2019-2020 Registration Checklist for Returning Students

Student’s Name ________________________ Student ID # ______________ Required Documentation to Register

Proof of Residency: _____ Current Electric or Gas Bill, Current Lease, Residency Affidavit

Immunization Record (If Applicable) _____ Provide proof of up to date records if needed

Required Forms to Register

_____ Enrollment Form

_____ Acknowledgement of Student Handbook /Code of Conduct

_____ KISD Notice of Directory/Permissions Form

_____ Acceptable Use Policy/G Suites for Education Form

_____ Student Residency Questionnaire

_____ Student Health Information for the School Nurse

_____ Device Loaner Agreement ONLY FOR Grades 5th – 12th (Please use form applicable to the student’s campus) JAA Device Agreement OR KJHS/JHS Device Agreement *This form is not needed for JFD or RFP Elementary*

**It is the parent or guardian’s responsibility to let the campus know of any changes to any contact information,

demographics, or permissions in regards to the parent, guardian or student. Please provide this information in writing so

our system has the most up to date and accurate information pertaining to the student. If you should have any questions,

please contact the campus office directly**.

KENNEDALE ISD ENROLLMENT FORM

Student’s Legal Name (**) ____________________________________________________________ ___________________ ________________ Last First Middle Student ID Today’s Date

Date of Birth _________________ Place of Birth (City, State) __________________________________ Gender _____ MALE _____ FEMALE

Social Security Number ___________________________ Grade _________ Campus _____ KHS _____ KJHS _____ JAA _____ JFD _____ RFP

Student’s Address ________________________________________________________________________________________________________ Number /Street City State Zip Code

Mailing Address (if different than above) ______________________________________________________________________________________ Number/Street/PO Box City State Zip Code

Student’s Home Phone ______________________ Student’s Cell Number ________________________

How student gets home from school: _____ Parent Pickup _____ Car Pool _____ Walks _____ Drives Self _____ School Bus _____ Daycare

Car Pool Name ___________________ Phone Number ______________ Day Care Name ___________________ Phone Number________________

Parent/Guardian #1 ____________________________________ Relationship to Student _______________ Legal Custody _____ YES _____ NO

Parent/Guardian DOB ___________________ Driver’s License # ______________ State _______ Enrolling Student _____ YES _____ NO

Address _________________________________________ City __________________________ State _____________ Zip Code ________________

Cell Phone _____________________________ Home Phone _____________________________ Other Phone ___________________________

Email Address ________________________________ Is Parent/Guardian: Active Military Duty _____ Texas Nat’l Guard _____ Reserves _____

Parent/Guardian #2 _____________________________________ Relationship to Student ________________ Legal Custody _____ YES _____ NO

Parent/Guardian DOB ___________________ Driver’s License # ______________ State _______ Enrolling Student _____ YES _____ NO

Address __________________________________________ City __________________________ State _____________ Zip Code ______________

Cell Phone _____________________________ Home Phone _____________________________ Other Phone __________________________

Email Address ________________________________ Is Parent/Guardian: Active Military Duty _____ Texas Nat’l Guard _____ Reserves _____

Emergency Contact #1 _____________________________________________________________________________________________________ Name Phone Phone #2 Relationship to Student

Emergency Contact #2 _____________________________________________________________________________________________________ Name Phone Phone #2 Relationship to Student

Additional Student Information for schools previously attended

School _____________________________ City/State ____________________________ Grade__________ From/Until ______________________

School _____________________________ City/State ____________________________ Grade __________From /Until______________________

Has the student been previously enrolled in the following programs/services:

_____ Special Education Campus _____________________________________ Years _____________________

_____ Gifted/Talented Campus _____________________________________ Years _____________________

_____ 504 Campus _____________________________________ Years _____________________

_____ Title I Services Campus _____________________________________ Years _____________________

_____ Dyslexia Campus _____________________________________ Years _____________________

_____ Speech Campus _____________________________________ Years _____________________

_____ Bilingual/ESL Campus _____________________________________ Years _____________________

Has this student ever been retained? ______ Grade ______ Year Student is coming from? _____ Regular Campus _____ Alternative (AEP)

____________ ______________________________________ ___________________________________ ____________________

Parent/Guardian Printed Name Parent/Guardian Signature Relationship to Student Date

**KISD IS REQUIRED BY THE STATE OF TEXAS TO USE THE STUDENT’S LEGAL NAME AS IT APPEARS ON THE STUDENT’S OFFICIAL BIRTH CERTIFICATE

2019-2020Acknowledgement of Student Handbook and Code of Conduct

My child and I have been offered the option to receive a paper copy of or to electronically access at www.kennedaleisd.net, the Kennedale ISD Student Handbook and the Student Code of Conduct for 2019-2020.

I have chosen to:

____ Receive a paper copy of the Student Handbook and the Student Code of Conduct

____ Accept responsibility for accessing the Student Handbook and the Student Code of Conduct by visiting the Web address listed above.

I understand that the handbook contains information that my child and I may need during the school year, and that all students will be held accountable for their behavior and will be subject to the disciplinary consequences outlined in the Student Code of Conduct. If I have any questions regarding this handbook or the Code, I should direct those questions to the principal of my child’s school by calling:

Kennedale High School 817/563-8100

Kennedale Junior High 817/563-8200

Arthur Intermediate 817/563-8300

Delaney Elementary 817/563-8400

Patterson Elementary 817/563-8600

Printed Name of Student

Printed Name of Parent/Guardian

Signature of Parent/Guardian

Date

The Family Educational Rights and Privacy Act (FERPA), a Federal law, requires that Kennedale Independent School District, with

certain exceptions, obtain your written consent prior to the disclosure of personally identifiable information from your child’s

education records. However, Kennedale Independent School District may disclose appropriately designated “directory

information” without written consent, unless you have advised the District to the contrary in accordance with District

procedures. The primary purpose of directory information is to allow the Kennedale Independent School District to include this

type of information from your child’s education records in certain school publications for school-sponsored purposes. Examples

include: • A playbill, showing your student’s role in a drama production• The annual yearbook• Honor roll or other recognition lists• Graduation programs• Sports activity sheets, such as for wrestling, showing weight and height of team members• District newsletter, websites, social media and newspaper*

Directory information, which is information that is generally not considered harmful or an invasion of privacy if released, can also be disclosed to outside organizations without a parent’s prior written consent. Outside organizations include, but are not limited to, companies that manufacture class rings or publish yearbooks. In addition, two federal laws require local educational agencies (LEAs) receiving assistance under the Elementary and Secondary Education Act of 1965 (ESEA) to provide military recruiters, upon request, with three directory information categories – names, addresses and telephone listings – unless parents have advised the LEA that they do not want their student’s information disclosed without their prior written consent.

If you do not want Kennedale Independent School District to disclose directory information from your child’s education records without your prior written consent, you must notify the District in writing within ten school days of student’s first day of instruction of the current school year. Kennedale Independent School District has designated the following information as directory information:

- Student’s name* - Participation in officially recognized activities and sports*- Address - Weight and height of members of athletic teams- Telephone listing - Degrees, honors and awards received*- Electronic mail address - The most recent educational agency or institution attended- Photograph*- Date and place of birth- Major Field of study- Dates of attendance- Grade level*

*District use of directory information for publications will be limited to designated information only.

These laws are: Section 9528 of the ESEA (20 U.S.C. 7908), as amended by the No Child Left Behind Act of 2001 (P.L. 107-110), the education bill, and 10 U.S.C. 503, as amended by section 544, the National Defense Authorization Act for Fiscal Year 2002 (P.L. 107-107), the legislation that provides funding for the Nation’s armed forces.

Family Educational Rights and Privacy Act (FERPA) Notice of Directory Information

Family Educational and Privacy Act (FERPA) Notice of Directory Information & Permissions Form

Student Name: _____________________________________________ Campus: _____________ Grade ______________

Student Directory Information Release and District Permissions Form

Parents and guardians are to determine what, if any, directory information is to be restricted from release. Please check one box in each applicable section. Making no selection will result in student directory information being made available upon receipt of a properly submitted request.

ALL STUDENTS – Release of Directory Information for school sponsored purposes

_____ OPEN TO ALL REQUESTORS - This option gives KISD permission to release student directory information to any group, person, business, organization, etc., who requests it.

_____ LIMITED TO SCHOOL SPONSORED PURPOSES ONLY – This option gives KISD permission to release student directory information for district purposes, including but not limited to yearbook, newsletters, website, district social media, honor roll list, and news stories about the district. This release option does not allow the district to release directory information requested through the open records process.

_____ CLOSED TO ALL REQUESTORS – This option does not give KISD permission to release student directory information for any purpose or reason. The student cannot be included in the yearbook, district newsletters, etc. This restriction also applies to student directory requests made through the open records process.

ALL STUDENTS – Phone Communication

I _____ DO GIVE/ _____ DO NOT GIVE my permission for KISD to contact me via the district’s auto dialer mass notification

system with Information pertaining to my child/child’s campus at (please list numbers) ____________________________,

____________________________, ______________________________.

SECONDARY STUDENTS ONLY (Grades 7-12) – Release of Directory Information to Military Recruiters or Institutions of Higher Education.

Military Recruiter (Grades 9 -12)

_____ Yes, I do want the name, address, and telephone number of my secondary student released to a military recruiter.

_____ No, I do not want the name, address, and telephone number of my secondary student released to a military recruiter.

Institutions of Higher Education (Grades 7-12)

_____ Yes, I do want the name, address, and telephone number of my secondary student released to institutions of higher education.

_____ No, I do not want the name, address, and telephone number of my secondary student released to institutions of higher education.

________________________________________ ________________________________________ ______________________

Parent/Guardian Please Print Parent/Guardian Signature Date

Kennedale ISD

2019-2020 Acceptable Use Policy/G Suite for Education Form

Pursuant to applicable Board policies regarding technology and media, our staff and students use technology to learn. Technology is essential to

facilitate the creative problem solving, information fluency, and collaboration that we see in today’s global economy. While we want our student to

be active contributors in our connected world, we also want them to be safe, legal, and responsible. This Acceptable Use Policy (AUP) supports our

vision of technology use and upholds in our users a strong sense of digital citizenship. This policy applies to all Kennedale Independent School

District (KISD) computer networks (including the resources made available by them), and all devices whether issued for use, on and off KISD’s

networks or maintained on campus in classrooms, libraries, labs or any other district location.

Acceptable Use and Digital Citizenship

Respect Yourself: I will select online names that are appropriate, and I will be polite and use appropriate language/content in all online posts.

Protect Yourself: I will not publish personal details, contact details or a schedule of activities for myself or anyone else. I understand that unless

otherwise authorized, I am the owner of my accounts, and I am responsible for all activity initiated by and/or performed under these accounts. I

understand that it is my responsibility to appropriately secure my account credentials. I understand that I am responsible for maintaining and

backing up all of my own data. If I am uncertain whether a specific computer activity is permitted or appropriate, I will ask a teacher/administrator

before engaging in that activity. Respect Others: I will not use technologies to bully or tease other people. I will not make audio or video recordings of students/employees

without their prior permission. I understand that posing as someone else is forbidden and I will not pose as a user other than myself when online. I

will be careful and aware when printing to avoid wasting resources and printing unnecessary items. Protect Others: I will help maintain a safe computing environment by notifying appropriate campus officials of inappropriate behavior,

vulgarities, risks, and breaches involving campus technology. I will not intentionally harm or cause damage to another student’s issued device,

digital environment, or digital files. Respect/Protect Intellectual Property: I will suitably cite any and all use of websites, books, media, etc. I will respect all copyrights, and I will

request to use the software and media that others produce. I will not share access to my accounts with any other student or allow any other

person to use my credentials for their own online activities.

General Policies ● The purpose of a KISD user account is to access the KISD network and facilitate creativity and innovation. We use this network to support

communication and collaboration. We use technology to extend research and information fluency, to collect and analyze data and to

solve problems.

● Access is a privilege, not a right. Access entails responsibility, and inappropriate use may result in cancellation of those privileges.

● KISD user accounts are owned by the KISD; consequently, they are subject to the Open Records Act. All digital files associated with user

accounts may be retrieved by KISD staff at any time without prior notice and without the permission of any user. The KISD reserves the

right to monitor all accounts in order to maintain system integrity and to ensure Acceptable use.

● Students should have no expectation of personal privacy in any matters stored in, created, received, or sent through the KISD computer

network, they are subject to review by the KISD at any time, with or without notice, with or without cause and without the permission of

any student or parent/guardian.

● To the extent practicable, a content filtering solution is in place in order to prevent access to certain sites that may contain inappropriate

material, including pornography, weapons, illegal drugs, gambling, obscenities, and any other topics deemed to be of non-educational

value by the KISD. This control also applies to other forms of communication such as e-mail, chat rooms, social networking sites, instant

messaging, gaming etc. The KISD has additional filtering in place for Chromebook devices which continues this filtering even when off the

KISD network. KISD is not responsible for the content accessed by users who connect via alternate networks or on alternate devices.

Government Laws

Technology is to be utilized in conformity with laws of the United States and the State of Texas. In conformity with Board policy and state and

federal law, violations include, but are not limited to the following: 1. Criminal Acts - These include, but are not limited to:

unauthorized tampering,

cyberstalking,

vandalism,

harassing email,

child pornography,

Cyberbullying.

2. Libel Laws - You may not publicly defame people through published material. 3. Copyright Violations - Copying, selling or distributing copyrighted material without the express written permission of the author or publisher

(users should assume that all materials available on the Internet are protected by copyright), and/or engaging in plagiarism.

Personal Devices

Please see your child’s Campus Student Handbook for more information about specific device/ phone policies.

Other Third Party Accounts In accordance with our district mission, goals and vision for technology our students may require accounts in third party systems. Many of these

accounts will be used at school for school related projects but may also be accessed outside of school with their parents’ permission. The use of

these accounts will help our students to master effective and proper online communications as required in the PreK-12 Technology Applications

Standards. By signing and returning this document, I give permission to the KISD to create and manage third party accounts (including examples

such as: Imagine Learning, Prezi, and VoiceThread) for my child.

G Suite Account Information

All students will have a G Suite for Education account. In grades K-4, this account does not include email access and is only used for accessing

educational applications. Accounts for students in grades 5 - 12 will include an email account through Google, monitored by Google and the

KISD via G Suite administrators. Gaggle (www.gaggle.net) will monitor student email accounts for violations that include inappropriate language,

inappropriate images, threatening statements, self-harm and other items. All accounts remain the property of Kennedale ISD, but students will

have access to them at all times. G Suite for Education will allow access to Gmail (grades 5-12), Google Drive, Google Apps, Google Classroom.

Google Calendar etc. It is designed especially for schools with productivity and safety in mind.

Students are required to utilize G Suite for Education in compliance with the KISD Acceptable Use Policy, Student Handbook, Student Code of

Conduct, Board policy, and state and federal law. Your child’s account shall remain the property of the Kennedale Independent School District and

will be under constant supervision. Students should have no expectation of privacy regarding the information kept in their accounts. Only

authorized District staff will have access to student accounts. As the parent of a student in the Kennedale Independent School District, you are

entitled to access to your child’s account. At any time, you may access this account by going to the Google homepage (accounts.google.com), and

typing your child’s username and password.

You may also feel free to communicate with your child via Gmail. Their email address will generally be last two numbers of the graduation year, last name, first initial of the first name (Example: 25johnsont), then @kennedaleisd.net. This example would be appropriate for a student set to graduate in 2025 whose name is Tommy Johnson. The email address for this student would be: 25johnsont@kennedaleisd.net. If you encounter difficulty with this set­up, please contact your school librarian for assistance. G Suite for Education usernames, passwords, and email addresses will be provided to parents and guardians upon request. Please contact your

child’s principal for this information. If you have any questions or comments, please feel free to contact your child’s principal.

Consequences I understand and will abide by this Acceptable Use Policy. If I break this agreement, the consequences could include suspension of my accounts, use

of devices whether assigned or located on campus and network access. In addition, I could face disciplinary/legal action including but not limited

to: school disciplinary action, criminal prosecution and/or penalty under the KISD Student Code of Conduct and/or appropriate state and federal

laws.

The following actions are not permitted and could result in the consequences outlined above.

● Users may not attempt to disable or bypass the KISD content filter.

● Users may not illegally access or manipulate the information of a private database/system such as gradebooks and other student

information systems.

● Users may not install unauthorized network access points, or other connections that may not effectively integrate with existing

infrastructure.

● Users may not use their accounts and/or assigned devices for non-school related activities including but not limited to:

○ Gaming

○ Attempting to access inappropriate materials.

○ Social networking

○ Hacking or to initiate/spread SPAM and/or any unlawful activities

○ Personal financial gain such as selling products etc.

○ Causing harm to others or other’s work

○ Distribution of advertisements, solicitations, commercial ventures, or political lobbying

○ Trespassing in another’s accounts, files, work etc.

○ Misrepresentation of Kennedale ISD, staff or students

○ Forgery of electronic transmission including email, social media, shared digital documents etc.

● Users may not send, save, view, forward, or create harassing or offensive content/messages or participate in Cyberbullying. Offensive

material includes, but is not limited to content/messages that would violate Board Policy, student handbook, student code of conduct, or

state or federal law. The school policies against harassment, bullying, and discrimination apply to the use of technology.

The campus principal, in conjunction with the KISD administration, will deem what is considered to be inappropriate use of the KISD computer

network access at any time. In addition, the administration, faculty, and staff of the KISD may request that a user’s account be suspended or denied

at any time. If a signed copy of this document is not returned to your school by the first day school of each school year, it will be presumed that

consent is not given.

Kennedale ISD Acceptable Use Policy/G Suite for Education

This form will be on file with the campus Librarian.

Please sign and return this page to your school’s office by the 1st day of school of each school year.

_____ I understand and agree to abide by and adhere to the Kennedale ISD Acceptable Use Policy, Board policies,

and all applicable state and federal law, and my understanding that my failure to abide by and adhere to these rules, guidelines, District documents and applicable state and federal law may subject me to disciplinary action and civil or criminal liability.

Student Name: ________________________________________________ Campus: ______________________

Student Signature: _____________________________________________ Date _________________________

Parent/Guardian’s Name: _____________________________________________________________________

Parent/Guardian’s Signature: __________________________________________________________________

For School Use Only

Student ID #: __________

Campus: ______________

________________

The information provided on this form will help the district determine if the student meets

eligibility requirements for services under the McKinney-Vento Act.

Name of Student: _________________________________________________________ Grade: ___________

Date of Birth: _______/_______/_______ Age: __________ Sex: Male Female

Address where the student sleeps at night: _______________________________________________________________ Street Address, Apartment # City Zip

Check the box(es) that best describes with whom the student resides:

Parents Legal Guardians Caregivers Other (explain) ______________________________

1. Is the address listed above a temporary living arrangement? ______ Yes ______ No

2. Is this temporary living arrangement due to loss of housing or economic hardship? ______ Yes ______ No

If you answered NO, you may stop here. If you answered YES to the above questions, please complete the remainder of this form.

Check all boxes below that best describes where the student is presently living, leave those that do not apply blank:

In House or apartment with parent or guardian

In shared housing with friends or family members (other than or in addition to parent/guardian)

In a hotel or motel

In a shelter

In unsheltered area (examples: car, park, campsite, etc.)

Other, please explain: ______________________________________________________________________________________________

________________________________________________________________________________________________________________

Do you have any other children attending Kennedale Independent School District? If so, please list them below:

Name Grade School

I understand that presenting a false statement in this document is a criminal offence under §37.10 of the Texas Penal Code and could be subject to imprisonment or fines.

________________________________________________________ ______________________ Signature of Person Providing Information Date Parent/Legal Guardian/Caregiver/Unaccompanied Student

PLEASE SEND COPY TO LISA WALSH AT CENTRAL OFFICE: FAX 817-483-3688

For School Use Only: Student meets McKinney-Vento criteria: _____ Yes _____ No ______________________________________________ _________________

Signature of McKinney-Vento Liaison Date

-Kennedale ISD Student Residency Questionnaire 2019-2020

The student lives in one of the above situations because of a natural disaster. Check the type of disaster below and provide the requested information:

Hurricane _______________________ Flood Tornado Wildfire Other: _________________________

Date the natural disaster took place: ________________ Where the natural disaster took place, including country: _______________________

Student Health Information for the School NurseS

TU

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Legal Last Name First Name Middle Name Nickname Birth Date Gender Grade

/ /

Street Address Apt/Lot # City Zip

Who resides with student at this address? (Please check all that apply) Father Mother Step-father Step-mother

Foster Family Grandmother Grandfather Aunt Uncle Other___________________

Sibling Name (must be 18 to pick up) School Attending Grade Age Pick Up

PA

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/G

UA

RD

IAN

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Parent/Guardian #1 - First and Last Name Cell Number Work Number Home Number

-( ) -( ) -( )

Email:

Relationship to student: Parent Step-parent Grandparent Aunt/Uncle Foster Parent Other ______________

Parent/Guardian #2 - First and Last Name Work Number Home Number Cell Number

( ) - ( ) - ( - )

Email:

Relationship to student: Parent Step-parent Aunt/Uncle Foster Parent

Alternate Contact #3 - First and Last Name

Grandparen

Cell Number Work Number

Other ____________

Home Number

-( ) ) -( ( ) -

Relationship to student: Parent Step-parent Grandparent Aunt/Uncle Foster Parent Other ______________

Alternate Contact #4 - First and Last Name Work Number Cell Number

( ) - ) -( Home Number

-

Relationship to student: Parent Step-parent Grandparent Aunt/Uncle Foster Parent Other ______________

MED

ICA

L IN

FOR

MA

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Primary Care Physician Phone ( ) - Hospital Choice

Does the student have any medical or health concerns (please check all that apply). Please provide additional details on back for anything checked.

ADD/ADHD Cancer/Leukemia Endocrine Immune System Disorder Skin Condition

Allergies: Environmental** Cerebral Palsy Genetic/Chromosomal Menstrual Problems Speech Disorder

Allergies: Insect Stings** Crohn’s Disease Gluten Sensitivity Mobility Issues Surgeries

Asthma/Breathing** Developmental Head/Spinal Injury Nosebleeds Vision/Eye Disorder

Behavioral Dizziness/Fainting Headaches/Migraines** Psychological/Emotional Wears Glasses/Contacts

Bladder/Kidney Diabetes* Heart Defect or disease Scoliosis Wears Hearing Aide

Bleeding/Clotting Digestive/Bowel Hepatitis or Liver Seizures/Epilepsy ____________________

Bone/Joint/Muscular Ears/hearing Hypertension Sickle Cell or Trait ____________________

*Diabetics required to have medical plan of care signed by physician per TX HB 984 , **Additional form required for medication administration at school

Does the student take any medications, homeopathic supplements, or nutritional/performance supplements on a daily basis? NO

YES Please list all:

Does the student have any medication allergies? NO YES - Explain

FOOD ALLERGY OR SPECIAL DIETARY NEEDS – Life threatening/Severe allergies will require a Food Allergy Action Plan to be on file. This is to be completed by parent and signed by the student’s doctor and returned to the school nurse per TX SB 27

NO, my child does not have a diagnosed food allergy or special dietary need (no further information required)

YES, my child has a NON-LIFE threatening food allergy to ______________________________ Reaction __________________________________

YES, my child is SEVERELY allergic to_________________________________________ Reaction ________________________________________

YES, my child has a special dietary need ______________________________________________________________________________________ (to receive alternative diet options a Special Diet Request Form must be completed by the parent and signed by the student’s doctor)

I, the undersigned, do hereby authorize officials of Kennedale ISD to contact directly the alternate persons named above to care for my child in the event that I cannot be reached. I authorize the named physician to render such treatment as may be deemed necessary in an emergency, for the health of said child. In the event physicians, or other persons named above cannot be contacted, the school officials are hereby authorized to take whatever action is deemed necessary in their judgment, for the health of aforesaid child. I will not hold the school district financially responsible for the emergency care and/or transportation for said child. I am also consenting to the electronic transfer of school health records.

Parent/Guardian Printed Name Parent/Guardian Signature Relation to Student Date

( )