Independent School District #911 Cambridge-Isanti Schools DISTRICT ADMINISTRATION Dr. Ray Queener Superintendent Greg Winter Director of Teaching & Learning

Dear Parents/Guardians, Enclosed you will find your child’s kindergarten enrollment paperwork for the 2016-17 school year. Complete and return it to the school that your child will be attending by February 12, 2016. This information is needed to determine program and classroom sizes. Below are the most frequently asked questions…

Kris Crocker Director of Finance & Operations

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Julia Lines Director of Administrative Services & Human Resources

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Dave Maurer Director of Community Education

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Shawna Carpentier Communications Coordinator

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Ray Sperl Technology Coordinator

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Pauline Bangma Director of Rum River Special Education Coop

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I cannot find the birth certificate. Can my child still enroll? Yes, your child may still enroll but we will need a copy of the birth certificate by Kindergarten Round Up in the spring. Turn in the enrollment paperwork to your child’s school ASAP. Can I enroll my child even if they have not had their early childhood screening? Yes, your child should still enroll but call the district’s Early Childhood Program to set up your state mandated, free screening at 763-691-6693. My child was screened in another district. What do I do? Contact the district they were screened in and have them fax or mail your child’s screening to the school your child will be attending. Can my child attend kindergarten every other day? No. Since legislature passed the 2013 Education Finance Bill, C-I district 911 is pleased to provide All Day/Every Day kindergarten to all of our kindergarten students for no additional fee. My child has not had their 5 year old shots. Should I still turn in the enrollment papers? Yes, enrollment paperwork should be turned in by Feb., along with any immunizations that your child has had so far. Additional immunizations can be turned in to the school as they are completed. My child will be waiting another year before going to kindergarten or will not be attending in District 911. Do I need to do anything? Yes, please contact us and we will update your information so that you are taken off of the mailing list and don’t get reminder calls in the spring. When is Kindergarten Round Up? Plan on attending with your child. o Isanti Primary School: Thursday, April 28th from 5:30-7:00pm. o School For All Seasons: Tuesday, May 3rd from 5:30-7:00pm. o Cambridge Primary School: Thursday, May 5th from 5:30-7:00pm. We have also included some additional information that you might find helpful regarding Kindergarten on the back of this letter.

If you have further questions, please contact your child’s school. Cambridge Primary School

Isanti Primary School

310 N Elm St Cambridge, MN 55008

301 Heritage Blvd NW Isanti, MN 55040

Phone: 763-691-6500 Fax: 763-691-6599

Phone: 763-691-8778 Fax: 763-691-8700

625A Main Street North, Cambridge, MN 55008 Phone 763-689-6188 Fax 763-689-6200 www.cambridge.k12.mn.us

School For All Seasons 101 9th Ave NE Isanti, MN 55040

Phone: 763-552-8800 Fax: 763-552-8899

CAMBRIDGE PRIMARY SCHOOL (P) 763-691-6500 (F) 763-691-6599

KINDERGARTEN 2016-2017

ISANTI PRIMARY SCHOOL (P) 763-691-8778 (F) 763-691-8700

SCHOOL FOR ALL SEASONS (P) 763-552-8800 (F) 763-552-8899

STUDENT INFORMATION (Please print) Legal Last Name

First Name

Birthdate: (Month/Day/Year)

/

/

Middle Name

Gender (circle one)

M

F

School (circle one)

CPS

IPS

SFAS

Spanish Immersion

BIRTH DOCUMENTATION  Copy of Birth Certificate Cambridge-Isanti Schools requires all students have a copy on file EARLY CHILDHOOD SCREENING Did your child complete state mandated Early Childhood Screening?  Yes  No If yes, which school district or city? _______________________________________________________ If your child completed screening outside of Dist. 911, you must provide a copy of the screening or fax it to the school If NO your child is REQUIRED to be screened or have a confirmed appointment PRIOR TO ENTERING KINDERGARTEN Call (763) 691-6690 to set up a free appointment ACADEMIC / SOCIAL Did your child receive Spec Ed services (IEP)?  Yes  No If yes, where? ______________________________ Did your child attend preschool?  Yes  No If yes, where? ________________________________________ Did your child attend a daycare?  Yes  No If yes, where? ________________________________________ Additional academic/social information that would benefit the teacher:

MINNESOTA IMMUNIZATION LAW IMMUNIZATIONS REQUIRED BEFORE STARTING KINDERGARTEN VACCINATION

DOSE REQUIRED

Dtap/Td/Tdap (diphtheria, tetanus, pertussis)

5

Polio

4

Hep B (hepatitis B)

3

MMR (measles, mumps, rubella)

2

Varicella (chicken pox)

2

Date

Date

Date

Date

Date

CONSCIENTIOUS EXPEMPTION Conscientious or medical exemption forms may be obtained from the school health office and must be notarized before school starts ENROLLMENT AUTHORIZATION I certify the above information to be true and recognize that falsification or omission could result in modification of the school or program placement.

Legal Parent/Guardian Signature ___________________________________________ Date ________________________ 1.29.16

CAMBRIDGE-ISANTI SCHOOLS STUDENT ENROLLMENT FORM TO BE COMPLETED BY LEGAL PARENT/GUARDIAN

www.c-ischools.org Office Use Only: Student ID

Today’s Date

Enrollment Date

Pin #

Teacher

Advisor

State ID

SCHOOL  Resident of ISD #911  Non-Resident (paperwork required) Non-Resident District and # ______________________ ______________________

 Cambridge Preschool  Cambridge Primary (K-2)  Cambridge Intermediate (3-5)  Cambridge Middle School (6-8)  Cambridge-Isanti High School (9-12)

 Isanti Preschool  Isanti Primary (K-2)  Isanti Intermediate (3-5)  Isanti Middle (6-8)

 School For All Seasons (K-5)  Minnesota Center (6-8)  Spanish Immersion (K)  ALC

STUDENT Last Name (Legal Name)

First Name

Middle Name

Does more than one family live at this dwelling?  Yes  No

Gender Birthdate (mm/dd/yyyy)  Male  Female Home Address (Student Resides Here)

Unit #

City/State/Zip Code

Mailing Address (If different)

Unit #

City/State/Zip Code

Home Phone

Grade

Effective date of move (if applicable)

Primary Phone

Student lives with:  Father  Mother  Step-Father  Step-Mother  Guardian  None  Other

Race/Ethnic Race/Ethnic data is used for the purpose of compliance with federal and state civil rights laws and statistical reports. Background: Hispanic/Latino (select only one) State Ethnicity (select only one) Federal Race (select one or more)  Hispanic  Non-Hispanic

    

    

American Indian/Alaskan Asian/Pacific Islander Hispanic Black, not Hispanic White, not Hispanic

American Indian/Alaskan Asian/Pacific Islander Hispanic Black, not Hispanic White, not Hispanic

GENERAL INFORMATION Does this student have any American Indian lineage?  Yes  No What is the student’s country of birth?  U.S.  Other: _______________________________________ If not in the U.S. when did the student enter the U.S.? _________________________________________ (mm/dd/yyyy) At what grade level? Check One:  K  1  2  3  4  5  6  7  8  9  10  11  12 Has this student ever attended Cambridge-Isanti Schools?  Yes  No If yes, Year _________ School/s __________________________ Has this student ever attended any other Minnesota public school?  Yes  No If yes, Year _______ School/s ______________________ Student’s previous schools attended ___________________________________________________________________________________ ** Please list most recent school attended first.

School Name

District#

Address

City/State/Zip

Phone#

___________________________________________________________________________________ School Name

District#

Address

City/State/Zip

Phone#

If Kindergarten, has this student had Early Childhood Screening?  Yes  No If yes, District ____________________________________ Student Enrollment Form Rev. 2/1/16

Page 1 of 4

STUDENT Last Name (Legal Name)

First Name

Middle Name

Grade

Custody Documents Is there an Order for Protection?  Yes  No Has the order been provided to the school?  Yes  No

If so, date of expiration (mm/dd/yyyy) ________________________________

Residency Information: Have you recently moved to the school district in the last 36 months for temporary or seasonal agricultural or fishing work?  Yes  No Is your current address a temporary living arrangement?  Yes  No If yes, please continue. Is this temporary living arrangement due to loss of housing or economic hardship?  Yes  No Do you and your student lack a fixed, regular, adequate nighttime residence?  Yes  No

Home Language Questionnaire: Which language did the student learn first?  English  Other:________________________________________ Which language(s) is/are most often spoken in your home?  English  Other:________________________________________ Which language does the student usually speak?  English  Other:________________________________________ Which language did the Mother speak first? _______________________________________________________________________________ Which language did the Father speak first? _______________________________________________________________________________ Is an interpreter required to communicate with anyone in your family?  Yes  No If yes, Language: _______________________________ Family members: ____________________________________________________________________________________________________ Are there any other language accommodations requested at this time?  Yes  No If yes, please specify: _________________________________________________________________________________________________

Additional Enrollment/Placement Information: Please answer all the questions. I certify that the student: Check one: Has never been enrolled in a special education program (has never been on an IEP)  Was previously enrolled in a special program and is no longer enrolled  Is currently enrolled in a special program (has current IEP)  The student has participated in the following special program(s): Mark the appropriate box for each of the following: Summer School within the past year  Yes  No If yes, where? ________________________________ Gifted & Talented Education Program (G&T)  Yes  No English Language Development (ELD)  Yes  No 504 Plan  Yes  No Title 1  Yes  No Other  Yes  No Please specify ________________________________

Transportation: Will the student need transportation by Cambridge-Isanti Schools?

 Yes  No

Student Pictures/Internet Access: Parent/Guardian permission for student’s picture to appear on School District hosted websites. Parent/Guardian permission for student to access the internet on School District systems.

 Yes  No  Yes  No

Minnesota Statues and Rules require the school district to keep accurate records and updated personal records for pupils. This information will become a part of the student’s permanent cumulative record and will be available in accordance to District Policy #515 of Cambridge-Isanti Schools. Student Enrollment Form Rev. 2/1/16

Page 2 of 4

STUDENT Last Name (Legal Name)

First Name

Middle Name

Grade

PRIMARY LEGAL PARENT/GUARDIAN – Family #1 (Primary Residence) Last Name:

First Name:

Middle Name:

Gender

Birth Date

Relationship

M F Phone Type

Phone Number:

Extension:

Home: Cell: Work:

Legal Custody  Yes  No Last Name:

Select One:

 Primary

 Not Listed  Ok to Contact

 Primary

 Not Listed  Ok to Contact

 Primary

 Not Listed  Ok to Contact

Email: First Name:

Middle Name:

Gender

Birth Date

Relationship

M F Phone Type

Phone Number:

Extension:

Select One:

 Primary

 Not Listed  Ok to Contact

Cell:

 Primary

 Not Listed  Ok to Contact

Work:

 Primary

 Not Listed  Ok to Contact

Home:

Legal Custody  Yes  No

Email:

Mailing Address: (if different)

City/State/Zip Code:

LEGAL PARENT/GUARDIAN – Family #2 Last Name:

First Name:

Middle Name:

Gender

Birth Date

Relationship

M F Phone Type

Phone Number:

Extension:

Home: Cell: Work:

Legal Custody  Yes  No Last Name:

Select One:

 Primary

 Not Listed  Ok to Contact

 Primary

 Not Listed  Ok to Contact

 Primary

 Not Listed  Ok to Contact

Email: First Name:

Middle Name:

Gender

Birth Date

Relationship

M F Phone Type

Phone Number:

Extension:

Select One:

 Primary

 Not Listed  Ok to Contact

Cell:

 Primary

 Not Listed  Ok to Contact

Work:

 Primary

 Not Listed  Ok to Contact

Home:

Legal Custody  Yes  No

Email:

Address:

City/State/Zip Code:

LIST ALL OTHERS LIVING IN THE PRIMARY HOUSEHOLD Last, First, Middle Name

Relationship

Date of Birth

Gender

Lives at Home  Yes  No

School Attending/Grade

 Yes  No  Yes  No Student Enrollment Form Rev. 2/1/16

Page 3 of 4

STUDENT Last Name (Legal Name)

First Name

Middle Name

Grade

EMERGENCY INFORMATION EMERGENCY CONTACTS List local contacts that the student may be released to in the case of illness or other emergency if unable to notify parent. In case of a serious accident or illness at school, 911 will be called. The parent/guardian is responsible for all expenses. For younger children, list daycare as an emergency contact. CONTACT 1 Name

Relationship

Address: CONTACT 2 Name

Work Phone

Other Phone

Work Phone

Other Phone

Work Phone

Other Phone

City/State/Zip Code:

Relationship

Address: CONTACT 3 Name

Home Phone

Home Phone City/State/Zip Code:

Relationship

Address:

Home Phone City/State/Zip Code:

HEALTH Please list all health concerns, medications, allergies, and disabilities. Information on this form may be shared with appropriate school personnel to meet your child’s health and educational needs in school. Please list names of all medications (including at home or at school) that the student is taking.

Physician Clinic:

Health Condition:

Physician Clinic Phone:

Health Comment:

As the parent/guardian of the above named student, in case I am unable to be reached during any emergency, I hereby authorize a representative of the school to act as an agent to consent to the giving of any and all medical, dental, hospital or surgical care to the above named student.  Yes  No

 The student has had or is currently receiving support through County Services (Children’s Mental Health, Family Services, Probation)  I DO NOT give Cambridge-Isanti Schools permission to share this health information with school staff. Signature of legal parent/guardian is required. Print Parent/Guardian Name: __________________________________________________________ Date: ____________________________ Signature Parent/Guardian Name: ______________________________________________________ Date: ____________________________ Student Enrollment Form Rev. 2/1/16

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Cambridge-Isanti Schools All Kindergarten Options 2016-2017 Frequently Asked Questions

Kindergarten things you should know  There is no charge for any of the kindergarten programs.  All kindergarten students are eligible to ride the bus every day if they live outside the one mile walking distance from school.  All kindergarten students have the same licensed teacher every day.  All kindergarten students have lunch each day. Students may purchase a lunch or bring one from home.  All kindergarten students have the same number of school days per year.  All kindergarten students are welcome in any of the three program options.  All kindergarten students have media, music, physical education and art.  All kindergarten students receive similar high quality curriculum based on the standards.  All kindergarten students enjoy a safe environment.  All kindergarten students utilize technology during the school day.  All kindergarten students practice the five character traits of honesty, responsibility, respect, compassion, and self-discipline. What are your next steps as a parent?  Ask questions so that you have the information needed to make the decision that is right for your child and family.  When the registration application arrives at your home, fill it out and turn it into the appropriate school as soon as possible.  Attend the Kindergarten Open House with your child. 1. April 28 (IPS) 2. May 3 (SFAS) 3. May 5 (CPS)  Make sure your child has participated in Early Childhood Screening prior to starting kindergarten. (This is required by law) You can call 763-691-6693 to schedule an appointment.  Make sure your child has all their immunizations prior to starting kindergarten. (This is also required by law.)

If you have questions about Cambridge-Isanti Schools Kindergarten options that are not addressed in this document, please contact: Greg Winter, Director of Teaching and Learning at [email protected] Michelle Glasgow, K-5 Curriculum Coordinator at [email protected]

Cambridge-Isanti Schools Spanish Immersion Program Kindergarten 2016-2017 Frequently Asked Questions

The Cambridge-Isanti Schools Spanish Immersion Program is a partial immersion program. What does that mean? The students in this program will receive the majority of math and science instruction in Spanish and the majority of literacy and social studies instruction in English. Will the immersion teachers be native Spanish speakers? It will not be a requirement for the teachers to be native Spanish speakers. Teachers are required to have a teaching license at the kindergarten level and be proficient in Spanish. Who is eligible to enroll in the Spanish Immersion program? This program is open to kindergarten students only. Any kindergarten student is eligible to enroll. Is a background in Spanish needed? No. The program is designed for children of families who do not speak Spanish. Teachers will consider this when communicating with families. If I register my child for the C-I Schools Spanish Immersion program, is he/she guaranteed a spot? There is no guarantee of placement in the program. Placement will be based on enrollment and staffing. If new students enroll over the summer, will those students be able to enroll in the Spanish Immersion Program? Students can be added if there are still openings in a class. If my child is not a resident of Cambridge-Isanti Schools and I would like to enroll him/her in the program, what forms do I need to fill out? You need to fill out the Spanish Immersion Registration Form along with the Open Enrollment Form. Where will this program be housed? The program location/s is dependent on student enrollment across the district. What will happen if this program doesn’t work out for my child? If, during the school year, the family decides that the program may not be a good fit for the child, the family, teacher and principal will meet to discuss placement options. How will the district monitor the academic performance of immersion students? All students in the district will participate in the same standardized tests in English as nonImmersion students.

What will happen to the program after the 2016-2017 school year? We will add one grade level per year until the program is taught in grades K-5.  2017-2018-Grade 1  2018-2019-Grade 2  2019-2020-Grade 3  2020-2021-Grade 4  2021-2022-Grade 5 Is the Spanish Immersion program tuition based? No, there are no fees for any of three kindergarten programs in Cambridge-Isanti Schools. Is busing provided? All kindergarten students are eligible to ride the bus everyday if they live outside the one mile walking distance from school. Is school lunch provided? All kindergarten students eat lunch each day. Students may purchase a lunch or bring one from home.

If you have questions about the Cambridge-Isanti Schools Spanish Immersion Program that are not addressed in this document, please contact: Greg Winter, Director of Teaching and Learning at [email protected] Michelle Glasgow, K-5 Curriculum Coordinator at [email protected]