPBSD 504 Student Accommodation Plan Student ID: Name: Meeting Date: Birthdate: Review Date: School: Grade: 1. The data gathered to assess the student’s eligibility included: (List the sources of evaluation information from the Eligibility Determination page and who performed each or gathered the data) 2

E 6146.51(b-1) Kenai Peninsula Borough School District 148 N. Binkley Soldotna, AK 99669 504 Eligibility Determination Student ID: Meeting Date: Name: Parent 1: Birthdate: Parent 2: School: Grade: School Contact Person: Position: Eligibility Team Members (For each member, check whether s/he is knowledgeable about the c

E 6153.1(a) FIELD TRIP PARTICIPATION CONSENT FORM Medically Fragile or Intensive Needs Students I have read the Kenai Peninsula Borough School District Field Trip guidelines for Students who are Medically Fragile or have Medical Intensive Needs and understand the contents. I give permission for my child to attend the

E 6153.1(b) Field Trip Accommodation Plan Students with Medical Needs Name: Grade: School: Field Trip Destination: Date: 1. Identify the nature of concerns for the student. 2. Describe the accommodations that are planned for the student. 3. Describe special equipment and medication needed: 4. Name of chaperone: 5.

E 6153(a) Preliminary Field Trip Preparation For Extended Out-of-State or International Field Trips This form is to be submitted to the Superintendent a minimum of 10 months (for out-of-state) prior to trip, 18 months (for international) prior to trip, or as soon as plans are initiated (whichever comes first) as th

E 6153(c) KPBSD FIELD TRIP INFORMATION FORM DEFINITIONS AND TIME LINES Routine: These trips are one day or less and require PRIOR approval by local administrator. A completed copy of this form for each routine field trip, approved by the site admini strator, shall be on file in the site administrator's off

E 6153(e) Kenai Peninsula Borough School District FIELD TRIP QUESTIONNAIRE What are the hours of intended travel between the District and the point of disembarkation? What specific lodging arrangements have been made for students, chaperones and drivers if anticipated departure or return times are be

Keywords: field trip E 6153(f)STUDENT INDEMNIFICATION STATEMENT (Waiver of Liability) STUDENT CONSENT FOR MEDICAL TREATMENT STUDENT CONSENT TO PARTICIPATE **** 

E 6153(g) Out-of-State or International Student Behavior Contract Student Name: Parent Name: Phone #: Work #: Cell Phone: Email: I give my permission for my child to participate in the field trip to on Parental Preparation: 1. I will go over the rules with my child prior to the trip. 2. I w

Keywords: field trip E 6153(h) CHAPERONE/VOLUNTEER INDEMNIFICATION STATEMENT (Waiver of Liability) VOLUNTEER ALCOHOL / DRUG-FREE STATEMENT To the maximum extent allowed by law, I, ____________________________________, being a ___________________________ (parent/volunteer, e tc.) at ___________________________ School, agree to defe

Keywords: field trip E 6153(i) Permission to Travel Outside the United States Due to international concern over child abduction, many governments have initiated additional requirements at arrival and departure points when children under 18 years old are not traveling with bot h parents. Many countries require documentary evidence of th

E 6155COURSE CHALLENGE APPLICATION FORMChallenge InformationSchoolStudentDateName of Course Being Challenged:Year/Semester Class Would Have Been Taken:Give Reason(s) for the Challenge:Student SignatureParent's SignatureTimelineThe challenge must be submitted to the principal at least nine (9) weeks prior to the

E 6158(a) ELEMENTARY HEALTH CURRICULUM OPT–OUT FORM Kenai Peninsula Borough School District Student's Name Grade School Homeroom Teacher In accordance with administrative procedure for opting–out of controversial issues taught in the KPBSD health curriculum, I request that my student, named above, be excluded from the

E 6158(b) SECONDARY HEALTH CURRICULUM OPT–OUT FORM Kenai Peninsula Borough School District Student's Name Grade School Health Teacher In accordance with administrative procedure for opting–out of controversial issues taught in the KPBSD health curriculum, I request that my student, named above, be excluded from the

E 6162.71(a) KENAI PENINSULA BOROUGH SCHOOL DISTRICT Internet Access Non-Permission Form ____________________________________ ______________________________________ Student Name School The Kenai Peninsula Borough School District makes access to the worldwide computer network, known as “the Internet,” available to all

Kenai Peninsula Borough School District E 6162.8 (a) BP 6162.8 Research states that and educational research that takes place within the Kenai Peninsula Borough School District requires prior approval of the Superintendent. Family Education Rights and Privacy Act (FERPA) (20 U.S.C. 1232g; 34 CFR Part 99) protects

E 6177Prior Approval for High School Credit for Summer ProgramsName: Date:School: Grade:Name of Summer Program or Activity:Location of Program: Dates of Program:From: toDescribe the content of the program. Please also attach a brochure or any other information that describes the content of the program.How

E 6185Kenai Peninsula Borough School DistrictHOMEBOUND STUDENT REPORT Date of Visit(s)Student NameAddressCity, State, ZipProgress Report: **********************************************************Teacher NameMailing AddressSocial Security NumberCity, State, ZipSchedule of Fees (Check One):[ ] $ Certified rate[ ]

E 6187(a) INTENT TO DEVELOP CHARTER SCHOOL APPLICATION Please complete all of the information required on this form. All intent forms for establishing a charter school must be received by August 1 of the year prior to the date of intended implementation. For further details see the following documents: A. KPBSD Board

E 6187(b) KENAI PENINSULA BOROUGH SCHOOL DISTRICT Charter School Application/Contract Provisions The following two sections of the KPBSD contract provisions serve as the charter school application and a contract proposal to the Board. Charter school applications must be received by the School District no later than

E 9000 Bylaws of the Board Role of Board and Members Board Members to Administrative Staff: Board member questions can be divided, usually, into three categories: Requests for simple facts. These questions may properly be addressed to an administrative staff member. Complaints regarding

E 9000b Role of Board and Members Administrator Selection Process Protocol Selection of a Site Administrator Contact Information: Donna Peterson, Superintendent dpeterson@kpbsd.k12.ak.us FAX: 907-262-9132 - Phone: 907-714-8888 Process Administrator resigns/re

E 9110 STUDENT REPRESENTATIVE ON KPBSD BOARD OF EDUCATION - JOB DESCRIPTION QUALIFICATIONS Student shall be a junior or senior in good standing in any public high school in the KPBSD. Student shall be elected by their fellow student council members at the first AASG meeting of the school

E 9130a Bylaws of the Board BOARD COMMITTEES   Committees of the Board Policy Committee  Name:  Board Policy Review  Department:  Board of Education   Focus Area:  Policy Manual  Membership:  School Board Members

E 9130b Bylaws of the Board BOARD COMMITTEES - CHARTER SCHOOL OVERSIGHT   Committees of the Board Charter School Oversight Committee  Name:   Charter School Oversight Committee  Department:   Board of Education  Focus Area:

E 9130c Bylaws of the Board Board Committees - Ethics &amp; Community Relations Ethics Committee (Charge and composition to be established) Community Relations Committee (Charge and composition to be established)  Adoption Date: 6/2/2008 BB 9130 Board Comm

E 9224KENAI PENINSULA BOROUGH SCHOOL DISTRICT148 N. Binkley Street Soldotna, AK 99669 DateSECTION 14.12.090. OATH. School Board Members, before taking oath,shall take and sign the following oath of affirmation:"I do solemnly swear (or affirm) that I will support and defendthe Constitution of the United States

E 9271 Bylaws of the Board Code of Ethics As a member of the Kenai Peninsula Borough School District Board of Education I will strive to improve public education, and to that end I will: Remember always that my first and greatest concern must be the educational welfare of all the students attending

E 9311 Board Policy Revision Time Line 2007-2008 2008-2009 2009-2010 2010-2011 2011-2012 Section 9000 (Bylaws of the Board) Section 2000 (Administration) Section 4000 (Personnel) Section 0000 (Philosophy-Goals-Objectives and comprehensive Plans) Section 7000 (New Construction) Section 1000 (Community Relations)

E 9322 ORDER OF BUSINESS Order of business for all regular meetings at which the Board may take action and hears reports. Opening Activities Call to Order Pledge of Allegiance/The National Anthem or the Alaska Flag Song Roll Call Approval of Agenda Approval of

E 9323Please Evaluate UsThe Kenai Peninsula Borough School District Board of Education is very interested in your feedback regarding the meeting.Date of the meeting: Comments regarding the meeting (please include specific suggestions for growth).Other information you would like the Board to

E 1330 (c)Application for Community Possession of a Firearm orDeadly or Defensive Weapon on School GroundsName or OrganizationAddressContact NamePhone NumberDescription of EventLocation of EventDate of EventTime of EventNarrative justification for request (include description of firearm or deadly or defensive

E1340I understand that I will be charged a fee of .25 plus sales tax for each page that I request to be copied. Ifurther understand that if it is determined that my request(s) will require more than five hours of staff timeper calendar month that I will pay, upon notification, the total actual personnel costs required

Keywords: field trip KENAI PENINSULA BOROUGH SCHOOL DISTRICTHealth Services AUTHORIZATION FOR MUTUAL EXCHANGE OF INFORMATIONEducation Amendments of 1974 P.L. 93.380CHILD:DATE OF BIRTH: SCHOOL:PARENT/GUARDIAN:I, the parent/guardian of the above named child, do hereby authorize the mutual exchangeof medical, social work, psychiatric,

Revised 1/2006 E 6153(b) Verification of Field Trip Information The SITE ADMINISTRATOR must initial each statement of assurance and attach appropriate documents. Part I For ALL Field Trips Administrator has reviewed and approved /or recommended the trip request. Administrator has verified that the field trip is

INDIAN STUDENT ELIGIBILITY FORM (ED 506 FORM) The LEA in documenting an Indian student's eligibility uses the Indian Student Eligibility Certification Form. At this time, the ED 506 Forms are not needed in schools funded by the Bureau of Indian Affairs. The ED 506 Forms you had on file as of October 19, 1994 meet the

1 APPENDIX A CO-CURRICULAR PARTICIPATION CONSENT FORM ELEMENTARY SCHOOL WARNING, ASSUMPTION OF RISK And HOLD HARMLESS AGREEMENT Student Name (Please Print) School Date FOR ALL SPORTS AND ACTIVITIES I understand that all co-curricular activities have a certain degree of risk. I also understand these risks may include

1 APPENDIX B KENAI PENINSULA BOROUGH SCHOOL DISTRICT Elementary School Activities Guidelines I. PHILOSOPHY STATEMENT The Kenai Peninsula Borough School District believes co-curricular activities are an integral part of the educational program. Activities shall be tailored to the physical, mental, emotional and social

1 APPENDIX C ELEMENTARY SCHOOL CO-CURRICULAR PARTICIPANT USER FEE CONTRACT __________________________ _____________________ ______ ______ Student Name (printed) School Grade Date Activity Fee Obligations In an effort to supplement available state and District funds for our co-curricular programs, a fee will be

Revised 9/11 Student Name: ________________________________________ Alaska Student I.D. # _________________ ? ? ? ? ? ? ? ? 3. 4.

Kenai Peninsula School District/ Bilingual Office/ 148 N. Binkley/ Soldotna, AK 99669/ (Ph) 714-8829 (Fax) 262-6354Language Observation ChecklistPart AThis form must be completed by English speaking teacher(s) in collaboration with program staff familiar with the student.Student Name:

Kenai Peninsula Borough School District 148 N Binkley Street Soldotna, AK 99669 (907) 714-8892 Phone (907) 262-6354 Fax ELL OFFICE REQUEST FOR PARENT PERMISSION Dear Parent: All school districts in Alaska are required to assess students to see if they are in need of English language services. As a result of the assessm

KPSAA END OF SEASON ANALYSIS FORM FOR ACTIVITIES In order to ensure equity and Title IX compliance in all of our school districts activities, please complete this Analysis Form at the conclusion of each activity season. DATE _________ ACTIVITY __________LEVEL (C, JV, V) ___V_________ OUTSOURCE ACTIVITY?____________

Educator Name: Subjects: Grade Level(s): Administrator Name: Dates: Pre-Observation: Observation: Post-Observation: Domain 1: Planning and Preparation UNSAT BASIC PROF DIST Component 1a: Knows, selects, and skillfully uses psychologic al instruments to evaluate students Component 1f: Demonst

Kenai Peninsula Borough School DistrictFEDERAL PROGRAMS ADVISORY COMMITTEEVOLUNTEER FORMPlease return to the Federal Programs Office as soon as possibleName (please print):Address:Phone:Email:I am a (please check): Parent Guardian Grandparent Teacher Student Community MemberI would like to

KENAI PENINSULA BOROUGH SCHOOL DISTRICT GIFTED PLAN OF SERVICE Revised 11/25/06 STATEMENT OF PHILOSOPHY The Kenai Peninsula Borough School District is committed to a differentiated program which serves those gifted students whose abilities, talents, and potential for accomplishments are so outstanding that they

Writing Skills Checklist Standards Based Assessments (Grades 3-9) As you write your response, use the Writing Skills Checklist below to • help you plan your writing. • check your writing when you are finished. Writing Skills Checklist ?? Have you written complete sentences? ?? Have you written well-developed

Revised 07/13/11 – SG Kenai Peninsula Borough School District Life Insurance Group Enrollment Employee Name: Last First Middle Date of Birth: Sex: Male or Female Month Day Year Marital Status: Single, Married, Widowed, Divorced, Legally Separated Employment Date: Social Security #: Month Day Year Job Title/Position: Sp

APPENDIX A KPBSD Athletic/Activity Participation Registration User Fee Form, Consent Form, Warning, Assumption of Risk, and Hold Harmless Agreement Eligibility Requirements for students participating in KPBSD and ASAA sponsored activities: • This form must be complete and on file in the Activities office for each

APPENDIX B KENAI PENINSULA BOROUGH SCHOOL DISTRICT HIGH SCHOOL ACTIVITIES GUIDELINES I. PHILOSOPHY STATEMENT The KPBSD believes co-curricular activities are an integral part of the educational program. We believe each student should have an equal opportunity to participate in a broad number of activities based on

Alaska Paraprofessional Qualifications Form Directions: 1. Print the paraprofessional s name in the space provided. 2. Indicate method used to determine the requirements were met by checking appropriate box or boxes. 3. The form must be signed an d dated by the paraprofessional and the district rep

Alaska “Highly Qualified” Verification Form1.) Name: has met the highly qualified requirements of the No Child Left Behind Act for:2.) Content Area/Teaching Assignment(s): 3.) Check all that apply:Highly Qualified in another state (attach verification)HOUSSE [Attach verification]Major(s): Equivalent to major:

Application for a Waiver from Passing the High School Graduation Examination Due to Late Arrival into the Alaska Public Schools System

Guidelines for Applying for Waivers and Appeals

Revised 01/06/09 Alaska Immunization Regulations 7 AAC 57.550, 4 AAC 60.100 and 4 AAC 06.055 require that all children in Alaska public/private schools, certified preschools, and licensed child care facilities be immunized, unless he/she is exempt due to medical contraindications, disease history, or religious reasons

KENAI PENINSULA BOROUGH SCHOOL DISTRICT HEALTH SERVICES RELIGIOUS EXEMPTION FORM ALASKA IMMUNIZATION REQUIREMENTS Alaska Immunization Regulations (4AAC 06.055, 4 AAC 62.450, 4 AAC 60.100) require that all children in Alaskan public/private schools and certified preschools be immunized against pertussis, di

Kenai Peninsula Borough School District Health Care Plan Participant Enrollment Form PARTICIPANT INFORMATION Name of Participant (Employee): Date of Enrollment or Change: Social Security Number: ? M ? F Date of Birth: IHS Eligible: ? Y ? N (Indian Health Services) Marital Status: Date of Marriage: Legal documentation i

KENAI PENINSULA BOROUGH SCHOOL DISTRICT PROFESSIONAL DEVELOPMENT KPBSD COURSE GUIDE I. Overview Course: The Kenai Peninsula Borough School District (KPBSD) is providing the opportunity for staff to receive contact hour credit through district-sponsored events. Administrators and certified staff are encou

ANCHOR POINT COOPER LANDING HOMER HOPE KACHEMAK SELO KENAI MOOSE PASS NANWALEK NIKISKI NIKOLAEVSK NINILCHIK PORT GRAHAM RAZDOLNA SELDOVIA SEWARD SOLDOTNA STERLING TUSTUMENA TYONEK VOZNESENKA KENAI PENI NSULA BOROUGH SCHOOL DISTRICT TO: All Administrators FROM: B

Becoming Highly Qualified Becoming Highly Qualified KPBSD Guidelines for Praxis Reimbursement TESTS FOR "HIGHLY QUALIFIED" PURPOSES UNDER NCLB The State Board of Education &Early Development approved the following list of Praxis II tests for teachers who wish to use the "state identified test" option to meet the

KENAI PENINSULA BOROUGH SCHOOL DISTRICT Assessment Data Release Student test scores provide teachers and administrators with valuable information about your students academic strengths and challenges. Reviewing test data helps us focus on the skills your student most needs to develop. If your student is new to our

KENAI PENINSULA COLLEGE SCHOLARSHIP APPLICATION Sponsored by the Kenai Peninsula Borough School District Career & Technical Education 2011-2012 One 2012/2013 full-year tuition waiver This application form is intended to aid in the Career & Technical Education scholarship review process. If you wish to b

Language Acquisition-Related Acronyms used in the Kenai Peninsula Borough School District Acronym Meaning Used to indicate… ACCESS for ELLs (or ACCESS) Assessing Comprehension and Communication in English State-to-State for English Language Learners WIDA’s annual English proficiency test BICS/CALP Basic Interpersonal C

Attention Employee: The following Lincoln Financial Group Beneficiary Designation Form is only needed if you have more than one Primary and/or Contingent Beneficiaries to list.The Lincoln National Life Insurance Company, PO Box 2616, Omaha, NE 68103-2616 toll free (800) 423-2765 Fax (877) 573-6177 www.LincolnFinancial.

AI PENINSULA BOROUGH SCHOOL DISTRICT Street, Soldotna, AK 99669-7598 -Phone 907 /714-8888 -Fax 907 /262-9645 Binkley STUDENT PHYSICAL EXAMINATION THIS SECTION TO BE COMPLETED BY PARENT STUDENT'S NAME AGE SCHOOL GRADE PARENT'S NAME PHONE ADDRESS CITY

KPBSD Health Services M114 Rev 3/04 KENAI PENINSULA BOROUGH SCHOOL DISTRICT Student Health Review STUDENT NAME BIRTHDATE GRADE SCHOOL For ADDITIONAL COMMENTS please use the back of the form. 1. LAST PHYSICAL EXAM: Date Doctor Clinic Name/Location 2. LAST DENTAL EXAM: Date Doctor Clinic Name/Location 3. LAST VISION

August 2011 M T W Th F 1 2 3 4 5 8 9 10 11 12 15 16 IS 17 IS 18 WK 19 IS 22 WK 23 O 24 25 26 29 30 31 September 2011 M T W Th F 1 2 5 V 6 7 8 R 9 12 13 R 14 I 15 I 16 19 20 21 22 R 23 26 27 28 29 30 December 2011 M T

Kenai Peninsula Borough School District 148 North Binkley Street Soldotna, AK 99669 Name of Student: Date of Birth: Name of Parent/Guardian: Is this student currently eligible for Medicaid or Denali Kid Care Benefits? YES NO Has this student ever been eligible for Medicaid or Denali Kid Care Benefits? YES NO

KENAI PENINSULA BOROUGH SCHOOL DISTRICT WORK EXPERIENCE MENTORSHIP AGREEMENT The Mentor will permit (student's name) to be trained in their career field for the purpose of gaining knowledge and experience in the occupation of ____________ from , 200 , to , 200 . The training will be provided in accordance with the

KENAI PENINSULA BOROUGH SCHOOL DISTRICT148 N. BINKLEY STSOLDOTNA, AK 99669METHOD OF PAYROLL PAYMENTCERTIFICATED PERSONNELPayday is the last business day of each month. If a bank holiday falls on the last business day of the month pay day will be the business day before the bank holiday.Each certificated employee has

APPENDIX A CO-CURRICULAR PARTICIPATION CONSENT FORM MIDDLE SCHOOL WARNING, ASSUMPTION OF RISK And HOLD HARMLESS AGREEMENT Student Name (Please Print) School Date FOR ALL SPORTS AND ACTIVITIES I understand that all co-curricular activities have a certain degree of risk. I also understand these risks may include injury

APPENDIX B KENAI PENINSULA BOROUGH SCHOOL DISTRICT MIDDLE SCHOOL ACTIVITIES GUIDELINES I. PHILOSOPHY STATEMENT The KPBSD believes co-curricular activities are an integral part of the educational program. We believe each student should have an equal opportunity to participate in a broad number of activities based on

1 APPENDIX C MIDDLE SCHOOL CO-CURRICULAR PARTICIPANT USER FEE CONTRACT __________________________ _____________________ ______ ______ Student Name (printed) School Grade Date Activity Fee Obligations In an effort to supplement available state and District funds for our co-curricular programs, a fee will be collected

Memorandum of Agreement for XXXXXXXXXXXXXXXXXXX Kenai Peninsula Borough School District 2009-2010 Partners: (Name/address of Organization) (Name/address of School/KPBSD) Contact: (KPBSD person responsible) (Title of above person) Purpose: XXXXXX XXXXXXXX Date: This agreement will begin XXXXXX

Memorandum of Agreement for Training / Consulting Services Kenai Peninsula Borough School District 2009 – 2010 Partners Name of Trainer/Consultant Kenai Peninsula Borough School District Address 148 N. Binkley St. Address Soldotna, AK 99669 Contact Name of KPBSD Contact Title Purpose Des

The Final Report of the National Mathematics Advisory Panel 2008 U.S. Department of Education This report was produced under U.S. Department of Education Contract No. ED04CO0082/0001 for Widmeyer Communications and No. ED04CO0015/0006 for Abt Associates Inc. Ida Eblinger Kelley served as the contracting officer’s techn

KPBSD Native Youth Council Information WHAT IS A YOUTH COUNCIL? As an Alaska Native youth, you can make a difference! But first you must be organized and prepared for action. An effective way to accomplish this is through a youth council. The youth council represents a practical way of enabling youth to have a meaningf

KPBSD Native Youth Council Letter of Recommendation Student you are recommending: School: Relationship to student: Your Name: Email: Contact #: Give a brief recommendation in the space below including any of the following: strengt hs, leadership skills, work ethic, weaknesses, concerns.

KENAI PENINSULA BOROUGH SCHOOL DISTRICT HEALTH SERVICES PREVENTION OF HEAD LICE The winter months are known as "lice months". In order to prevent the spread of lice in our schools, the Kenai Peninsula Borough School District has a "No Live Lice" policy as recommended by the National Association of School Nurses and the

KENAI PENINSULA BOROUGH SCHOOL DISTRICT HEALTH SERVICES KPBSD Health Services NP 303 Rev. 10/2010 DIRECTIONS FOR HEAD LICE REMOVAL NOTE: The following treatment schedule is recommended at this time. Several optional/alternative treatments are being tested. Feel free to use your school nurse as a resource for informatio

KENAI PENINSULA BOROUGH SCHOOL DISTRICT HEALTH SERVICES RECOMMENDATIONS FOR CARE CONJUNCTIVITIS (PINK EYE) Student Date ____________ Student Presents the Following: _____________________________________ Notify your health care provider if you observe the following signs of infection: pink or red color where the eye

KENAI PENINSULA BOROUGH SCHOOL DISTRICT HEALTH SERVICES RECOMMENDATIONS FOR CARE SORE THROAT Student____________________________ Date ____________ Grade______ Student Presents the Following: _____________________________________ GENERAL INFORMATION Sore throats have a variety of causes. A new sore throat is often

KENAI PENINSULA BOROUGH SCHOOL DISTRICT HEALTH SERVICES CONJUNCTIVITIS (PINK EYE) Date_______________________ Dear Parent/Guardian, Conjunctivitis, often known as Pink Eye, has recently been reported in our school population. WHAT IS CONJUNCTIVITIS Conjunctivitis is an inflammation of the eye. It can be caused by a

OMB Number: 1875-0240 Expiration Date: 09/30/2007 U.S. DEPARTMENT OF EDUCATION OFFICE OF INDIAN EDUCATION WASHINGTON, DC 20202 TITLE VII STUDENT ELIGIBILITY CERTIFICATION Elementary and Secondary Education Act, Title VII, Part A, Subpart 1 Parents: Please return this completed form to your child's school. In order to

KENAI PENINSULA BOROUGH SCHOOL DISTRICT Dear Parent: Welcome to the Kenai Peninsula Borough School Districts Title VII, Indian Education Program. The federal governments Indian Education Program provides money to public school districts through the Title VII Program. The KPBSD uses this money to meet the educational

KENAI PENINSULA BOROUGH SCHOOL DISTRICT CAREER EXPLORATION, ASSESSMENT, and OJT TRAINING AGREEMENT The work station will permit (student name) to be trained in their business for the purpose of gaining knowledge and experience in the occupation of from , 200 , to , 200 . The training will be provided in accordance

START HEREIEP case manager contacts OT to discuss student concernsInvolvement of the Related Services Occupational TherapySpecial Education StudentsProceed with assessment?Gen. ed. classroom interventions discussed – Refer to “Interventions for Classroom Difficulties” and data collection formNoProgress?Continue with in

Intervention Team -Student concern is introducedGen. ed. classroom interventions discussed – Refer to“Interventions for Classroom Difficulties” and data collection formI-Team Follow Up -Discuss intervention results and review data form colelction (4–6 weeks later)Progress?Continue with general ed. interventions as need

Career and Technical Education Parent Permission Form Dear Parent: As part of our vocational/career & technical education program, your son or daughter will have the opportunity to operate various types of power machinery. We would like to stress that, before a student is allowed to operate power tools: 1. S/he will

Kenai Peninsula Borough School District Request for Payment /Payment-in-Lieu of Transportation Agreement Number: This request covers the period of _____________________ through _____________________, 20___ , during which time school was in session for ______ days. Student Name School Name Days Present Daily Rate Total

Kenai Peninsula Borough School District Payment-in-Lieu of Transportation Agreement Agreement Number: This agreement is entered into this _____ day of ____________, 20___, between _____________________ of _____________________, and the Kenai Peninsula Borough School District. This agreement is for school days

KENAI PENINSULA BOROUGH SCHOOL DISTRICT 148 N. Binkley Street Soldotna, Alaska 99669 Phone: (907) 714-8888 Fax: (907) 262-9645 PHYSICAL EXAMINATION INSTRUCTIONS EMPLOYEE: 1. The State of Alaska 4 AAC 06.050 and the Kenai Peninsula Borough School District Board of Education Policy 4112.4 require a physical examination p

Kenai Peninsula Borough School District Federal Programs Sandy Miller, Assistant Director 148 North Binkley Street Soldotna, Alaska 99669-7553 Phone (907) 714-8892 Fax (907) 262-6354 Title I PRE-K Application circle school of attendance area SECTION 1 – CHILD INFORMATION Child s Name:

Professional Development Related to the Content Area: (Must serve more than one day) Workshop or Committee Attended: Attendance at teacher inservice activity requiring participation for more than one day and which resulted in a certificate of attendance. Name of Facilitator: Signature: 1. Workshop or Committee

General Questions: What does highly qualified mean? All teachers must have at least a bachelor's degree, full state certification, and have demonstrated subject matter competency in each of the core academic subjects in which they teach. This means that a person cannot teach on an Emergency Certificate. What are the

PLEASE READ CAREFULLY The Rehn & Associates enrollment form must be completed and returned within 31 days of your hire date. If you are enrolling a Spouse, you must provide a copy of your legal marriage certificate. If you are enrolling a child, you must include a copy of that child’s birth certificate, or legal guardi

I Praxis II Exa~ination Secondary Required Score I Art Content ~owledge -0133 155 I Earth Science COntent ~owled2e -057-1-1144 Economics -O~10 460 158 157 149 ! English Content~owledge -0041 ! French Co~ent Knowledge -0173 General Science Content Knowledge -0435 General Science Content Knowledge, Part I -0431 and Part

Requisition Import Process Qty UOM Desc1/Title Desc2/Author Desc3/ISBN Unit Cost Discount Merge Desc 1 ea Adoration of Jenna Fox, The Joan of Arc 312594410 5.99 N Y 1 ea Airborn Jim Dahler 756353997 7.19 N Y 1 ea Breathing Underwater Jane Doe 80285297 1 7.65 N Y 1 ea Brigid's Cloak John Doe 64472574 15.49 N Y

Sheet3 Sheet2 Sheet1 Qty UOM Desc2/Author Desc3/ISBN Unit Cost Discount Merge Desc ea Adoration of Jenna Fox, The Joan of Arc N Y Desc1/Title 1.00 312594410.00 5.99

DAVID R. CAREY BOROUGH MAYOR May 25, 2010 RE: Accident and Workers’ Compensation Packet The appropriate Accident Packet is attached to this letter (Borough or School District). Please read the instructions and follow those instructions when completing the forms. The most common mistakes are as follows: ? The Accident R

11/3/2010 SM 2010-2011 Kenai Peninsula Borough School District School/Address/Phone/Administration/Secretary List 148 North Binkley Street, Soldotna, Alaska 99669 714-8888 262-9645-Fax 65 Aurora Borealis, K-8 705 Frontage Rd., Suite A Kenai, AK 99611 283-0292 283-0293 Fax Larry Nauta, Admin. Anita LeDoux, Sec. 38 Nikol

Place on school letterhead. Enter space to delete this line. SEASONAL WORK SURVEYPlease take time to complete this quick survey. All your answers will be treated as confidential. The information you provide may help the Kenai Peninsula Borough School District qualify for federal funding to provide more education

Section 125 Reimbursement Forms

KENAI PENINSULA BOROUGH SCHOOL DISTRICT PROFESSIONAL DEVELOPMENT SITE LEVEL COURSE GUIDE I. Overview Site-Level Course: The Kenai Peninsula Borough School District (KPBSD) is providing the opportunity for staff to receive contact hour credit through si te-level professional development. Administrators and

Forms Needed for a Student Injury E 3530a Student Visitor InjuryIncident Report Please complete this form on line. An email copy of the form will be generated to administration, risk management and to the email address you entered. Send any additional updates to

Kenai Peninsula Borough School DistrictSTUDENT REGISTRATION INFORMATION FORMSTUDENT'SLEGAL NAMELAST FIRST MIDDLEOFFICE USE ONLYID #GRADESCHOOLACADEMIC YEARLOCKERElem. TeacherBUS ROUTE P/D/PHY ADDRESSSTUDENTMAILINGADDRESSSTREET CITY STATE ZIP CODE PHONEPARENT E-MAIL2ND MAILINGADDRESSSTREET CITY STATE ZIP CODEPARENT E-MA

http www.asaa.org handbook pdf asaa forms generaluse Health_Review_Exam.pdf

Kenai Peninsula Borough School District Educational Support PersonnelPlan for Improvement ____________________________________________________________________________________Employees SignatureEvaluators SignatureInitial DateTarget Date for CompletionArea that needs improvement (taken from Performance Evaluation

KENAI PENINSULA BOROUGH SCHOOL DISTRICT EDUCATIONAL SUPPORT PERSONNEL EVALUATION PROCEDURES Revised 2/1/96 TABLE OF CONTENTSBoard of Education Policy Statement................................................................................... 1 Statement of Responsibility for Supervision and Evaluation.................

TUBERCULIN TEST CONSENT Dear Parents /Guardians: State Law 7 AAC 27.213 requires that each kindergarten, 7th grade and new-to-the-district child receive a tuberculin (TB) skin test. A tuberculin skin test is not required if the school is provided with one of the following: 1. Documentation showing negative results of

Kenai Peninsula Borough School District TITLE VII PARENT ADVISORY COMMITTEE VOLUNTEER FORM Please return to the Federal Programs Office Name: (please print): Addr

Kenai Peninsula Borough School District VENDOR Application Applicant Information Business Name: Current address: City: State: ZIP Code: Federal Employer ID or SSN: Phone: Fax: Contact Name & Email Address: Previous Business Name ( if applicable): Previous address: City: State: ZIP Code:

What is the Difference between Section 504 and IDEA? Component IDEA Section 504 Title Individuals with Disabilities Act (IDEA) The Rehabilitation Act of 1973 Type An Education Act A Civil Rights Law General Purpose Individuals with Disabilities Education Act is a federal funding statute thats purpose is to provide

WORK FORCE DEVELOPMENT CENTER APPLICATION ACADEMIC YEAR 2006/2007 Student_________________________ Date______________ School_________________________ Grade_____________ Address_________________________ Phone_____________ City__________________Zip_______ School ID#_______________ Have you taken WDC before? Yes____