Get Title Vii Summer Enrichment Program Form

Title VII Indian Education Summer Enrichment Program When June 16 2008 July 11 2008 Where Denali Elementary School 952 Cordova Time 12 30 PM 5 00 PM Bus Transportation will be provided at select schools listed on the Summer Enrichment application. Come learn something new and exciting this summer Physical Education Yup ik Drums Alaska Native Masks Tlingit Button Blankets Native Languages Yupik Tlingit Dena ina Writing Mathematics To obtain more information and an application call ASD Education Center 5530 E. Northern Lights Blvd. Anchorage AK 99504 Phone 907-742-4445 Fax 907-742-4585 Website http //www. asdk12. org/depts/IndEd/index. asp Student Application 2008 Eligibility grades 1st 8th Commitment to attend each day Student Name Date of Birth Grade going into Ethnicity School Parent s Guardian Name s Cell Phone Home Phone Work Phone Street Address State Zip E-mail Address Emergency Contact Name Emergency Cell Emergency Phone Number Does your child have IEP with special education 504 plan or health accommodations Yes No The student must be on time for session and must be picked up promptly after each session* I intend to transport my child to and from Denali Elementary. I would like to use one of the transportation sites to drop off my child and pick him/her up* Spring HIll TBA Chinook TBA Begich TBA Mt. View Boys Girls Club TBA Willow Crest TBA I/We give permission for to participate in Enrichment activities at Denali Elementary. I/We understand that transportation is provided by the parent/guardian* Title VII Indian Education Program staff will provide proper supervision* It is agreed that my child will abide by all rules and regulations of the Anchorage School District and follow all safety guidelines while handling and using tools to complete activities. I/ We understand that if my student for any reason fails to abide by all rules and regulations disciplinary steps will be taken which may include dismissal* Parent Signature Date Application Due May 9 2008 5 00 PM Phone 742-4445 Fax 742-4585 E-mail GouldNancy asdk12. Anchorage AK 99504 Phone 907-742-4445 Fax 907-742-4585 Website http //www. asdk12. org/depts/IndEd/index. asp Student Application 2008 Eligibility grades 1st 8th Commitment to attend each day Student Name Date of Birth Grade going into Ethnicity School Parent s Guardian Name s Cell Phone Home Phone Work Phone Street Address State Zip E-mail Address Emergency Contact Name Emergency Cell Emergency Phone Number Does your child have IEP with special education 504 plan or health accommodations Yes No The student must be on time for session and must be picked up promptly after each session* I intend to transport my child to and from Denali Elementary. asp Student Application 2008 Eligibility grades 1st 8th Commitment to attend each day Student Name Date of Birth Grade going into Ethnicity School Parent s Guardian Name s Cell Phone Home Phone Work Phone Street Address State Zip E-mail Address Emergency Contact Name Emergency Cell Emergency Phone Number Does your child have IEP with special education 504 plan or health accommodations Yes No The student must be on time for session and must be picked up promptly after each session* I intend to transport my child to and from Denali Elementary. I would like to use one of the transportation sites to drop off my child and pick him/her up* Spring HIll TBA Chinook TBA Begich TBA Mt.