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WELCOME TO KINDERGARTEN! IMPORTANT DATES TO REMEMBER
FEBRUARY 6-10 – Enrollment Packet pick-up and return. Please go through each form carefully
and fill out everything. Return the white registration forms with 2 proofs of residence and a copy of your
child’s birth certificate to the school office this week, or no later than Feb. 27. Blue health assessment forms
and a copy of current immunizations can also be turned in at this time if your child has already has his/her 5
year wellness checkup. If not, please return this form to the office as soon as it has been filled out by the
doctor.
APRIL 25- 6:00-7:30PM - Kindergarten Information Night. Please mark your calendar to join us in
the media center to learn all about Kindergarten at Indian Trail Elementary. Current Kindergarten teachers,
Principal and Assistant Principal, and other staff will be on hand to answer all your questions.
AUGUST 8 and AUGUST 15 at 9:30AM – 11:00AM OR 12:00PM – 1:30PM -Kindergarten
Camp. When you return your white registration forms with proof of residence and birth certificate, you
will be asked to sign up for 1 of the above dates and times. This “camp” allows the teachers to assess each
child’s strengths and weaknesses in order place the students equitably in classrooms.
AUGUST 28, 29, 30, 31 - Staggered Start days for Kindergarten students
To help the kindergarten children adjust to the procedures, teacher and kindergarten school environment,
your child will be assigned to attend only ONE DAY the week of August 28th – 31st (M-TH). This will allow
your child and your child’s teacher to bond in a smaller group setting before the first day of school for ALL
KINDERGARTENERS on Tuesday, September 5th. You will be notified the third week of August to inform you
of your child’s STAGGERED DAY and Open House/Meet the teacher.
SEPTEMBER 5TH – All Kindergarten students attend together.
DATE & TIME TO BE ANNOUNCED Open House/Meet your Teacher Night. All Students in
grades K-5 are invited to come to ITES and meet their assigned teacher for the 2017-2018 school year.
KINDERGARTEN ENROLLMENT PACKET CHECKLIST
1. WHITE PACKET – Student Enrollment Form
Documents Needed – 2 Proofs of Residence and Child’s Birth Certificate (*Note –
Child cannot be signed up for Kindergarten Camp until this packet with required
documents are turned into front office)
2. GREY FORM - Bus Ridership form
Please complete and return if you think your child may be a bus rider
3. BLUE FORM – Kindergarten Health Assessment
Please complete the parent portion and have your child’s physician complete the
rest of the form. It MUST by signed by a physician it will not be accepted. This
form must be turned in by September 30th with current immunizations or your
child will be suspended from school.
4. ORANGE FORM – Immunization Law Information and signature form
Please read, sign and return with enrollment forms
5. YELLOW FORM – Chronic Health Conditions
Please fill out and return with enrollment packet – will be kept in nurses office
6. LIGHT PINK- Information regarding the After School Program
7. LAVENDER – Names and phone numbers of other Daycares that may offer afterschool
pick-up service to ITES. (These are all independent of UCPS- this is for informational
purposes only)
8. 2017-2018 TRADITIONAL SCHOOL YEAR 1 PAGE CALENDAR – For you to keep.
STUDENT ENROLLMENT FORM UNION COUNTY PUBLIC SCHOOLS
For Office Use Only: Student ID ______________________________ Enrollment Date______________ Grade____ Registration completed ___________________ School ________________________________ Need □ Immunization Record □ Birth Certificate □ POR Transportation _________________________ School Receiving Packet _________________________ Teacher’s Name ________________________ Date Received ____________________ Packet received by______________________
Please indicate the student’s academic placement: □ New Kindergartener for the _______________ school year □ New Pre-Kindergartener for the _____________ school year □ New student entering grade ______ for the _______________ school year
Student Information Birth certificate or other satisfactory evidence of age and official record of immunizations must be presented at time of enrollment.
Copies of these documents are to be placed in folder and originals returned to parent/guardian.
Legal Name _________________________________________________________________ / ____________________ Last First Middle Nickname
Physical address ___________________________________________________________________________________ House/Apt. Number Street City State Zip
Mailing Address(if different)____________________________________________________________________________ House/Apt. Number Street City State Zip
Home Phone ________________________
□ Male □ Female Date of Birth __________________ Place of Birth________________________________ Month/Day/Year City/State/Country
Ethnicity: □ Hispanic □Non-Hispanic Race: (select all that apply) □ American Indian □ Black □ Asian □ Hawaiian/Pacific Islander □ White
Child resides with ______________________________________________ ___________________________________ Relationship to Student
Legal Custodian_________________________________________ Legal paperwork provided to school □ Yes □ No
Family Information Father’s Full Name _________________________________________________________________________________
Place of Birth (City/State/Country) ___________________________________________________ Deceased □ Yes □ No
Address __________________________________________________________________________________________
Home Phone _________________________ Cell Phone _____________________________
Employer _____________________________________________ Work Phone ____________________________
Highest Education level completed _____________ E-mail address __________________________________________
Mother’s Full Name (include maiden name)_________________________________________________________________
Place of Birth (City/State/Country) ___________________________________________________ Deceased □ Yes □ No
Address __________________________________________________________________________________________
Home Phone _________________________ Cell Phone ______________________________
Employer _____________________________________________ Work Phone ____________________________
Highest Education level completed _____________ E-mail address __________________________________________
Stepparent’s, Legal Guardian’s, or Sponsor’s information (if applicable) Relationship to student_____________________
Name _______________________________Address______________________________________________________
Home/Cell Phone ____________________Employer _____________________ Business Phone___________________
E-mail address _____________________________________________________________________________________
Other Information Pick up Child
Emergency Contact_______________________________________________________________________ □ Yes □ No (Other than parent) Name Relationship Phone
Emergency Contact_______________________________________________________________________ □ Yes □ No (Other than parent) Name Relationship Phone
Emergency Contact_______________________________________________________________________ □ Yes □ No (Other than parent) Name Relationship Phone
If someone does not have your permission to pick up your child, please list name and relationship. _________________________________________________________________________________________________
Other children in the family (please note if the sibling is a stepsibling) Name__________________________________ School_______________________________________ Grade ____ Name__________________________________ School_______________________________________ Grade ____ Name__________________________________ School_______________________________________ Grade ____ Give pertinent health or medical information and instructions (including any medicines prescribed and any physical restrictions) __________________________________________________________________________________________________________________________________________________________________________________________________Permission to obtain medical attention □ Yes □ No Medical Provider ___________________________________________________________________________________ Name Address Phone
Dentist ___________________________________________________________________________________________ Name Address Phone
Please indicate the student’s previous academic placement (if applicable) □ Private School _______________________________ ___________________________________________________ Name Street Address, City, State, Zip
□ Charter School _______________________________ __________________________________________________ Name Street Address, City, State, Zip
□ Public School ________________________________ __________________________________________________ Name Street Address, City, State, Zip
□ Group Home/Institution _______________________ __________________________________________________ Name Street Address, City, State, Zip
□ Home School
Date last attended previous placement ____________ Grade___ Homeroom teacher __________________________ Month/Year
Has the student ever been enrolled in Union County Public Schools? □ Yes □ No If yes, School Name ________________________________________________________ School Year ______________ Is the student identified as a student with special needs and being served with a(n): Individualized Education Program (IEP) □ Yes □ No If yes, has a copy of the plan been provided? □ Yes □ No Section 504 Plan □ Yes □ No If yes, has a copy of the plan been provided? □ Yes □ No Academically Gifted (AIG or TD) □ Yes □ No If yes, has a copy of the plan been provided? □ Yes □ No Has the child ever been retained? □ Yes □ No If yes, what grade? _______________ Has the student ever left any school due to a Suspension or Expulsion? □ Yes □ No If yes, explain: _________________ _________________________________________________________________________________________________
Transportation Morning-student will arrive by □ Bus □ Car□ Walk Afternoon-student will leave by □ Bus □ Car□ Walk
Military Information Does your child have any member of their immediate family serving in the US Armed Forces? □ Yes □ No If yes, ____________________________________________________________________________________________ Name Relationship Branch of military service ______________________________________________________________________________________________________ Name Relationship Branch of military service
Parent/Legal Guardian___________________________________________________ ________________ Signature Date
400 North Church Street Monroe, NC 28112 Phone 704.296.9898 Fax 704.289.9182 www.ucps.k12.nc.us
Andrew G. Houlihan, Ed.D. – Superintendent
Board of Education Melissa Merrell - Chairman
Gary Sides - Vice Chairman Leslie Boyd
Kathy Heintel Christina Helms
Matt Helms Joseph Morreale
Dennis Rape Candice Sturdivant
PROOF OF RESIDENCE
Student Name:_______________________________________________ Grade:_____________________
Parent / Guardian Names: _________________________________________________________________
Home Address: _________________________________________________________________________
Subdivision Name: ______________________________________________________________________
Home Phone: ________________________________ Cell Phone: ________________________________
PLEASE ATTACH TWO (2) PROOFS OF RESIDENCE FOR THE ABOVE ADDRESS FROM THE
LIST BELOW:
List of acceptable documents include:
Notarized rental/ purchase agreement for a house with your name and address on it
Recent Utility bills (electric, phone, gas, power, cable, etc) If two utility bills are submitted, they
will count as our 2 proofs of residence
Current Driver’s License and automobile registration (as long as the address is the same) These
documents together are considered ONE proof
Current Car insurance and property insurance policies (as long as the address is the same) These
documents together are considered ONE proof
Recent Income tax W-2 form and property tax bill These documents together are considered
ONE proof
Note: While attending Indian Trail Elementary School the student and a parent MUST reside at the address
listed above and on the proof of residence documents.
I have read and understand the above attendance area policy. The documents I am submitting as proof of the
student’s residence are true and accurate.
Parent/Guardian Signature Date
If you reside in a home other than your own and the homeowner resides with you, then you will need to complete the
CERTIFICATION OF RESIDENCE form. The homeowner is responsible for signing this document in front of a notary and
providing proof of residency to Indian Trail Elementary School.
HOME LANGUAGE SURVEY
INDIAN TRAIL ELEMENTARY SCHOOL
Student Name_________________________________________________________________________
Date____________________ DOB ___________________ Grade _____________________
Address _____________________________________________________________________________
Phone Number Home ______________________________________ Cell/Work _________________
Parent/Guardian Name __________________________________________________________________
Parent or Guardian’s Native Language_______________________________________
Has the student ever attended a U.S. school? Yes ______________ No ______________
If yes – Date of Entry ____________________
What is the student’s country of origin and ethnicity? __________________________ / _____________
Origin Ethnicity
Do you need free translation services to understand school records and/or free interpretation services at conferences in
your native language? Yes ___No____
1. Is the student’s first learned or home language anything
other than English? Yes ________ (Please continue survey)
No ________ (Stop here & sign below)
2. Which language did your student learn when he/she
first began to talk? ______________________________
3. What language does your student speak most often? ______________________________
4. What language is most often spoken in your home? ______________________________
5. Other than languages studied in school, what language(s) does
your student speak? ______________________________
** If the answer to questions 2 – 5 is a language other than English, the student will be assessed with the State
designated English language proficiency test to ensure appropriate placement and English
language assistance if needed.**
_______________________________________________ ______________________________
Parent/Guardian Signature Date
Phone 704-289-5460 Fax 704-296-3107
Indian Trail Elementary School
Candice Boatright, Principal 200 Education Road
Indian Trail, NC 28079 Phone 704.296.3095
Fax 704.821.7712 http://ites.ucps.k12.nc.us
Confidential Information for the Principal / Teacher
Child’s Name________________________________________Grade:___________ Date of Birth:_________________
Parent / Guardian Name:_______________________________________________________ Date:________________
The information provided below will assist in the class assignment process. This process is the responsibility of the
school principal. While requests for specific teachers cannot be honored, the input you provide will be considered
carefully in assigning your child to a class.
1. Academic Characteristics of your child: (Describe academic strengths and/or areas of need. If enrolling a
child for kindergarten, please list any pre-school experience.)
2. Describe the learning environment and teacher characteristics that suit your child’s learning needs /
personality:
3. Social Concerns: (Are there other children / relatives from whom your child may need to be separated in a
class? Do you have concerns about you child in group situations?)
4. Physical Concerns: (emergency medical information, allergies, significant medical history, etc.)
5. Other information you wish to share with the principal/teacher. (use back of form if necessary)
ELEMENTARY SCHOOL ATTENDANCE
The Public School Laws of North Carolina require compulsory attendance for all children between the ages of seven and 16 years.
Every parent* or person having control of a child between these ages enrolled in the Union County Public Schools is responsible to
make sure the child attends school continuously during the time school is in session.
Class attendance, as well as reporting to school on time, is essential to high student achievement. With this is mind, all students are
expected to be in attendance each day school is in session, for the entire school day. Furthermore, it is expected that students
report to school on time and not be signed out early unless extenuating circumstances exist. FOLLOWING ANY ABSENCE(S) OR
TARDY(IES), A STUDENT IS REQUIRED TO PRESENT WRITTEN DOCUMENTATION FROM THE PARENT/GUARDIAN/CUSTODIAN
STATING THE REASON FOR THE ABSENCE OR TARDY. Written documentation must be presented within three school days after the
student returns to school; otherwise, the absence(s) or tardy(ies) will be recorded as unexcused. Upon review of documentation, the
absence or tardy will be coded lawful or unlawful based on the criteria set forth below:
CODE 1-LAWFUL -- See listing below
The following are lawful reasons for school absences:
1. Illness or Injury
2. Death in the Immediate Family
3. Medical or Dental Appointments
4. Court or Administrative Proceedings
5. Religious Observances – a minimum of two days each academic year for observance of an event required or suggested by the
religion of the student or the student’s parent(s) with written prior approval from the principal.
6. Educational Opportunity with prior approval by Principal
7. Quarantine
8. Military Deployment – for students attending ceremonies related to military deployment of family members
CODE 2-UNLAWFUL -- All absences that are not classified as lawful.
CODE 3—OUT-OF-SCHOOL SUSPENSION (OSS) Absences include those that are lawful, unlawful, and due to suspension. Students
will not be counted absent from school when participating in school sponsored functions.
CONSEQUENCES FOR EXCESSIVE ABSENCES When a student has accumulated three unexcused absences, the principal or designee
shall notify the parent/guardian/custodian of the absences. When a student has accumulated six absences for any reason, the
principal/designee shall notify the parent/guardian/custodian by mail that the student has accumulated this number of absences,
and that the parent/guardian/custodian may need to consult with school personnel pertaining to attendance and possible future
consequences. School personnel will be available to assist the student and family in solving any attendance problems. When a
student has accumulated ten absences for any reason, the principal/designee shall have a conference with the student and his/her
parent/ guardian/custodian to discuss the accumulated absences and to develop a plan relative to school attendance for the
remainder of the school year. When a student accumulates three, six, and/or ten unlawful absences in a school year, the
principal/designee will follow the procedures required by law. These procedures include the above referenced notification
provisions, referral to school personnel to address the underlying causes of the attendance issues and if, after ten unexcused
absences, the principal determines that there has not been a good faith effort on the part of the student and/or
parent/guardian/custodian to comply with the attendance requirements, a notification to both the district attorney and department
of social services shall be made. Students in grades K-5 who are absent 20 days, (lawful, unlawful, or OSS) can be retained.
TARDIES All tardies/early leave will be addressed on a school-by-school basis. Attendance in school for all classes the full time
allotted for classes is essential for student success. However, at the 10th unexcused tardy or early leave, the student will be referred
to the school attendance counselor for discussion with parents. At the 15th unexcused tardy or early leave, the student and his/her
parents will be required to meet with the school principal to determine a plan that allows the student to be on time and in school all
day. A student who has been tardy/early leave 20 times (unexcused) may be referred to Truancy Court.
I HAVE READ AND UNDERSTAND THE ELEMENTARY SCHOOL ATTENDANCE POLICY
Parent / Guardian Signature Date
Transportation Department
201 Venus Street Monroe, NC 28112
Phone 704.296.3015 Fax 704.226.1895 www.ucps.k12.nc.us
Transportation Department
BUS RIDER INFORMATION FORM
School Year: _____________ Date: _____________ Indian Trail Elementary School Grade: _________
Student Name: ___________________________________ Power School #: __________________
Residence Street Address: ____________________________________________________________
(NO PO BOX #’S) ____________________________________________________________
Parent (Guardian) Names ____________________________________________________________
Home Phone Number_______________________ Mobile Phone Number_______________________
Transportation Needs: AM only PM only Both
Daily Bus Rider _____ Occasional Bus Rider ____ (Student MUST ride at least once a week or will be dropped from bus roster)
Please record the address in which the student will be picked up and dropped off IF DIFFERENT from the
residence street address. Three to five (3-5) business days are needed for processing unless an existing stop is
available. Each school should review Everyinfo software for transportation start date.
Address for Morning Stop: ___________________________
Address for Afternoon Stop: _______________________________________________________________
Please check all that apply:
______ Student has special transportation as a related service on an IEP.
______ Student is on a modified schedule FROM ____________________TO _______________________
______ Student is transitioning FROM _______________________TO____________________________
(school) (school)
Modified Transportation Schedules: This form must be faxed to the EC Office for the EC Director’s signature only when a student is not following
the regular school transportation schedule.
EC Director Signature: _______________________________________ Date: _________________
Please check all that apply (attach documentation where appropriate):
___Medical condition, if so what condition____________________________________________________
___Hearing Limitation ___ Vision Limitation ___ Communication Concerns
___Medication, if so what_________________________________________________________________
___BIP ___IHP ___ Allergies, if so, to what? ______________________________
Action needed, if any _____________________________________________________________________
Is the child on medication? ____ Yes ____ No;
If yes, will administration be required during transport? _____ (Attach doctor’s order);
Does child have self-administration/carry approval? _____ (Attach copy);
Will medication be transferred between adults?______
If yes, identify what medications will either be carried by student or transferred by adults:
________________________________________________________________________________
Union County Public Schools North Carolina Immunization Law Information
Every parent, guardian and person or agency, whether governmental or private, with legal custody of a child shall have the
responsibility to ensure that the child has received the required immunizations at the age required by law. It shall be the responsibility
of the parent to provide a complete immunization record of each school age child to the school not later than 30 calendar days after the
child enters school or the child will be suspended from school until such time as a valid complete immunization record can be
provided to the school. Please review your child’s record to assure that it meets N.C. Immunization Law requirements.
General Statute 130-A-152 through 130-A 157 states in part that each child’s immunization record must have the dates of each
immunization and the specific immunizations. The following is a description of the requirements:
4 DPT last dose on or after 4th birthday
3 Polio last dose on or after 4th birthday
2 Measles first dose after 1st birthday
1 Mumps
1 Rubella
5 DPT last dose on or after 4th birthday
4 Polio 3 doses if last dose on or after 4th birthday
3 Hib at least 1 Hib on or after 1st birthday and before 5 years of age
2 MMR 1st dose on or after 1st birthday
5 DPT last dose on or after 4th birthday
4 Polio 3 doses if last dose on or after 4th birthday
3 Hib at least 1 Hib on or after 1st birthday and before 5 years of age
2 MMR 1st dose on or after 1st birthday
3 Hepatitis B last dose not before 6 months of age
2 Varicella before school entry
Additional requirements:
1 Tdap before entry into 7th grade (this booster dose is required if no Tetanus
vaccine given within the last 5 years)
1 Menigiococcal before entry into 7th grade
Any medical exemption must be in writing from a physician and must state the basis for the exemption pursuant to G.S. 130-A-156.
North Carolina Health Assessment Law G.S. 130-A-440 states that every child in the State entering kindergarten in public schools shall receive a health assessment. The
health assessment shall be made no more than 12 months prior to the day of school entry. The parent, guardian, or responsible person
shall have 30 calendar days from the first day of school to present the required health assessment form for the child.
Please feel free to call the School Health Office @ 704-296-0845 to speak with a school nurse if you have questions about the North
Carolina Immunization Law or Health Assessment Law.
I am aware that my child’s complete immunization record is due at my child’s school within 30 calendar days of today’s date or
he/she will not be allowed to continue in school until such time as a valid immunization record can be provided to the school. I realize
that this responsibility is that of the parent/guardian not that of the former school. A health assessment form is required for my child if
he/she is entering Kindergarten for the first time.
____________________________________________________________________________________________
Student Name Date of Birth Enrollment Date
_____________________________________________________________________________________________ Parent/Guardian Signature Date
THIS WILL BE THE ONLY NOTIFICATION OF HEALTH REQUIREMENTS
If a child enrolled in first grade for the first time after 7/1/87 but before 7/1/94
If a child enrolled in kindergarten or 1st grade for the first time after 7/1/94, but before7/1/99:
If child enrolled in kindergarten for the first time after 7/1/15
After School Program
400 North Church Street
Monroe, NC 28112 Phone 704.290.1516 FAX 704.289.1539 www.ucps.k12.nc.us
Andrew G. Houlihan, Ed.D. – Superintendent
Board of Education
Melissa Merrell - Chairman Gary Sides - Vice Chairman
Leslie Boyd Kathy Heintel
Christina Helms Matt Helms
Joseph Morreale Dennis Rape
Candice Sturdivant
January 2017
Dear Parents:
The After School Program provides purposeful activities in a caring atmosphere for children in grades K-5 enrolled in the
Union County Public School system. The program consists of supervised enrichment and recreational activities suitable to
appropriate age groups.
Plans are to continue After School Programs at 27 elementary school locations for next school year. The program is self-
supporting; therefore, we will continue to have programs at schools that have and maintain sufficient interest. We must have a
minimum of 20 students enrolled at each site in order to continue the program.
There is an annual $25 registration fee per each family enrolled in the program. Currently, the cost is $55.00 per week for the
first child enrolled in a family and $50.00 per week for any additional children in the same family. The weekly fee includes all
materials and a daily snack. We are anticipating a possible $5.00 increase in the weekly tuition for the upcoming school year.
Parents will be notified of weekly tuition rates prior to the beginning of the school year. Tuition is paid in advance on Friday
for the following week. The full weekly fee is to be paid for each day the program is in operation regardless of a child’s attendance, holidays during the week, or child’s start date. Once your child is enrolled into the program you will receive a
payment schedule indicating amounts and due dates. Prior to school starting in the fall, you will be invited to attend After
School Open House. At that time you will receive additional information regarding our policies and procedures.
Our daily activity schedule includes homework time, free play, teacher directed activities, student choice time and snack time.
The After School Program operates from the closing of school until 6:00 p.m. each day school is in operation and on teacher
workdays, if there is sufficient interest. We also offer Summer Camp at selected elementary school locations during the summer
months. Please see the After School Program Coordinator at your school for information on this program.
To add your child’s name to the Contact List for After School please follow these steps:
1. Visit the Union County Public Schools Webpage Departments After School Program Online Enrollment/
Wait List Click on the link provided;
2. Select New Family Registration, Fill out Information, and Submit. (If you are a UCPS employee please add that
information in the comments section.)
Once you have added your name to the contact list the After School Program Coordinator from your school will contact you
with further instructions about registering. We look forward to working with you!
Sincerely,
Suzanne Thompson
After School Program Director SFT 1/13/17
Afterschool Options
Please call for availability and rates
Siskey YMCA- 704-716-4222
Corey Family Martial Arts- 704-620-2072
Ms. Dee Dee’s – 704-882-9386
Creative Care- 704-635-7829
Christ Our Shepherd- 704-845-7673
Primrose- 704-821-9300
June Bugs- 704-882-1465
ROAR- 704-282-1400
Tutor Time- 704-847-3223
Child Time- 704-234-2763
Children’s Lighthouse-704-882-1100
Gateway Academy- 704-847-0046
Miss Donna’s Bright Beginnings- 704-684-0038
Kid’s R Kid’s – 704-821-2005