Oconomowoc Area School District

Registration Form

(Legal Name Must Be Used for Student and Parents)

Section I Student Information

Student's Legal Name: DOB:

Gender:

Address: County:

City, State & Zip:

*Home Phone (Required):

Child resides with: (mark one) Both Parents Mother Father Guardian Foster Joint Custody

Part 2 Race Background: (Check all that apply)

Primary Language Spoken:

Grade:

Birth Country: Entry date into US: Reentry date into US:

Start of school in US:

Birth City: Birth State: Birth County:

Apt #:

Black

Yes

AsianAmerican Indian or Alaskan Native

Native Hawaiian or Other Pacific Islander White

Part 1 Ethnic Background: Hispanic/Latino

Mailing Address: Mail Zip: Mail P.O. Box:

No

Please answer Part 1 and Part 2.

Secondary Language Spoken:

WI First Time Enrollment Date (if after kindergarten):

Guardian Legal Name:

Cell Phone:

**E-mail Address (Required):

Relationship to Student:

Work Phone:

Language Spoken:

Section II Guardian Information FAMILY 1 INFORMATION

Guardian Legal Name Spouse:

Cell Phone:

E-mail Address:

Relationship to Student:

Work Phone:

Language Spoken:

FAMILY 2 INFORMATION

Guardian Legal Name: *Home Phone

(Required):

Cell Phone:

Language Spoken:

Relationship to Student:

City, State & Zip:

Address:

**E-mail Address (Required):

Work Phone:

A copy of all forms and reports will be supplied to Family 2 unless appropriate information is on file.

Guardian Legal Name Spouse:

Cell Phone: Relationship to Student:

E-mail Address:

Work Phone:

Language Spoken:

Legal Name Birthdate

Section III Family Sibling Information

Legal Name Birthdate

(List siblings living in your home under the age of 22 who have not graduated)

Gender Gender

* This phone number is used for notifications.

** This e-mail is used for notifications.Page 1

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Oconomowoc Area School District

Registration Form

(Legal Name Must Be Used for Student and Parents)

Student's Legal Name: DOB:

Emergency Name: Work Phone: Relationship to Student:

Section IV Emergency Information (Do not use a parent name as an emergency contact, the

parents/guardians are already the first contact).

Cell Phone:Home Phone:

School Address and/or Phone and Fax:

School Last Attended:

Has your child been expelled from another school ? Yes No If Yes, where from?

Section V Previous School Information (If not OASD public school)

The Oconomowoc Area School District provides assurance that no student is discriminated against

because of the student’s sex, race, color, religion, national origin, ancestry, creed, pregnancy, marital or

parental status, sexual orientation, or physical, mental, emotional, or learning disability.

Birth Certificate Verification: (New to the district)

Birth Certificate Verified

Office Workers Initials:

Date:

For Office

Use Only: Legal Name Verified

Proof of Residency Verified

Page 2Last Updated:12/5/14

OCONOMOWOC AREA SCHOOL DISTRICT Oconomowoc, Wisconsin

PARENT INFORMATION SCREENING FORM

Child’s Name: Date:

Child’s Birthdate: Grade Place of Birth:

Is English the primary language spoken in your home? ☐ Yes ☐ No Does anyone in your home speak a language other than English? If yes, what is the other language _______________________ Does your child understand and speak this language

☐ Yes ☐ No ☐ Yes ☐ No

What language did your child learn when first beginning to talk?

What language is most often spoken by the adults in the home?

Please indicate if you suspect or are aware of any of the following conditions in your child:

Orthopedically Impaired ☐ Yes ☐ No Cognitive Disability ☐ Yes ☐ No Hearing Impairment (uncorrected) ☐ Yes ☐ No Visual Impairment (uncorrected) ☐ Yes ☐ No Speech or Language Impairment ☐ Yes ☐ No Emotional Behavioral Disability ☐ Yes ☐ No Specific Learning Disabilities ☐ Yes ☐ No Other Health Impaired ☐ Yes ☐ No Traumatic Brain Injury ☐ Yes ☐ No Autism ☐ Yes ☐ No Significant Developmental Delay ☐ Yes ☐ No

Does your child have an IEP from your previous school district?

☐ Yes ☐ No

Does your child have a 504 plan from your previous school district? ☐ Yes ☐ No Have there been any recent events that might affect your child emotionally, and thus affect school performance, such as a birth, death, remarriage, etc.? If yes, please explain:

☐ Yes ☐ No

Are there any other points that you would like the school to take into consideration in working with your child? If yes, please explain:

☐ Yes ☐ No

Has your child been retained for a grade? What grade? _____________

☐ Yes ☐ No

Has your child ever been expelled from school?

☐ Yes ☐ No

Parent Signature Date Please return this form at registration or in a way convenient to you. We ask that it be returned even though conditions listed may not exist. Any information given will be treated confidentially.

SIGNATURE PAGE Information Technology and Network Use Agreement The Oconomowoc Area School District provides employees and students access to its Information Technology and Network (ITN) resources for educational and other school-related purposes. ITN resources include, but are not limited to, computers, software, mobile devices (e.g., laptops, iPods/MP3, cell phones, etc), e-mail, and Internet access. These resources are available in each school and, in some cases, via remote access. Use is a privilege and users agree to comply with all provisions of the Information Technology and Network Use Policy. As a user of District ITN resources, I recognize and understand that these resources are the exclusive property of Oconomowoc Area School District. I agree not to use ITN resources in a way that is disruptive, offensive, or harmful to others or to the District. Further, I agree not to use a password that has not been disclosed to the District. I agree not to use pass codes, access a file or retrieve any stored communication, other than where authorized, unless there has been prior clearance by a teacher or District administrator. I agree not to copy, send or receive copyrighted or confidential materials without permission. I am aware that the District reserves, and will exercise the right, to review, audit, intercept, access and, if necessary, disclose all matters on the District’s ITN resources when legitimate purposes require it. I am aware that the District may exercise these rights with or without notice. I am aware that use of a password or code does not guarantee confidentiality or privacy or restrict the District’s right to access electronic communications. ▼STUDENT / STAFF: I understand and will abide by the Information Technology and Network Use Policy. Should I commit any violation, my access privileges may be revoked and school disciplinary and/or appropriate legal action may be taken. Name (please print): Grade:______________ Signature: Date: ▼PARENT OR GUARDIAN: As the parent or guardian of this student, I have read the Information Technology and Network Use Policy. I understand that access to these resources is for educational and school-related purposes. I recognize that it is impossible for the Oconomowoc Area School District to restrict access to all controversial materials, and I will not hold them responsible for materials acquired on the network. I hereby give permission to issue accounts for my child and certify that the information contained in this form is correct. Parent or Guardian’s Name (please print): Signature: Date: Final Approval: July 10, 2001 Regular Board of Education Meeting Reviewed: March 20, 2007 Regular Board of Education Meeting Revised: December 18, 2012 Regular Board of Education Meeting

Parents please fill out the first part of this form and return to your student’s school with your registration paperwork.

REQUEST FOR PUPIL RECORDS

Previous School_________________________________________________________________________________ Address:_______________________________________________________________________________________ Street City State Zip FAX Number: _________________________________ The following student has enrolled at Oconomowoc Area School District: __________________________________________________________________ ______________________ Name of Student Grade Date of Birth The student listed above has enrolled in our school district. Please forward to our school office the student’s progress and behavioral records to include the cumulative folder, health record, and transcript of academic performance. If applicable, include a copy of your system of grading students, how many credits are required for graduation and (all Wisconsin Schools) please send the WIAA physical card.

School records should be sent to (to be filled out by OASD requesting school): School Name:

Address:

Phone Number:

Fax Number:

Thank you.

Parental Permission is no longer required when authorized school personnel request records.

(Family Educational Rights and Privacy Act, Final Rule on Educational Records.

Federal Register, June 17, 1976. Vol. 41, No. 118. Page 24673)

Updated 11/30/16 Page 1 of 1

Dear Parent: We would like your child to gain the most from his/her school experience. In order for us to assist in accomplishing this, it is necessary to have a current health history. Please complete this form and return it to your child’s school when you register. Child's Name Sex Birthdate

School Attending Father's Name Mother's Name ______________________

HEALTH HISTORY: Please check () the following if applicable to this child:

ADHD Heart disorder

Asthma Hearing/Vision issue

Autism Mental health concern

Bleeding disorders Migraines

Seizures Musculoskeletal disorders

Bowel/Bladder issue Other (Fill in):

Diabetes

Food Allergies

*Additional forms or health care plan may be required for some health conditions. If you checked that your child has a health problem, please explain. Also include any medical history that we should be aware of in the event of an emergency:

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Does your child have allergies? Yes No If yes, to what? Date of last reaction What happened? Is an Epi-Pen prescribed for allergy? Yes No *Additional Allergy Care Plan may be required. MEDICATIONS

Is your child currently taking medication(s) at home? Yes No Name of medication(s)

Do you anticipate your child will need to take medications at school? Yes No Name of medication(s) *Additional medication consent form will be required.

Is there anything more about your child that you think is important for us to know? Yes No If yes, please comment:

Parent Signature Date

District Nurse Signature Date

School Health History Form District Nurse Phone: 262-560-2104

District Nurse Fax: 262-560-2106

EMPOWERING A COMMUNITY OF LEARNERS AND LEADERS

State of WisconsinDepartment of Regulation and Licensing

KINDERGARTEN EYE HEALTH EXAMINATION REPORT

Student’s Name ____________________________Birth Date ________ Sex ___________

Parent or Guardian ____________________________________________ Phone __________

Address _____________________________________________________ County__________

School/Kindergarten ___________________________________________ City ___________

Date entering Kindergarten _____________________________________

The State of Wisconsin encourages parents of Kindergartners to arrange for their child’s eyes to beexamined by an optometrist or evaluated by a physician by December 31 of the child’s first year inschool. An examination or evaluation should include, at a minimum, the elements listed below. (Bychecking the box, the examining doctor is indicating that the element checked was performed.)

p Brief history (general health and eye health) of the child, including family historyp General external observation of the child’s eyes and surrounding structuresp Ophthalmoscopic examination through an undilated pupilp Gross measurement of peripheral visionp Evaluation of eye coordination and function (alignment and motility)p Visual acuity for each eye (separately)

Findings:

As a result of this examination, follow-up care for the child is recommended: p Yes p No

IMPORTANT NOTICE TO PARENTSDate of examination:

_____________________________

Doctor/Physician Signature:

_____________________________

Print or stamp:Doctor/Physician NameAddressPhone

This examination is not required by law.Disclosure of the information noted above isnecessary to comply with the statutory purpose asoutlined in s. 118.135, Wis. Stats.

Disclosure of this information is voluntary and thereis no penalty for non-compliance.

You are encouraged to provide a copy of this form tothe school and keep a copy for your record.

Consent of parent or guardian: I agree to releasethe above information on my child to appropriateschool authorities and consent to my child obtainingan eye examination.

Signature _______________________________Date _______________________________

#2540 (2/02)s. 118.135, Stats.

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Online Registration for the 2017-18 School Year

Oconomowoc Area School District will again be using Online Registration for the 2017-2018 school year!

Similar to last year, you will be able to view and pay your student fees and lunch account balance online through Family Access.

For Elementary and Intermediate schools;

Picture day will again take place the first few weeks of the new school year. A link will be provided in the registration process to take you directly to the Lifetouch School Photography website to place an order for your student’s school picture and make payment.

School Open-House Day (Meet, Greet, and Find Your Seat) is scheduled for August 29th. Open House will be used to drop-off your student’s supplies, meet the teacher, find your seat, and pick up items that were purchased through the online registration fee payment process. Please drop off any medications your student will need during the school year at this time to the health room.

OHS will host Pick up Materials & Picture Day on August 9th. Students will have their photos taken for the 2018 yearbook and ID badges, which are needed on the 1st day of school. Items purchased during online registration (goggles, padlocks, 2017 yearbooks, parking permits, etc.) will ONLY be available for pick up on August 9th. Chromebooks will also be distributed on this day. Please drop off any medications your student will need during the school year at this time to the health room

Online registration will be open from July 3rd through August 9th. The registration process is completed

through your Family Access account. Computer access will be available at Meadow View, Nature Hill, Silver Lake, and Oconomowoc High school during normal summer office hours, please check the district website for hours. There will also be access at Summit during summer school hours. It is imperative that this update process be completed by August 9th to ensure accurate student records for the first day of school. You are required to complete the process for each student. Upon completion of online registration, you will receive an email confirming that you have completed the process. If you do not receive an email please verify that the process has been completed for each student. Detailed instructions will be available on the district’s website.

For families who have not completed the registration process PRIOR to August 9th, computer stations and assistance will be available at Oconomowoc High School on August 9th from 11 a.m. to 7:00 p.m. Please note, a $25 fee will be assessed for all registrations completed after August 10th. Schedules and teacher assignments will be visible on August 21st only to families who have completed online registration. Enclosed please find your student’s Health Immunization/Registration Form. Thank you for your continued support of our schools!

Greenland Elementary 262-560-8100 Summit Elementary 262-560-8300 Ixonia Elementary 262-560-8400 Nature Hill Intermediate 262-569-4940 Meadow View Elementary 262-560-8000 Silver Lake Intermediate 262-560-4300 Park Lawn Elementary 262-560-8200 Oconomowoc High School 262-560-3100

Dear Parents: A student fee schedule is approved each year by the Board of Education, which is specifically authorized by state statute to establish and collect such fees. Student fee revenues are important in our efforts to provide quality instructional materials in every classroom. Please be aware that unpaid student fees may result in a student being excluded from participation in certain school activities, events, and ceremonies. Although student fees are due in full at time of registration, we understand that in certain, limited circumstances (where financial hardship can be demonstrated), full and immediate payment of these fees may place a financial burden on some families. If you are unable to remit full payment at time of registration, we encourage you to take the following actions:

1. Complete a Free and Reduced Lunch application available late summer on the Food Services page at the District website www.oasd.org. You must re-apply each school year for Free and Reduced Lunch even if you qualified in prior school years. If you are eligible for Free and Reduced Lunch, your student’s annual fee will be waived. You will still be responsible to pay for special course fees (High School and Intermediate) and tangible items (example: assignment notebooks). IMPORTANT: Fee waivers will not be processed in student fee accounts until 10/3/17. Please log in to your Family Access account under the Fee Management tab to verify waivers after this date.

2. If you are not eligible for Free and Reduced Lunch and are unable to remit full payment, please

complete a payment plan through online registration or through your school office after online registration closes. All accounts arranging for a payment plan will be granted extended payment terms and must be paid in full by June 7, 2018 (the last student school day).

Accounts with outstanding balances as of December 1, 2017 that have not arranged for a payment plan, will be referred to the Waukesha County Department of Administration – Collection Division. If you have any questions, please do not hesitate to call your school office. Thank you again for your cooperation. Sincerely,

Beth M. Sheridan Beth M. Sheridan Director of Business Services CC: School Office

Immunization and Health Information – 2017-18 School Year

Please update, sign and return the Immunization and Health Registration Form to the school office or address listed at the bottom of this page by June 1st, 2017. If your student needs to receive vaccinations over the summer in order to be compliant in fall, please mail the form to the address below after immunizations are given.

The Wisconsin Immunization Registry (WIR) is a secure computerized data system that tracks the immunizations given in Wisconsin. To access the WIR go to: http://dhfswir.org. For further immunization information, contact your doctor, clinic, HMO or nearest public health department.

Health Care Plans

If your student has a health concern that requires a care plan, care plans must be updated on an annual basis. Health Care Plans will be e-mailed to applicable families’ in June. If you require a paper copy, please contact your school’s health room or the Health Services Office at 262-560-2114 or ernserj@oasd.org.

District Nurses and Health Services Team available August 9th, 2017

Health Services Team Members will be available for walk-in appointments at Oconomowoc High School on August 9th from 11 a.m. to 7:00 p.m. to discuss any health/medical questions or concerns regarding your student. Families can also use this opportunity to drop off medications and health paperwork to District Health Staff for students attending any of our schools. If you would like to schedule an appointment on a different day to discuss the medical needs of your child, please contact Jody Ernser, Health Services Administrative Assistant, at 262-560-2114 or e-mail ernserj@oasd.org. Please note the District Nursing Office closes June 9th, 2017 and will re-open August 14, 2017. District Nurse’s Office 641 E. Forest Street Oconomowoc, WI 53066 To insure student safety please supply the health room with medications your student will need

at school PRIOR to the first day of school.

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State law requires all public and private school students to present written evidence of immunization against certain diseases within 30 school days of admission. These requirements can be waived only if a properly signed health, religious, or personal conviction waiver is filed with the school. Students not in compliance by the 30th day of school may be excluded until compliance is achieved.

Please complete this form entering the dates (month, day and year) in the appropriate boxes for each immunization received to date.

7-18

7-18

11/30/16