“Empowering and Inspiring ALL” __________________________________________________________________

201 S. Seventh Street ∙ St. Charles ∙ IL ∙ 60174-2664 ∙ (331) 228-2000 ∙ Fax (331) 228-2001 ∙ www.d303.org

Community Unit School District 303

REQUIRED DOCUMENTS FOR ENROLLING STUDENTS

Students who will be attending any District 303 school for the first time must register at the school(s) where children from their area currently attend. Parents/Guardians are asked to present the following documents, along with the attached forms, to register their new students:

1. General Information● Student name, parent name, address, phone and email● Parcel identification number

District policy requires that this information be provided. It is on your property tax bill or at:(Kane County http://www.co.kane.il.us/TaxAssessment/) or(DuPage County http://www.waynetownshipassessor.com.)

2. Reliable proof of child’s identity and age (original birth certificate*, passport, visa, etc.)

3. Health Records (may be transferred from previous school)● Physical and dental reports of examinations within one year prior to entering● Immunization records showing compliance with State requirements (due no later than the first

day of school)

4. Academic Records for Transfer Students (report cards or transcript)● The school will send for an official transcript or records when you sign the Request for Transcript

of Student Records form● Illinois Student Transfer Form (ISBE 33-78) if transferring from an Illinois Public School

5. Two (2) proof of residency documents which show the address:● Driver’s license● Voter’s registration card● Signed lease or rental agreement● Rental receipt● Bill of sale or closing statement showing ownership of a home● Recent property tax bill (includes PIN)● Recent gas, electric, water, or telephone bill● Utility hook-up completion statements● Occupancy permit (for newly constructed homes)● Affidavit of residency (when no other proofs are available)

If residents do not have two of the listed proofs of residency, other reasonable proofs may be acceptable.

Homeless pupils (per the Illinois Education for Homeless Children Act, 105 ILCS 45/1-1) must be immediately enrolled at any public school that non-homeless students who live in the attendance area in which the homeless pupil is living are eligible to attend. Please notify the school if you are living in a homeless situation as defined by the Illinois Education for Homeless Children Act such as sharing the housing of others due to loss of housing or not residing in a fixed, regular and adequate nighttime residence.

If you have any questions about enrolling in District 303, please call the District Administrative Office at 331.228.2000 or the specific school where your child will attend.

*Required to comply with the Missing Children Records Act [325 ILCS 50/5]

Student ID

Community Unit School District 303 New Student Registration Form

School Name: Grade: Date:

Student’s Legal Name: Male Female (First Name) (Middle Name) (Last Name)

Date of Birth: Place of Birth: (MM/DD/YYYY) (CITY / COUNTY / STATE)

School Last Attended (Name & City/State):

Student’s Home/Primary Phone: Previous D303 Student? YES No

Student’s Address: (House Number) (Street Name) (Apt) (City) (Zip Code)

PARENT/GUARDIAN #1 PARENT/GUARDIAN #2

Parent/Guardian Name

Relationship to Student

Parent/Guardian Address (if different from student)

Home Phone

Work Phone

Cell Phone

Email Address

Employer/Occupation The following people may be contacted in case of emergency if the school cannot reach the parents/guardians:

Emergency Contact #1 First Name: Last Name:

Relationship to Student: Phone:

Emergency Contact #2 First Name: Last Name:

Relationship to Student: Phone:

Student resides with (check all that apply): MOTHER FATHER STEP-MOTHER STEP-FATHER LEGAL GUARDIAN

Siblings (Please list names and birthdates):

Student Request for the Loan of Textbooks: I hereby request the loan of secular textbooks in accordance with Public Act 79-961 of 1975. I understand that this request will remain valid so as long the student listed above is enrolled in Community Unit School District 303 and that I may at any time withdraw this request.

The Federal Family Educational Rights and Privacy Act (FERPA) – This allows (but does not require) District 303 to release certain “directory” information about students unless the parent/guardian objects in writing to the release of such information.

District 303 MAY NOT release the following information for my student:

Student Name Student Address Student Phone Student Photo

Parent/Guardian Signature: Date:

STUDENT FILE (Blue Copy) – HEALTH OFFICE FILE (Green Copy) Updated August 2015

Community Unit School District 303

All-Day Kindergarten or Half-Day Kindergarten Selection Form

I would like to enroll my child in: All-Day Kindergarten Half-Day Kindergarten

Student Name School

Parent Name Phone

Email

Please note: All Day Kindergarten (ADK) and Half Day Kindergarten (HDK) classroom placement is dependent upon enrollment numbers at each individual school. ADK and/or HDK students may be combined with other schools and will attend the school site determined by District Administration.

D303 Bilingual Program

Child’s Name: School:

Parent’s Name: Phone:

St. Charles CUSD 303 offers a self-contained bilingual program for Spanish-speaking students in Grades K-5. In this program, students are instructed in both English and Spanish by their classroom teacher. Potential candidates for this program would need to qualify for English Language Learners services, in addition to having a foundation in the Spanish language.

If your child qualifies for participation, would you consider enrolling your child in this program?

_______ YES, I would consider enrolling my child in this program.

_______ NO, I am not interested in enrolling my child in this program due to the following

reason:

“Empowering and Inspiring ALL Learners” __________________________________________________________________

201 S. Seventh Street • St. Charles • IL • 60174-2664 • (331) 228-2000 • Fax (331) 228-2001 • www.d303.org

Community Unit School District 303

All Day Kindergarten Fee Agreement

Please complete, sign, and return this fee agreement with your registration. School Name __________________________________________________________ Parent/Guardian Name ___________________________________________________ Student Name _________________________________________________________ Your child’s placement in the program is assured only when the Fee Agreement has been completed, signed and returned. I understand the registration fee for All-day kindergarten is $100.00*. I also understand and agree to pay the tuition for the 2018-2019 All Day Kindergarten program which is $2,025.00 annually ($900 for reduced, and $225 for free, based on National School Lunch Program), payable in nine equal payments** (pending Board of Education approval). I understand that all monthly payments are due on the 15th of the month at my school office, one month in advance, with the first payment due on August 15, 2018. I also understand that if payment is not received by the last school day of the month during office hours, my child may be dropped from the program and placed at the bottom of the waiting list. If my child is dropped twice, they may not re-enroll in CUSD 303 All Day Kindergarten. I understand that no partial payments will be accepted, that I will not receive a monthly billing statement, and that it is my responsibility to make sure that my payment reaches the school office on time. I understand that there is no tuition credit, refund, or make-up time offered for absences. I understand that there is a $35.00 NSF Check fee on all checks returned by your bank, and that payment of NSF checks must be made by a money order or credit card. Parent/Guardian Signature _______________________________ Date ___________ *Early Bird Discount – Pay $90 if registration payment is received on or before April 28, 2018.

**A 10% discount will be given for full tuition payment made by July 1, 2018 ($1,822.50).

FORM: ELL 1a Eng. Office Use: Forward copy to ELL Coordinator/ELL Teacher if another language is present Revised: 3/16 ELL Teacher: Place copy in student’s ELL folder

23 IL Adm. Code 228.15

Community Unit School District 303

Home Language Survey/Race and Ethnicity Data

The state requires the district to collect a Home Language Survey for every new student. This information is used to count the students whose families speak a language other than English at home. It also helps to identify the students that need to be assessed for English language proficiency. Student’s Name: _____________________________________________ Grade: __________________

School: ________________________________ Phone Number_______________________________

1. Is a language other than English spoken in your home?

_____No _____Yes*** What language? ____________________________

PLEASE EXPLAIN: ___________________________________________________________

____________________________________________________________________________

2. Does your child speak a language other than English?

_____No _____Yes*** What language? ____________________________

***IF THE ANSWER TO EITHER OF THE ABOVE QUESTIONS IS “YES,” THE LAW REQUIRES THE SCHOOL TO ASSESS YOUR CHILD’S ENGLISH LANGUAGE PROFICENCY.

3. I prefer school communications in: _____English ____Spanish ____My Home Language

Part A. Is your child Hispanic/Latino? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.) Choose only one.

_____No, not Hispanic/Latino _____Yes, Hispanic/Latino Part B. What is your child’s race? Choose one or more.

_____ American Indian or Alaska Native: A person having origins in any of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment.

_____ Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

_____ Black or African American: A person having origins in any of the black racial groups of Africa.

_____ Native Hawaiian or Other Pacific Islander: A person having origins in any of the original people of Hawaii, Guam, Samoa, or other Pacific Islands.

_____ White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.

_________________________________________________ _________________ Signature of Parent/Guardian Date

_________________________________________________ Print Name

Office Staff: Copy and give to ELL Teacher/Coordinator ELL Teacher: Place copy in student’s ELL folder

Updated 11/2014 23 IL Adm. Code 228.15

Community Unit School District 303

Extended Home Language Survey To be completed if you answered “yes” to questions 1 or 2 on the Home Language Survey.

Student’s Name:

Parent’s Name(s): Entering Grade:

Date of Entry into U.S. Schools: Birth Date:

Student Place of Birth (City, State, Country):

Where outside the United States did your child attend school?

Country: City: STUDENT’S EDUCATION

Pre-K K 1 2 3 4 5 6 7 8

School years completed outside of the U.S.

School years completed within the U.S.

Years in Bilingual/ESL classes

Years in special education classes

LANGUAGE USE: 1. What was the first language your child learned?

2. List all of the languages normally spoken in your home.

3. What language do you (parent) use most frequently to speak to your child?

4. What language does your child use most often when he/she speaks to you?

Speaks to his/her siblings? Speaks to his/her friends?

6. Does your child read in another language other than English? _____ Yes _____No

What language?

7. Does your child write in another language other than English? _____ Yes _____No

What language?

Signature of Parent/Guardian Date

“Empowering and Inspiring ALL” __________________________________________________________________

201 S. Seventh Street ∙ St. Charles ∙ IL ∙ 60174-2664 ∙ (331) 228-2000 ∙ Fax (331) 228-2001 ∙ www.d303.org

Community Unit School District 303

New Student Registration Information This form must be completed, signed and returned to the school for each student.

Student Name Grade Date

MILITARY CHILDREN INFORMATION: This information will help identify Illinois military families. Answering these voluntary questions will help schools get U.S. Department of Defense assistance for children whose parent/guardian serves in the military, National Guard or Reserve.

Does this student’s parent or guardian serve in the military, including National Guard or Reserve? YES NO Is the parent or guardian currently serving on active duty or expected to be deployed this year? YES NO Has the parent or guardian returned from deployment in the past six (6) months? YES NO

FIELD TRIPS: From time to time we may take educational field trips in the surrounding area. Your signature gives

permission for the student listed above to attend educational field trips in Community Unit School District 303. You will

be notified before each trip.

DISTRICT’S AUTHORIZATION FOR ELECTRONIC NETWORK ACCESS: I have read the District’s policy regarding Access to

Electronic Networks (http://district.d303.org/6235-access-electronic-networks) and the District’s Authorization for

Electronic Network Access (6:235 AP1) and understand that failure of any student to follow the terms of this policy and

administrative procedure will result in the loss of privileges, disciplinary action and/or appropriate legal action.

PARENT/STUDENT ACKNOWLEDGEMENT OF STUDENT HANDBOOK: I understand that all students will be held

accountable for their behavior and will be subject to the guidelines and the disciplinary consequences outlined in the

student handbook and discipline procedures found on the District’s website at http://district.d303.org/student-

handbooks.

FERPA (Family Educational Rights and Privacy Act) gives custodial and non-custodial parents certain rights with respect to their children’s education records, unless a school is provided with evidence that there is a court order or State law that specifically provides to the contrary. Both custodial and non-custodial parents have the right to inspect and review education records, seek to amend education records believed to be inaccurate, and consent to the disclosure of personally identifiable information from education records, except as specified by law. When a student reaches 18 years of age, he or she becomes an “eligible student,” and all rights under FERPA transfer from the parent to the student. The term “education records” is defined as those records that contain information directly related to a student and which are maintained by an educational agency or institution or by a party acting for the agency or institution.

Parent Signature: Date:

Student Signature: Date:

Please return this permission form to your child’s school with registration materials.

WEB 2.0 RESOURCES AND STUDENT ONLINE ACCOUNTS

**PLEASE SIGN AND RETURN WITH REGISTRATION MATERIALS IN ORDER FOR YOUR STUDENT TO CREATE WEB 2.0 ACCOUNTS**

In our commitment to provide the best learning experience for your student, D303 continues to search for

relevant instructional tools that meet the needs of 21st Century learners. Over time, we have located websites

and mobile apps which provide students with tools that allow them to work and collaborate in new ways. These

sites fall into a category broadly defined as Web 2.0 Resources. These online programs are usually free or

inexpensive and are a way digital information is created, shared, stored, distributed, and managed. A registered

account, requiring personal student information (such as their name or their D303 Google credentials), is

needed in order for these projects to be saved online for future editing and easy remote access.

In keeping with Internet Safety Protocol, parent(s) and/or guardian(s) must grant permission for their student

to sign-up for any account which requires a student to enter personal information online. If permission is not

granted, then the student will complete an alternate assignment. Students using an approved Web 2.0 site as

part of their classroom learning will be expected to follow established classroom and school expectations for

acceptable use and behavior.

Links to these sites, the data collected from students, and more information about the approval process can be

found at: http://district.d303.org/web-20-resources

The Web 2.0 Resources site will be updated throughout the year as teachers find new resources and request

district approval. After this form is signed and returned, teachers will provide an email notification if a new tool

is approved to use in their classroom.

The behavioral expectations and consequences for misuse are identical to classroom rules for behavior except

not bound by time of day or location.

Please fill in student’s name and sign for either of the two options listed below: I do give permission for _________________________________to sign-up for an account for district approved

Web 2.0 Resources.

OR

I do not give permission for ________________________________to sign-up for an account for district approved Web 2.0 Resources. Parent/Guardian Signature: Date

“Empowering and Inspiring ALL”

__________________________________________________________________ 201 S. Seventh Street ∙ St. Charles ∙ IL ∙ 60174-2664 ∙ (331) 228-2000 ∙ Fax (331) 228-2001 ∙ www.d303.org

Community Unit School District 303

Student Records Transfer Request (To be used when requesting records from the official records custodian of another school)

Today’s Date

To the Records Custodian of:

School Name:

Address:

City:

State & Zip Code:

Request sent via: Email Fax Mail

Student’s Name Date of Birth ______________________________enrolled in school on (Student’s Name) (CUSD 303 School) . The student is assigned to grade for the school year. (Enrollment Date)

Please send all permanent and temporary student records for the above mentioned student to:

School Name

School Address

School Address

Attention

Except as otherwise provided in 23 Illinois Administrative Code, Section 375.75, the records of a student shall be transferred by the official records custodian of a school to another school in which the student has enrolled or intends to enroll upon the request of the of the official records custodian of the other school or the student, provided that the parent receives prior written notice of the nature and substance of the information to be transferred and opportunity to inspect, copy, and challenge the information to be released. Parent/guardian consent to release records to another public education institution in which the student intends to enroll in not required. Record Custodian’s Signature Date Parent/Guardian Signature Date

1-15 OVER

Community Unit School District 303

School Health Services

Dear Parents: The State of Illinois recognizes that your child’s health is very important to the educational process and has established requirements to preserve and protect the health of all students. Please carefully read over and note the following mandated health requirements: A completed physical form with required immunizations must be on file prior to the start of school for all students. Students who fail to submit the required health forms will be excluded from school until health requirements are met. All health forms may be accessed on the CUSD 303 website at www.d303.org in the “For Parents” section under Forms. All forms are also available through your child’s school.

CLICK HERE FOR HEALTH / DENTAL / EYE EXAM FORMS THE PHYSICAL EXAMINATION:

The examiner must be a Physician licensed to practice medicine in all of its branches, a licensed Physician’s Assistant, or an Advanced Practice Nurse. An examination by a Chiropractor is not acceptable.

The Health History portion on the back of the Certificate of Child Health Examination form must be filled out and signed by the parent or guardian prior to your child’s examination.

Inform your health care provider about any known illnesses, health or physical concerns that might be important in determining your child’s physical condition.

The physical examination must include an evaluation of all body systems including:

Height, weight, blood pressure, diabetes screening/BMI,

Lead screening required for children age six years or younger for admission into preschool or kindergarten programs.

Medications, diet restrictions, allergies, special equipment or other needs must be listed by the examiner.

Participation in Physical Education must be approved by the examiner in order for your child to participate in the physical education program.

REQUIRED IMMUNIZATIONS: Evidence of immunity against the following diseases must be submitted according to the following schedule: 4 or more doses of DPT (last one given after 4 years of age) 3 or more doses of Polio (last one given after 4 years of age) 2 doses of MMR (first one given on or after the 1st birthday) 2 doses of Varicella (first one given on or after the 1st birthday) or written statement by healthcare

provider verifying chickenpox disease THE DENTAL EXAMINATION:

All kindergarten students must present proof of a dental examination by May 15th of the school year.

The dental examination must be performed and signed by a licensed dentist.

A waiver has been established by the Illinois Department of Public Health for children who show undue burden or lack of access to a dentist.

Dental care is important to the health of your child. Good hygiene, proper diet and visits twice yearly to the dentist are important in maintaining healthy teeth.

THE VISION EXAMINATION:

All children enrolling in kindergarten must present proof of having been examined by a physician licensed to practice medicine in all of its branches or a licensed optometrist within the previous year before October 15th of the school year.

The eye examination shall include history, visual acuity, subjective refraction to best visual acuity near and far, internal and external examination, and a glaucoma evaluation, as well as any other tests or observations that are deemed necessary in the professional judgment of the doctor.

A waiver has been established by the Illinois Department of Public Health for children who show undue burden or lack of access to a licensed physician or optometrist.

If your child has a medical condition that may impact any part of his or her school day, please contact the Certified School Nurse in your child’s school so that adjustments or accommodations can be made. Thank you for your cooperation with these important health matters.

CLICK HERE FOR HEALTH / DENTAL / EYE EXAM FORMS

Community Unit School District 303 School Health Services

Kindergarten Health Forms Checklist

Please make sure that all forms are complete by checking off each box. All sections MUST be completed to be accepted.

� Physical Exam Form � Immunization section completed, signed & dated � Health History portion completed and signed by parent � Ht, Wt, B/P, BMI � Diabetes Screening � Lead Screening � Physical Education participation � Signed and dated by a licensed MD, DO, APN or PA � Dental Exam Form � A complete dental exam performed, signed and dated by a

licensed dentist � Vision Exam Form � A complete vision exam performed, signed and dated by a

licensed optometrist or licensed physician � Return to your School Nurse � Best for processing purposes if all forms are returned

prior to May 1. � First Day Exclusion Policy - Physical form and Required

Immunizations Must be on file before the first day of school for you child to begin classes on the first day.

Thank you for your attention to these important health concerns.

Community Unit School District 303

Health Services Survey In an effort to best serve our students, we request that you provide current health information.

1. Has your child had a serious illness, injury or surgical procedure within the past year?

If yes, please explain:

Will your child require medication, restrictions, or accommodations at school?

Yes □ No □

Yes □ No □

2. Does your child have a known allergy/sensitivity that may impact him or her at

school?

If yes, please explain:

Is your child’s allergy considered life-threatening?

Please list all allergy medications your child has been prescribed:

Will your child require medication, restrictions or accommodations at school?

Yes □ No □

Yes □ No □

Yes □ No □

3. Does your child have asthma?

Is your child’s asthma: □mild □moderate □severe?

Is your child’s asthma: □seasonal □exercise □illness □allergy induced?

Please list all medications your child takes for asthma:

Will your child require medication, restrictions or accommodations at school?

Yes □ No □

Yes □ No □

4. Does your child have a history of seizures? If yes, please explain the nature of your child’s seizure history:

When did the last seizure occur?

Please list any seizure medications your child currently takes:

Will your child require medication, restrictions or accommodations at school?

Yes □ No □

Yes □ No □

5. Does your child have a history of cardiac concerns? If yes, please explain the nature of your child’s cardiac history:

Is your child currently under the care of a cardiologist?

Please list all cardiac medications your child takes:

Will your child require medication, restrictions or accommodations at school?

Yes □ No □

Yes □ No □

Yes □ No □

6. Does your child have any other health concerns; physical, emotional or attention

related, that could impact him or her while at school? If yes, please explain:

Does your child take medication at home?

If yes, please indicate:

Does your child require medication, restrictions or accommodations at school?

Please indicate:

Yes □ No □

Yes □ No □

Yes □ No □

7. Does your child wear glasses/contacts and/or have a visual impairment? If yes, please explain the nature of the visual impairment:

Yes □ No □

8. Does your child have a known hearing loss, ear tubes or frequent ear infections? If yes, please explain the nature and frequency of your child’s hearing difficulty:

Yes □ No □

This information will be kept confidential and shared only with educational personnel on a need to know basis.

Please contact your school nurse if this information is not to be shared.

Health information and health forms are available under Parents/Forms/Health Forms at www.d303.org

Child’s Name: Grade: School Year: