2015-2016 EPS Family Handbook

FAMILY HANDBOOK 2015-16 BACK TO SCHOOL INFORMATION AND RESOURCES

CONTENTS:

Welcome to the 2015-16 School Year!

Greetings Edina Public Schools families,

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The excitement of another new school year is contagious. We feel the energy throughout the district as we ready classrooms and buildings for a new year of learning. We know your homes are also buzzing with activity as students prepare to return to familiar faces and places, or perhaps a new school building and the prospect of making new friends. It is a time of anticipation for everyone.

Next Generation Family Resources Family Communications Food + Nutrition Health + Wellness Calendar Information Community Education Free Lunch Student Information Release Health Insurance Immunization Information

LOOK INSIDE!

At Edina Public Schools, we are excited to continue building on the previous three years of work of our Next Generation of SUPERINTENDENT'S Edina Public Schools Strategic Plan. Program studies made PERSPECTIVE great progress last year, some with pilot studies that provided information for future curriculum development. Others began the process of gathering stakeholder input and research. They all will point the way to engaging, personalized learning that will better prepare Edina students for career and life in a rapidly changing, culturally diverse, global society.

We reached a significant milestone last spring with the approval of the facilities bond referendum. Our work in this area has already begun and will continue throughout the school year with planning and design phases specific to each building. All planning teamwork and phase progress will be archived on our website at edinaschools.org/FacilitiesPlanning. Construction is slated to begin at some sites in Spring 2016. The Next Gen learning and activity spaces we create will complement the work of our program studies, with each aspect supporting the other as we continue to refine and advance our Edina Excellence.

The continued success of our Strategic Plan depends greatly on the partnerships we have developed throughout the local community and beyond. None is more important than our partnership with you, our school families. Your support of our work, our staff, our vision and most importantly, your children — our students — is a critical ingredient in the recipe for the Next Generation of Edina Public Schools.

We provide this handbook as a means to keep you informed and involved. In these pages are annual notifications as required by law, including information about key policies and expectations; district health, safety, food service and transportation program information; and more. Key dates are noted, along with updates on the progress of our Next Generation Plan, resources lists, and important forms.

All of this information will help us get the year off to a good start and, we hope, will continue to be a resource for you as we progress through the 2015-16 school year.

We’ll be ready and are excited to welcome you all back to school in a few weeks. We look forward to seeing our students and our parents, to meeting new families, and to another amazing school year.

Together, we will continue to make progress toward our All for All mission, ensuring an excellent Edina education for all learners.

Warmest regards,

Check inside for a pullout of the 2015-16 calendar.

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Ric Dressen, Superintendent superintendent@edinaschools.org

GET READY!

SCHOOL STARTS AUG. 31/SEPT. 1

BACK TO SCHOOL DATES: Please check with your school for detailed back-to-school information and additional August events.

Tuesday, Aug. 18 Elementary teacher assignments and bus route information posted to SchoolView at 8 a.m.

DISTRICT MISSION - All for All The mission of Edina Public Schools, working in partnership with the family and the community, is to educate all individuals to be responsible, lifelong learners who possess the skills, knowledge, creativity, sense of self-worth, and ethical values necessary to thrive in a rapidly changing, culturally diverse, global society.

CORE

VALUES

WE CARE

Compassion in helping others with what they need as a part of who we are.

Appreciation of Diversity by understanding, respecting and embracing all people.

WE SHARE Responsibility by being accountable for my work, interactions and relationships.

Commitment in keeping the promises we make to self and others.

NEXT GENERATION OF EPS VISON: Edina Public Schools will continue to be among the premier school districts both nationally and internationally.

Our high expectations in academics, arts, extracurricular activities and community involvement best prepare each learner to achieve success in college, career and life.

WE DARE

Integrity by doing the right thing at the right time even when no one is watching.

Courage by meeting challenges in the midst of easier ways out and doubt.

Wednesday, Aug. 12 Get Connected Day: South View, Valley View Wednesday, Aug. 19 Get Connected Day: Edina High School Wednesday, Aug. 26 6th grade WEB/Orientation Day at South View Thursday, Aug. 27 Open House: Concord, Countryside, Cornelia, Edina Family Center, ECSE, Edina High School, Highlands, Normandale 6th grade Orientation at Valley View Friday, Aug. 28 Open House: Creek Valley Monday, Aug. 31 First Day of School: Grades 1-12 Tuesday, Sept. 1 First Day of School: Kindergarten, Edina Family Center and ECSE

EPS FAMILY CHECKLIST o Be sure EPS has your current family contact information (update in SchoolView or contact your child’s school) o Attend your school’s Open House/Get Connected Day o

Check your child’s lunch account

o Confirm your child’s immunization information is up to date

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EDUCATIONAL COMPETENCIES As part of its strategic efforts over the past three years, Edina Public Schools has refined these core educational competencies, which embody the life skills that learners need for social, emotional, academic and professional success. They not only include required state or national academic standards, but also go further to represent a holistic view of the learner. They are intended to help guide a student along his/ her educational journey. Visit edinaschools.org/EdCompetencies for more information.

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STRATEGIC STUDY UPDATES Program studies are a key part of the implementation of the Next Generation Strategic Plan.

The Secondary, Birth to Grade 5 and Community Education Services program studies focus on aligning programs and services in ways that promote personalized learning for all students.

They explore innovative ways to achieve key learning outcomes desired, and align all other resources — time, space, talent and funds — to meet those expectations. Learn more at edinaschools.org/NextGen. Here is a brief update on program studies:

COMMUNITY EDUCATION SERVICES (CES) STUDY In its first year, the CES study completed an environmental scan of current programming and trends, and a program portfolio assessment. Current work involves the development of a three-year operational plan that builds on that work and moves CES programming into alignment as an integral part of the district’s educational program and strategic plan. The CES Vision 2018 is for seamless delivery of community education services that leverages resources through partnerships and facilities, and supports lifelong learning in a multi-generational, multi-cultural environment.

SECONDARY PROGRAMS STUDY

BIRTH TO GRADE 5 (BG5) STUDY

To advance the Secondary Study recommendations, which the school board approved in 2014, 20 pilot studies were conducted in secondary classrooms and programs during the 2014-15 school year.

Based on information from the pilot studies, this year some of the studies will be adopted as standard work, others will be “sunsetted,” and a few will enter a second year of pilot study status.

To prepare to make reccomendations to the school board this summer, a team of staff during the 2014-15 academic year researched best practices and implementation options for personalized learning across the early childhood through grade five experience. Aligned to the four core strategies of the study and pending board approval, BG5 pilot studies will be a source of action research and additional learning in the coming school year.

SECONDARY COUNSELING & ADVISING

GIFTED & TALENTED

MENTAL HEATH & WELLNESS

In the first of a two-year study, stakeholder feedback was gathered to assess current service delivery models and determine needs for Next Gen counseling and advising to meet the needs of all learners. Research focused on best practices based on the American School Counseling Association Developmental Guidance Model and innovative secondary advising options.

This learning will contribute to recommendations for 2016-17 implementation.

The Gifted Education design team gathered input from stakeholders through in-person meetings and online surveys. They identified the top 10 themes that emerged and conducted a literature review on gifted education. The team is working to identify key design elements for program recommendations, which will align with the Next Generation Strategic Plan. (This study applies to both Secondary and BG5 programs.)

Recommendations are expected this fall.

This study focused on identifying elements to provide a full continuum of mental health services in a tiered delivery model, developing universal screening tools, and an improved referral process. Pending board approval, site-based clinic models will be explored at secondary schools this year, and a Behavioral Health and Wellness Advisory will be established. (This study applies to both Secondary and BG5 programs.)

NEXT GEN FACILITIES PLAN UPDATE

eLEARNING2 UPDATE Edina Public School’s digital initiative, eLearning2, continues to evolve and transform learning.

With digital tools in hand, students find their learning more personalized and engaging, fulfilling the district’s technology philosophy statement: We believe technology is both a tool and a catalyst for excellence in education. Here is what’s new in eLearning2 for the 2015-16 school year: •

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Carts of Chromebooks will roll into all 4th grade classrooms, expanding the 1:1 availability of devices to another grade level of students. The emphasis will be on learning positive digital citizenship in a safe environment and becoming familiar with the digital devices as learning tools.

The expectation continues that all secondary students will bring a personal digital device to school daily. A digital device is defined as a laptop or tablet that has a keyboard and can run the Chrome browser. Students who do not have a device can check one out from their school by completing the loan agreement. In addition, sixth grade students will be eligible to purchase discounted devices through the district’s partnership with Best Buy. Middle school Smart Bar Clubs offer the opportunity for students to learn Chromebook repair while helping fellow students receive screen repair at a discounted rate.

Watch for new sessions of Parenting in the Digital Age, courses taught by district technology staff several times a year that cover a variety of internet and digital topics.

To read more about eLearning2, including information on upcoming classes for students and families, visit edinaschools.org/eLearning2 or email eLearning2@edinaschools.org.

With the approval of the Next Generation Facilities Bond Referendum on May 5, the district is poised to align learning spaces with the education strategies outlined in the strategic plan. Personalized and engaging learning experiences, and coherent and comprehensive educational programs, all require a physical environment that is different than the school facility models of the 1950s and ‘60s. The referendum will fund $124.9 million in renovations and additions to learning spaces throughout the district.

A five-phase planning process will lay the groundwork for the design process. The district will use a “participatory planning” approach, using Core Planning Teams (CPT) at each site as well as user group input sessions to ensure all stakeholder voices are represented.

Construction will be staggered throughout the district over the next two years in an effort to accommodate the size of the total project and construction projects that are part of the district Alternative Facilities/Deferred Maintenance Plan, which are not funded by the referendum.

A preliminary construction schedule is as follows: Spring 2016 - Fall 2017 | Edina High School Spring - Fall 2016 | Concord Elementary

Countryside Elementary

Highlands Elementary Summer - Fall 2016 | Early Childhood

District Offices (Moved to

3rd floor ECC) Spring - Fall 2017 | Cornelia Elementary

Creek Valley Elementary

Normandale Elementary

South View Middle School

Valley View Middle School TBD | Transportation Services Read more about the Next Gen Facilities Planning process and follow the progress of the CPTs at edinaschools.org/FacilitiesPlanning.

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FAMILY RESOURCES EDUCATIONAL PROGRAMS AND SERVICES Edina Public Schools (EPS) provides extensive educational programs and services to support and challenge its students. For details on specific programs, contact the Welcome Center, your school’s office, or visit www.edinaschools.org.

ADDITIONAL BACK TO SCHOOL INFORMATION Additional information will be shared with families focused on specific schools, programs and services, including individual school information.

Bus route information will be posted to SchoolView on August 18 at 8 a.m. Please check the district’s website for additional information. We also welcome your input as we continue to assess effective ways to connect with families. c

N E X T

G E N E R AT I O N

STUDENT ACTIVITIES Student activities are an integral part of the district’s total educational program. EPS sponsors a variety of activities, which are available to all students at each school site and through Edina Community Education.

To participate, middle and high school students must meet district eligibility requirements and, if applicable, Minnesota State High School League requirements. Participation fees may be assessed, with scholarships available for eligible students. For more information, contact the Activities Office at 952-848-3815.

CHEMICAL AND TOBACCO FREE SCHOOLS EPS property, school sites, and school-related activities are chemical and tobacco free.

MEDICAL, HEALTH AND ACCIDENT INSURANCE The district does not purchase medical, health or accident insurance for your child. If your child has an accident, becomes ill, or is injured while at school or participating in district-sponsored activities, families will need to access their own insurance plans to cover any associated costs (e.g. medical care, emergency transportation). The district cannot pay these associated costs. Questions about insurance can be directed to Margo Bauck, Director of Business Services at 952-848-4916 or margo.bauck@edinaschools.org.

BULLYING PREVENTION EPS is committed to ensuring a safe and civil learning environment for all students, families and staff. Bullying, like other violent or disruptive behavior, is conduct that interferes with students’ ability to learn and teachers’ ability to educate students in a safe environment.

In an effort to help curb incidents of bullying, the Minnesota Legislature and Gov. Mark Dayton passed a law in the spring of 2014 that requires additional training for school staff and volunteers in the prevention of bullying, as well as clarification and enhanced definitions of bullying. In response, the School Board and district administration revised the district’s policy on bullying prevention (District Policy 514) to align with requirements of the new state law, which include prohibiting any form of cyberbullying.

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EQUITY AT EDINA PUBLIC SCHOOLS All for All mission describes district’s commitment to equity Edina Public Schools is committed to looking at all district work and initiatives through a lens of racial equity and cultural competence so that all learners have the skills, opportunities and access to experiences that will help them reach their full potential and achieve success.

HEALTH PROMOTION AND CARE Good health is important to student learning and to active participation in HEALTH school. Health services are provided during the instructional day at each school site. Students enrolled in and admitted to Edina Public Schools are required to be in compliance with the Minnesota School Immunization Law. Some students may require prescription and non-prescription medication during the school day. In such cases, medication may only be administered by a licensed school nurse or trained school personnel. For more important health information, visit www.edinaschools.org.

EMPLOYEE BACKGROUND CHECKS EPS places a high priority on ensuring a safe and healthy learning environment for staff and students. This includes requiring that all applicants who have been offered school district positions complete a criminal background check as part of the process for determining employment.

The district also requires a criminal background check for all unsupervised volunteers. This process meets the requirements of Minnesota state statutes. Questions about employee background checks can be directed to Gwen Jackson, Director of Human Resources and Operations, at 952-848-4946 or gwen.jackson@edinaschools.org.

STUDENT RIGHTS & RESPONSIBILITIES HANDBOOK

A safe, secure and welcoming learning environment is essential to helping our students be successful learners. EPS has developed comprehensive policies and procedures that define student rights and responsibilities and ensure a positive learning environment. These expectations are outlined in the Student Rights and Responsibilities Handbook, which includes information regarding: • • • •

Attendance Technology Use Field Trips and Travel Grading and Reporting

• • • •

We partner with families and the community to gain a better understanding of and eliminate barriers rooted in racial constructs and cultural misunderstandings that can interfere with a student’s learning or reduce his/her willingness to persist academically. By applying this lens of racial equity and cultural understanding to all teaching and learning experiences, Edina Public Schools will be able to achieve its mission of educating all learners with the skills they need to thrive in a rapidly changing, culturally diverse, global society.

The district’s All for All plan, originally developed in 2013, advances strategic initiatives that focus on growth and achievement for each and every student, without predictable links to race or income.

The plan focuses on action strategies around five central “gap” areas – belief, leadership, preparation, teaching and learning, and time.

Each area includes specific strategies and actions that engage and incorporate diverse voices and perspectives, and approaches success through a lens of racial equity and cultural competence.

For more information, contact Mary Manderfeld, director of equity and enrollment, at mary.manderfeld@edinaschools.org or 952-848-4961.

Homework Student Discipline policy Bus Rider responsibilities And more

The full Student Rights and Responsibilities Handbook is available online at edinaschools.org/students. Families may also request a copy from their school office. Teachers will review with students the handbook at the beginning of the school year, and parents/guardians are asked to review the handbook with children at home.

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FAMILY COMMUNICATIONS SCHOOLVIEW ENHANCEMENTS

NEW ON SCHOOLVIEW Two enhancements to SchoolView, the parent portal, will make life easier for busy parents.

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Info Updates - Make changes to your family’s contact and health information directly via your SchoolView login. If your family moves, or if phone numbers or email addresses change, be sure to login and update your information so that important messages and information will continue to reach you. Likewise, you may submit new or changed information to your students’ health records. All of your information is stored securely in SchoolView

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FeePay - This one-stop location allows you to pay online for things such as school meals, field trips, activities, before and after school age childcare, school supplies, community education courses and more. Log into your SchoolView account and click on FeePay. View tutorials on both of these enhancements on the Parent Resources page of the district website at edinaschools.org/parents

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Edina Public Schools (EPS) places a high value on the connections we have within the school, the home and throughout the community.

We recognize that effective communications are critical to a strong partnership, and we are committed to providing a variety of ways families can communicate and engage with EPS in an effort to nurture and grow these important partnerships.

DIGITAL RESOURCES ONLINE ACCEPTABLE USE PROCEDURES Students can access a world of online resources from their classroom through the Internet. Parents/guardians must approve of their child(ren) accessing Internet resources, and students must agree to follow the district’s Acceptable Use Policy. Consent forms are required for families with students new to the district and for those with students entering grades 3, 6 and 10. The form is available online at edinaschools.org/parents.

ONLINE COMMUNICATIONS ACCESS Through the use of a variety of online technology tools, EPS is able to advance information sharing with families and students. The information shared online includes school communications, student educational progress reports and grades, and district emergency messages. Families who do not have online access should contact their respective schools to ensure they are able to receive this information via alternative means.

SCHOOLMESSENGER This electronic notification system is used by EPS to send direct messages via email or voicemail to all district families and staff. The system is used to communicate emergency information quickly, while also allowing staff to share important information about school and program issues, important reminders, and upcoming events. The SchoolMessenger system is integrated with the district’s student database system, so be sure your school has your most current contact information on file.

NEW this year — EPS will also be utilizing SchoolMessenger’s SMS (short message service) to sent alerts via text message to EPS families and staff. Be looking for more details soon on how to opt-in for SMS text alerts from EPS!

TOP FIVE WAYS TO STAY CONNECTED:

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WEBSITE

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SCHOOLVIEW

3

SCHOOL NEWSLETTER

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EPS IN THE KNOW

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SOCIAL MEDIA

Edinaschools.org is your one-stop shop for easy access to important district, school, activities, and community education information and resources. The website is updated regularly with current news and information, so check back often.

S ADDITIONAL EPS PUBLICATIONS EXPERIENCE EPS Experience EPS is the district’s printed newsletter, published quarterly and is mailed to all district families and residents of Edina Public Schools.

Experience EPS includes key district updates, student and staff spotlights, and current news. View past issues online at edinaschools.org/experience.

SCHOOL BOARD VIDEOS Videos from all regular meetings are posted online. Visit edinaschools.org/ schoolboard to learn more.

TRANSITION E-NEWSLETTERS EPS recognizes that during times of transition (i.e. entering kindergarten, middle school or high school) families are looking for additional information and guidance to help prepare their student for success at the next level. The district offers three e-newsletters - Countdown to Kindergarten, Movin’ On To Middle School and Next Step EHS - to help ease transition periods with information and resources.Visit edinaschools.org/transitions to learn more.

CALENDARS CALENDAR ACCESS Website calendars have the most current information about important dates in the district and events and happenings at your students’ schools.

20 21 Customize your online calendar to a color-coded view showing events for your children’s schools. Then download the information to your personal or mobile calendar so you can always be in the loop. Check Page 14 for a pullout district calendar. Also, pick up a hanging district wall calendar at your school (limited number available).

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LEARN MORE ON PAGE 14

WANT MORE? DISTRICT COMMUNICATIONS EPS uses a variety of tools to connect with families and provide periodic updates but understands that each family has their own communications needs. Families are encouraged to contact their teachers and/or school with questions, concerns, comments, etc. A full list of school and district contact information is listed on the back cover of this publication and is also available online at edinaschools.org/contactus.

This online tool allows families to access their students’ academic progress, keep current on school assignments, tests and other activities, and track student attendance. SchoolView connects families to a wealth of student information that enhances the school-home partnership and is accessible either online or via mobile app. To sign up for School View, visit edinaschools.org/parents.

All EPS schools send out regular communications to help keep families informed about school news and events. Check with your school for complete details.

Great stories are happening every day in EPS. For this reason, families automatically receive the EDINA In The Know e-newsletter, a weekly publication that provides a glimpse of what is happening in our schools, with links for extended articles and details for those who want to know more. To subscribe, visit edinaschools.org/know.

EPS is committed to communicating with and engaging families wherever they are. Like us on Facebook, follow us on Twitter, watch us on YouTube or view photos on Flickr! Stay tuned throughout the school year as we expand our social media efforts to further engage all stakeholders in the work of the district. Visit edinaschools.org/social to learn more.

LEARN MORE ON BACK COVER

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FOOD + NUTRITION Edina Public Schools (EPS) contracts with Chartwells to facilitate its food service program, which is part of the National School Nutrition Program offering food-based combo meals. Combo meals are required to meet specific nutritional guidelines established by the Federal Government. Several different entrees and sides are offered each day for lunch. Breakfast is available at school before the start of classes.

Menus are posted on the website and within school buildings.

ALL STUDENTS HAVE A LUNCH ACCOUNT. IF YOU DO NOT WANT YOUR STUDENT TO PURCHASE LUNCH, YOU MUST FILL OUT A MEAL RESTRICTION FORM TO CLOSE THEIR ACCOUNT. We will not deny a child a combo meal unless we have a restriction form online.

A lunch combo meal is comprised of five components: vegetable, fruit, protein, grain and milk. Students must choose three of these components, and one of the three must be a fruit or vegetable. They may choose up to five different components. If this combination of food is not selected by the student, we cannot charge it as a combo meal by federal government regulations. Each item will be charged separately at a la carte prices, and if more than five components are taken the additional items are charged a la carte prices. Parents may request restrictions for combo meal purchases only or they can limit spending to a specific dollar amount per day. Families interested in restricting their child’s meal account should complete a “meal account restriction form,” which can be found online at edinaschools.org/food.

PRICING INFORMATION ELEMENTARY: • Breakfast - $1.55 (free for kindergartners) • Milk - $0.60 • Lunch - $2.65 SECONDARY: • Breakfast - $1.65 • Milk – $0.60 • Lunch combo meal - $2.80 • Premium combo meal - $3.35 • A la carte items are also available FREE MEAL PROGRAM Families with limited incomes may qualify for their students to receive free lunches and breakfasts at school. All kindergarten students qualify for free breakfasts regardless of family income. To apply for free school meals, complete the application on page 18. A new application must be submitted each year. If you don’t qualify now, you may apply at any time during the school year. Additionally, your application helps the district qualify for education funds and discounts and is often used in awarding scholarships to students for participation in classes, activities and programs. Check out the free lunch Q&A on page 11.

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MEAL ACCOUNTS AND ONLINE PAYMENTS The district uses an individual meal accounting point of sale system. Each student has their own individual account. Accounts are debit accounts, and therefore, there must be money in the account in order for the student to use it. Deposits to student lunch accounts may be done in several ways: • • •

Online through FeePay, the district’s new one-stop student account system accessible through the SchoolView parent portal (See page 8 for more information) Online through PayPAMS.com By check: For a single account, give to cashier in cafeteria, drop off at school office, or mail to district food service office. Checks to be split among several accounts must have allocation amounts identified by student name and school and mailed to the food service office. Make checks payable to ISD #273 Nutrition Program; mail to Food & Nutrition Services, Edina High School, 6754 Valley View Road, Edina MN 55439.

If a student’s meal account holds a negative balance, they may either pay with cash or will be provided a bag lunch. You may sign up to receive low balance notifications via email on both the FeePay and PayPAMS online services. For additional questions about account balances or activity, contact the Food Service Office at 952-848-3811.

STUDENT ID AND PERSONAL IDENTIFICATION NUMBERS Elementary and middle school students receive a Personal Identification Number (PIN) at school to access their meal account. The same number is used throughout elementary school, with a new PIN provided to students in middle school. Meal account balances transfer from year to year through high school. High school students can also present their student ID to the cashier to access their account.

QUESTIONS If you have any questions or comments, please contact Chartwells Administrative Assistant Joanne Meyer at 952-848-3811 or joanne.meyer@edinadschools.org

FREE LUNCH QUESTION + ANSWER Who can get free school meals?

Children in households participating in the Supplemental Nutrition Assistance Program (SNAP), Minnesota Family Investment Program (MFIP) or Food Distribution Program on Indian Reservations (FDPIR), and foster children, can get free school meals without reporting household income.

Children also qualify for free school meals if their household income falls below the maximum income shown for their household size (see page 18).

FOOD FOR THOUGHT: STUDENT FAVORITE - APPLE YOGURT SALAD (Serves 6) There is nothing like apple season in Minnesota and fall apples are ready to go! What better way to enjoy a refreshing snack than to combine apples with some simple ingredients for a recipe kids love!

Ingredients: • 3 cups apples, chopped • 1/3 cup plain yogurt • 1 ½ Tbsp. Celery, minced • 2 ¾ Tbsp. Honey • 1 Tbsp. Orange Juice • 1/8 tsp. cinnamon

Do foster children qualify for free meals?

Yes, foster children who are the legal responsibility of a foster care agency or court are eligible for free meals regardless of household income. Please complete an application identifying the children who are in foster care.

I get support from WIC. Can my children get free meals? Children in households participating in WIC may be eligible for free meals. Please fill out an application.

May I apply if someone in my household is not a U.S. citizen? Yes. You or your child does not have to be a U.S. citizen to qualify for free meals.

Directions: 1. Make dressing by placing the yogurt, honey, cinnamon and orange juice in a mixing bowl. Mix well to combine. Chill in the fridge.

2. Wash the fresh apples and celery and dice. Combined the prepped apples and celery with the chilled dressing.

Serve immediately or store in fridge until ready to serve.

Who should I include as household members? Include yourself and all other people living in the household, related or not (e.g., grandparents, other relatives or friends).

What if my income is not always the same? List the amount that you normally get. If you normally get overtime, include it, but not if you get overtime only occasionally.

SCHOOL GARDENS In addition to providing many hands-on learning opportunities for students, gardens at five EPS schools instill an appreciation for the environment, good nutrition, and service to others. Produce from the gardens is sometimes used for food tastings in school lunchrooms and much of it is donated to the VEAP food shelf.

How will the information I provide be kept? Information you provide on the form, and your child’s approval for school meal benefits, will be protected as private data.

See the back page of the Application for Educational Benefits for more information about how the information you provide is used.

Will the information I give be verified?

Yes, and we may also ask you to provide written documentation.

If you have other questions or need help, please contact Dan Hutchinson at daniel.hutchinson@edinaschools.org or 952-848-3813.

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HEALTH + WELLNESS The mission of Edina Public Schools Health Services is to promote optimal health for optimal learning.

ILLNESS - Your child should not come to school if he/she has had: •

a fever of 100 degrees or more, the student should stay home for 24 hours after the temperature returns to normal without fever reducing medication such as ibuprofen or acetaminophen. has vomited or had diarrhea, the student should stay home until 24 hours after the last episode. has had any rash that may be disease-related or the cause is unknown, check with your health care provider before sending the student to school.

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Call the Absence Line at your child’s school when your child is absent due to illness. Please notify your school’s health office if your child has a condition that can be spread to others, such as strep throat, chickenpox or head lice.

When students become ill or are injured during the school day, parents/ guardians are contacted first. If a parent/guardian cannot be reached, a call is made to other individuals listed on the student’s emergency forms. Students will not be released unless accompanied by a responsible adult. It is expected that students will be picked up within one hour of the call to the parent/ guardian.

MEDICATIONS AT SCHOOL

Whenever possible, medications should be given during non-school hours.

When it is necessary for a student to receive medication during the school day, the student must bring the following for each medication: • Medication in the original container with directions; • Written permission from the parent/guardian; and • A written order from the physician for all medications including over the counter medications for pain relief.

All medications must be kept in the Health Office unless special arrangements (e.g. emergency epipens or inhalers) are made with the Licensed School Nurse (LSN). Please contact your school’s health office to obtain medication authorization forms.

CHILDREN WITH CHRONIC HEALTH CONDITIONS

Parents should consult with the LSN if they have a child with a diagnosed chronic health condition such as asthma, diabetes, seizures or severe allergies. The nurse, student and family work with the child’s health care provider to establish a health plan that will assist school staff in understanding and accommodating the student’s health needs.

IMMUNIZATIONS IMMUNIZATION REQUIREMENTS FOR NEWLY ENROLLED STUDENTS AND THOSE ENTERING KINDERGARTEN AND 7th GRADE In order to attend school in Minnesota, state law requires students entering kindergarten, 7th grade, and those newly enrolled to EPS to show proof of required immunizations or to file legal exemptions from immunizations with the school. You may review your child’s school immunization record through your SchoolView account (accessible at edinaschools.org/parents). A schedule of required immunizations is also located on the EPS website under health services.

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You will be contacted if immunization information is needed in order for your child to attend school. Updated or new immunization information should be sent to your child’s school health office no later than Friday, Aug. 7 to allow time for processing.

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Immunization clinics are held at Bloomington Public Health, 1900 W. Old Shakopee Road in Bloomington, Minn. All uninsured or underinsured children are welcome. Call for times: 952-563-8900

If you have questions about immunization requirements, contact your child’s school health office or Mary Heiman, EPS Health Services Coordinator at 952-848-4890 or mary.heiman@edinaschools.org.

ADVANCING WELLNESS

EPS continues to track and incorporate the latest brain research and the findings of the mind/body connection, which emphasize a whole-child approach to foster learner engagement and ensure learning opportunities for all students. These initiatives are led by the Student Wellness Committee, which is charged primarily with monitoring the implementation of school board policies 715 (Food and Nutrition Services Program) and 533 (Wellness).The desired outcome of these efforts is for all EPS learners to maintain optimal well-being so that they can identify and follow their sparks and achieve their full physical, social/emotional and intellectual potential.

Student Wellness Challenge On April 23, 2016, EPS students, parents and staff will learn about the importance of exercise and the mind-body connection while discovering ways to beat stress and sharpen the mind. Watch for more information.

ANNUAL HEALTH & SAFETY NOTIFICATIONS Concerning the Use of Pest Control Materials: Our district utilizes a licensed, professional pest control service firm for the prevention and control of rodents, insects and other pests in and around the district’s buildings. Their program consists of: 1. Inspection and monitoring to determine if pests are present and whether any treatment is needed; 2. Recommendations for maintenance and sanitation to eliminate pests without need for pest control materials; 3. Utilization of non-chemical measures such as traps, caulking and screening; and 4. Application of EPA-registered pest control materials when needed.

Pests can sting, bite, cause contamination, damage property and spread disease; therefore, we must prevent their presence and control them as necessary. Our district or outside contractors may also apply herbicides on district properties, as deemed necessary.

The long-term health effects on children from the application of pest control materials may not be fully understood. All pest control materials are chosen and applied according to labeling directions per Federal law.

An estimated schedule of pest control inspections and possible lawn treatments are available for review. Parents of students may submit a request to receive prior notification of any application by calling the school principal or the Buildings and Grounds Department at (952) 848-3999. Material Safety Data Sheets for all pesticides and herbicides utilized are available for review by calling the Buildings and Grounds Department.

Asbestos Notification for Staff and Building Occupants: The Asbestos Hazard Emergency Response Act (AHERA) requires that each school district notify workers and building occupants annually regarding asbestos-related activities. Until the late seventies, asbestos was commonly used in commercial and residential building materials, such as floor tile, fireproofing spray and thermal system insulation on pipes, tanks and boilers. In the late 1980’s, all school buildings were inspected for asbestos-containing building materials according to AHERA protocol, using accredited inspectors.

Based on the results of these inspections, management plans were developed for each school where asbestos was found. These plans are on file at the Edina Community Center and are available for review by contacting the Buildings and Grounds Office at (952) 848-3999.

AHERA also requires that we conduct periodic surveillance inspections

In the 2015-16 school year we will continue to work through policy guidelines to improve: • Food services and snacks • Nutrition education and promotion • Physical activity • Communication with families Other 2015-16 district strategic wellness initiatives include: • Adding a made-to-order salad bar at high school • Continue with superfood taste testing’s at elementary schools • Promotion of the importance of breakfast and reminder of opportunity for school breakfast at all grade levels • Continued partnership with local apple orchard for local apples in the fall and looking to increase farm-to-school opportunities every six months to evaluate the condition of asbestos-containing materials and that we completely re-inspect our buildings every three years. This is done to best ensure all asbestos-containing materials are maintained in a safe condition. Identified below are asbestos-related activities that were completed over the past year or are planned for the upcoming year. Complete details are available upon written request and copies of inspections are available at each individual school.

Activities Scheduled For 2015-2016 • Periodic Surveillance • Abatement activities at Highlands Elementary School, Countryside Elementary School and Creek Valley Elementary School associated with the Renovation Projects Rest assured that the District is focused on providing a safe and healthy environment for our building occupants and employees, to include ongoing efforts related to the management and control of asbestosrelated materials.

Indoor Air Quality To help improve our school environment and comply with requirements established by the Minnesota Department of Education (MDE), the Edina Public Schools has developed and implemented an Indoor Air Quality Management Plan that addresses indoor air quality issues throughout the District. Walkthroughs and inspections of District buildings are performed annually to detect current problems and help prevent future problems from occurring. Specific District information is available upon request from the Buildings and Grounds Department at (952) 848-3999. General information regarding indoor air quality is available from the Department of Health at: www.health.state.mn.us/ divs/eh/indoorair/schools/

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CALENDAR INFORMATION 5

NOTEWORTHY COMMUNITY EVENTS

Homecoming Friday, Sept. 18 The Homecoming Parade at 4 p.m. begins at the Edina Country Club and proceeds down Wooddale Ave. Afterward, cheer for the Hornets football team at 7 p.m., Kuhlman Field on the ECC campus.

SEPT

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CUSTOMIZED CALENDAR INFORMATION Online calendars make it easy to access calendar information online, anytime. You can customize the calendar to view all calendars for your child(ren)’s schools at once and download the information to your personal or mobile calendar.

See instructions below:

33 4 4

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Edina Day of Service Saturday, Oct. 24 Each year, in partnership with the Edina Community Foundation’s Connecting With Kids program, an Edina Day of Service is held to celebrate and encourage a culture of service in the community.

OCT

24

Election Tuesday, Nov. 3 Three seats on the Edina School Board are up for election this year. Don’t forget to vote!

NOV

3

Technology and Learning Open House Saturday, April 16, 2016, 9-11 a.m., Edina Community Center See firsthand how technology helps unleash students’ passions for learning and empowers great teaching. Edina teachers and students will showcase Digital Age learning as experienced throughout the 2015-2016 school year.

APR

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Student Wellness Challenge Saturday, April 23, 2016 South View MS EPS students, parents and staff will learn about the importance of exercise and the mind-body connection while discovering ways to beat stress and sharpen the mind.

STEP

1

STEP

2

STEP

3

STEP

4

APR

23

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STEP

5

Visit edinaschools.org/calendar to view the district calendar or go to the calendar page of any of the school sites. From this calendar page, you can find all of your school’s events as well as customize your own calendar view events from all of Edina Public Schools (EPS).

To customize your own calendar, simply click “Customize Calendar View,” located directly above the month and year of the calendar grid. With this customization feature, you can add or remove other school’s calendars, as well show or hide calendar categories, so that you can easily keep track of the events most important to you.

To add additional schools, click on the pencil icon next to calendars and click “add/remove.”

A pop-up window will appear allowing you to add or remove any school/program from your personalized calendar by checking or unchecking the box next to the school of your choosing.

Once you are done adding schools click “I’m Done” to return to the calendar.

To edit categories that will appear on your calendar, click the pencil icon next to categories.

To remove any categories that you do not wish to see on your calendar, click the “x” next to that category. To add a category, click on “add/remove.” A pop-up window will appear allowing you to check/uncheck the categories will appear on your calendar. Once you are done, click “I’m Done” to return to your calendar.

You can also migrate your EPS calendar to your iOS or Android device, or your Google, Microsoft Outlook, or other calendar program, by clicking on the iCAL icon near the top right of the calendar. Instructions on how to migrate your calendar to these platforms will be provided when you select the device or application to which you want to migrating your calendar.

EMERGENCY SCHOOL CLOSINGS All school closings, due to severe weather or other emergencies, will be shared with families through the district’s messaging system (School Messenger), via the district’s website (edinaschools.org), district social media accounts, and through local media. This applies to unscheduled late starts and early dismissals as well.

Families are encouraged to have plans for possible emergency school closings.

N 2015-16 EARLY RELEASES/LATE STARTS Late Starts and early releases were introduced with the 2013-14 school year to provide critical collaboration time that allows teacher to better customize learning experiences for each student. Scheduling occasional late starts and early releases throughout the school year provides our teachers with critical planning time to analyze student achievement data, collaborate with colleagues, and align their instruction for maximum student learning.

During the 2015-16 school year there are two early release and two late start days that apply to all K-12 students: Early Release: Tuesday, Sept. 29 and Friday, Feb. 12 Late Start*: Wednesday, Nov. 11 and Thursday, April 21 *There is no Edina Family Center or Early Childhood Special Education morning programming (before noon) on late start days.

Note: Families of EHS students should consult the high school calendar for additional early release/late start dates pertaining to testing and special programs.

WILL THERE BE BUSING ON THESE DAYS? District transportation will be adjusted for the two-hour late start, meaning that on late start days the bus will arrive two hours after the usual pickup time. For example, if your student’s pickup time is 8:05 a.m., the time will be adjusted to 10:05 a.m. Similarly, for early releases, buses will drop-off students two hours earlier than usual.

ENRICHMENT OPPORTUNITIES Edina Community Education Services (CES) invites students to participate in enrichment programs before or after on the scheduled early release/late start days. CES collaborates with EPS classroom teachers to offer activities that complement what students are learning during the school day.

• • • •

Elementary Program – Elementary students can enroll in enrichment program at their home elementary school for any or all of the early release/late start days.

Cost – The cost per student for each two-hour time block is $20. To learn more about scholarships for the CES enrichment program, please call 952-848-3952.

Registration – Interested families can register for enrichment programs at Edina. thatscommunityed.com School-age care programs - Current participants in KIDS Club, WISE Guys and SURGE will receive information about early release/late start options with your registration packets. These dates will be offered as additional registration choices. Note that the middle school SURGE program will offer programming on early release days, but not on late start days.

In accordance with district policy, all school closings and/or schedule changes are decided by the superintendent or his designee. The most compelling reason for closing schools involves the safety of students and employees. Decisions to cancel or shorten the regular school day or after school activities shall be made by the superintendent, or his designee, in consultation with other staff. Consultation may also include City of Edina personnel and neighboring school districts, as appropriate. Decisions on school closings and late starts will be made as early as possible – either the night before or as early in the morning as possible.

EMERGENCY NOTIFICATIONS: • • • • •

Automated voicemail Email District and school websites Social media Local media - WCCO 830-AM (radio), WCCO (Channel 4), KSTP (Channel 5), FOX 9 KMSP, and KARE 11 TV

UNSCHEDULED DELAYED STARTS In the event of a delayed start, Edina High School’s Zero Hour is cancelled as well as morning ECSE and morning Edina Family Center programs. Some Community Education programs may also be cancelled.

EVENING CANCELLATIONS Decisions to cancel after-school and evening activities will be made by 3 p.m. if possible and are not necessarily tied to a school closing.

LEARN MORE AT EDINASCHOOLS.ORG/ EMERGENCY-SCHOOL-CLOSINGS

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COMMUNITY EDUCATION EDINA COMMUNITY Education

Edina Community Education is an integral part of Edina Public Schools, extending the work of our shared mission and vision beyond the traditional K-12 school day.

Community Education programs and services build skills, promote health and well-being, support families, and develop learning competencies.

EARLY EDUCATION The Edina Family Center offers high-quality early education programs for families with children from birth through age five. Programs include New Baby and Me classes, Early Childhood Family Education (ECFE), preschool, childcare and more. For more information, call 952-848-3908.

I loved the variety of curriculum for the parents, from behavior to safety to nature and I feel like I learned so much, most importantly to trust myself!

Also, the class was a positive learning experience and great socialization for my child.

YOUTH PROGRAMS Youth Programs offer a variety of fun and educational activities for ages 3-18. KIDS Club (gr. K-3) WISE Guys (gr. 4-5) and SURGE (gr. 6-9) provide high quality out-ofschool time care. Service Learning and Youth Serving Youth provide student leadership and service opportunities. Youth Enrichment offers opportunities before and after school, and on many school release days. For more information, call 952-848-3952.

My grandson had so much fun.

He had a chance to connect with classmates from his school and tapped on his creativity and technology skills.

ADULT EDUCATION We offer educational opportunities for every learner at every age. From Adult Basic Education and English Language Learning to fitness, wellness, global awareness, current technology and professional development classes, CES Adult Education helps adults stay engaged and thrive in our community. For more information, call 952-848-3952.

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This class was beyond expectations. My skills have gone from minimal to quite good, I am motivated to keep learning, and I am having a great time meeting others!

The Edina Resource Center listens to your needs and connects you to the resources that can help. A partnership of Edina Community Education Services, Edina Public Schools and the City of Edina, the Edina Resource Center is your connection to community resources, services and information in Edina. All services are free and confidential.

BECOME A VOLUNTEER

Make us your first call for resources such as:

EPS is committed to using volunteers to promote and strengthen partnerships between the school and the community as well as to help personalize instruction and enrich curriculum for all learners. Volunteering has always been a hallmark of Edina and in the 2015-16 school year, additional volunteer opportunities have been created to meet the evolving needs of students and allow for more volunteers to make a difference, all with a schedule that meets their needs. Volunteer opportunities are available in the morning, afternoon or after school, on a one-time, weekly or monthly basis.

• • • • • • • •

VOLUNTEER OPPORTUNITIES • Classroom support (e.g., reading, math, writing, science, art) • One-On-One student support • Non-academic support • Office support • Edina Family Center support (early education) • Media Center support In addition to benefiting students, volunteering in EPS provides personal satisfaction, improved self-esteem a sense of accomplishment, opportunities to learn, a greater knowledge/understanding of the EPS school system, and work experience.

Get Started Volunteering Today! Complete a volunteer application and the Edina Volunteer Program will match your skills and interests with available volunteer opportunities. Appropriate preparation and training will be provided prior to starting your volunteer experience. We are committed to working with you to ensure volunteering is a rewarding experience for everyone. Thank you for your interest in volunteering with Edina Public Schools!

• After school homework support • Before and after school Success Center support • Reading Buddy support program • One-time special projects • Special event support • Saturday School • And more!

As a volunteer for Project Lead the Way’s Civil Engineering class, I’ve seen up close how beneficial it can be for both students and volunteers. Students get a real-world look at life-long career experiences and volunteers are rewarded, in an altruistic sense, by sharing themselves with the students. - Bob Pfefferle (82-year-old retired

Civil Engineer)

• • • • •

Chemical and Mental Health City and Community Information Childcare Chore Services Education (Early Childhood to Adult) Energy, Food and Housing Assistance Family and Individual Supports Financial Resources and Tax Assistance Health Care Supports Immigrant Services Legal/Mediation Services Transportation And more!

Contact 952-848-3936 or visit www.edinaresourcecenter.com to get connected.

SIGN UP FOR OUR E-NEWSLETTER! Sign up for the new Edina Resource Center Newsletter to receive seasonal notifications, updates on community resources, upcoming events and more.

To sign up, email contact@ edinaresourcecenter.com or call 952-848-3936. This newsletter is available only in an electronic format.

LEARN MORE AND APPLY AT EDINASCHOOLS.ORG/VOLUNTEER

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APPLICATION FOR EDUCATIONAL BENEFITS HOW TO COMPLETE THE APPLICATION FOR EDUCATIONAL BENEFITS Complete the Application for Educational Benefits form for school year 2015-16 if any of the following applies to your household: • Any household member currently participates in the Minnesota Family Investment Program (MFIP), or the Supplemental Nutrition Assistance Program (SNAP), or the Food Distribution Program on Indian Reservations (FDPIR). or • The household includes foster children (a welfare agency or court has legal responsibility for the child). or • The total income of household members is within the guidelines shown below (gross earnings, not take-home pay). Do not include as income: foster care payments, federal education benefits, MFIP payments, or value of assistance received from SNAP, WIC, or FDPIR. Military: Do not include combat pay or assistance from the Military Privatized Housing Initiative. The income guidelines are effective from July 1, 2015 through June 30, 2016.

MAXIMUM TOTAL INCOME:

Household Size

$ Per Year

$ Per Month

1 2 3 4 5 6 7 8 Additional

21,775 29,471 37,167 44,863 52,559 60,255 67,951 75,647 7,696

1,815 2,456 3,098 3,739 4,380 5,022 5,663 6,304 642

$ Twice Per Month 908 1,228 1,549 1,870 2,190 2,511 2,832 3,152 321

$ Per 2 Weeks

$ Per Week

838 1,134 1,430 1,726 2,022 2,318 2,614 2,910 296

419 567 715 863 1,011 1,159 1,307 1,455 148

Step 1 Children List all children living in the household, their birthdate and, if applicable, their grade and school. Fill in the circle if a child is in foster care. Attach an additional page if necessary. Providing racial/ethnic information for each child is optional; this information helps to make sure we are fully serving our community.

Step 2 Case Number Complete Step 2 if any household member currently participates in any of the three assistance programs listed in Step 2. If Step 2 is completed, skip Step 3.

Step 3 Adults / Incomes / Last 4 Digits of Social Security Number Regular earnings to children – If any children in the household have regular income, such as SSI or part-time jobs, list the total amount of regular income to children. Do not include occasional earnings like babysitting or lawn mowing.

Social Security number – The person signing the application must provide the last four digits of their Social Security number, or check the box if they do not have a Social Security number.

Adults / Incomes – List all adults living in the household, whether related or not (such as grandparents, other relatives, or friends). Include any adult who is temporarily away, such as a student away at college. Attach an additional page if necessary.

• List gross incomes before deductions, not take-home pay. Do not list an hourly wage rate. For farm or self-employment income only, list net income after subtracting business expenses.

• For adults with no income to report, enter a ‘0’ or leave the section blank. This is your certification (promise) that there is no income to report for these adults.

• For each income, fill in a circle to show how often the income is received.

Return your completed application to: Food & Nutrition Services Step 4 If you do not want Information to be shared with state health insurance programs, Edina High School check the box.

6754 Valley View Road Step 5 Signature and Contact Information An adult household member must sign the form. Edina, MN 55439

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STUDENT INFORMATION RELEASE NOTE TO PARENTS

This is an “opt out” form for the 2015-16 school year. You should complete this form only if: • You DO NOT want your student’s name, photograph, or directory information to be included in school directories, yearbooks, on school and district websites, or news releases, AND: • You have not already completed this form online via SchoolView for the 2015-16 school year.

You do not need to submit this form if you have no objection to your student’s information and photograph potentially appearing in internal and external publications.

LIMITATION ON DISTRICT RELEASE OF STUDENT INFORMATION Edina Public Schools recognizes its responsibilities in regard to the collection, maintenance and dissemination of students’ educational records and data. District Policy 515 defines the procedures and practices for protecting the privacy of student information in accordance with state and federal law.

Completion of this form is to prohibit the release of student directory information.

STUDENT DIRECTORY INFORMATION Directory information regarding a student is public information under state and federal law. Directory information as defined in District Policy 515 includes, but is not limited to, a student’s name, address, telephone number, email address, photograph, date and place of birth, attendance dates, grade level, participation in activities and sports, degrees and awards received, and weight/height of athletic team participants. It also includes the name, address and telephone number of the student’s parent(s).

A parent/guardian may refuse to have any or all of the directory information made public by notifying the building principal in writing or via SchoolView (http://ow.ly/P6Bzd) by Friday, Sept. 11, 2015 or 30 days after enrollment in Edina Pubic Schools. Submission of the bottom of this form to the building principal satisfies this notice requirement.

PHOTOGRAPHY As noted above, a student’s photograph/image/recording is also directory information and may be released. A student may be photographed or recorded while at school or participating in school activities and events. Care is taken to ensure that the student and learning/activity/event environment is portrayed appropriately. If you choose not to have your child photographed or recorded by the district, please log in to SchoolView (http://ow.ly/P6Bzd) or, notify the building principal in writing by Friday, Sept. 11, 2015. Submission of the bottom of this form to the building principal satisfies this notice requirement.

In accordance with District Policy 515, the above-noted designations or refusals will remain valid until the end of the 2015-16 school year. If you have any additional questions please contact your building principal.

I, as parent/guardian of the below named student(s), elect that the district is not able to disclose directory information for the 2015-16 school year. (Please select one of the following choices.)

A

The district may not release any directory information regarding the child(ren) listed below. This election includes the non-release of photographs/images/recordings.

B

The district may not release any photographs/images/recordings of the child(ren), but may release directory information regarding the child.

Child’s name: _______________________________

School:________________

Grade: ____

Select: oA oB

Child’s name: _______________________________

School:________________

Grade: ____

Select: oA oB

Child’s name: _______________________________

School:________________

Grade: ____

Select: oA oB

Child’s name: _______________________________

School:________________

Grade: ____

Select: oA oB

Parent/Guardian name (please print): ______________________________________ Parent/Guardian signature: ______________________________________________

Date:________________

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have health insurance?

If not, helphave may health be available.

Does your child insurance?

If not, it may be available Minnesota Health Care Programs have free and low-cost health insurance for children and families who qualify.

Your child may qualify if your household income is below: Family size

Monthly income

2

$

3

$

4

$

5

$

Yearly income

3,650

$

43,807

4,603

$

55,247

5,557

$

66,687

6,510

$

78,127

Income is one factor for qualifying. Other rules and limits apply. For more information, call your county office or visit www.dhs.state.mn.us/healthcare. The income limits above are valid until June 30, 2016.

To get a MNsure application for health coverage and help paying costs (DHS-6696): Print one from www.dhs.state.mn.us/healthcare Call 877-KIDS-NOW toll free Call Hennepin County Human Services and Public Health Department at 612-596-8500

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Student Immunization Form Student Name _________________________________________________ Birthdate _____________________Student Number __________________ Minnesota law requires children enrolled in school to be immunized against certain diseases or file a legal medical or conscientious exemption.

FOR SCHOOL USE ONLY ( ) Complete; booster required in ___________ ( ) In process; 8 mos. expires _____________ ( ) Medical exemption for _________________ ( ) Conscientious objection for _____________ ( ) Parental/guardian consent _____________

Parent/Guardian: You may attach a copy of the child’s immunization history to this form OR enter the MONTH, DAY, and YEAR for all vaccines your child received. Enter MED to indicate vaccines that are medically contraindicated including a history of disease, or laboratory evidence of immunity and CO for vaccines that are contrary to parent or guardian’s conscientiously held beliefs.

Sign or obtain appropriate signatures on reverse. Complete section 1A or 1B to certify immunization status and section 2A to document medical exemptions (including a history of varicella disease) and 2B to document a conscientious exemption.

Additionally, if a parent or guardian would like to give permission to the school to share their child’s immunization record with Minnesota’s immunization information system, they may sign section 3 (optional).

For updated copies of your child’s vaccination history, talk to your doctor or call the Minnesota Immunization Information Connection (MIIC) at 651-201-5503 or 800-657-3970.

School Personnel: Be sure to initial and date any new information that you add to this form after the parent/guardian submits it.

Also, record combination vaccines (e.g., DTaP+HepB+IPV, Hib+HepB) in each applicable space.

1st Dose 2nd Dose 3rd Dose 4th Dose 5th Dose Mo/Day/Yr Mo/Day/Yr Mo/Day/Yr Mo/Day/Yr Mo/Day/Yr Required (The shaded boxes indicate doses that are not routinely given; however, if your child has received them, please write the date in the shaded box.)

Type of Vaccine

DO NOT USE () or ()

Diphtheria, Tetanus, and Pertussis (DTaP, DTP, DT) • for children age 6 years and younger • final dose on or after age 4 years Tetanus and Diphtheria (Td) • for children age 7 years and older • 3 doses of Td required for children not up to date with DTaP, DTP, or DT series above

5th dose not required if 4rd dose was given on or after the 4th birthday

Tetanus, Diphtheria and Pertussis (Tdap) • for children in 7th - 12th grade Polio (IPV, OPV) • final dose on or after age 4 years

4th dose not required if 3rd dose was given on or after the 4th birthday

Measles, Mumps, and Rubella (MMR) • minimum age: on or after 1st birthday Hepatitis B (hep B) Varicella (chickenpox) • minimum age: on or after 1st birthday • vaccine or disease history required Meningococcal (MCV, MPSV) • for children in 7th - 12th grade • booster given at age 16 years

Recommended Human Papillomavirus (HPV) Hepatitis A (hep A) Influenza (annually for children 6 months and older)

Additional exemptions: • Children 7 years of age and older: A history of 3 doses of DTaP/DTP/DT/Td/Tdap and 3 doses of polio vaccine meets the minimum requirements of the law.

• Students in grades 7-12: A Tdap at age 11 years or later is required for students in grades 7-12. If a child received Tdap at age 7-10 years another dose is not needed at age 11-12 years. However, if it was only a Td, a Tdap dose at age 11-12 years is required.

• Students 11-15 years of age: A 3rd dose of hepatitis B vaccine is not required for students who provide documentation of the alternative 2-dose schedule.

• Students 18 years of age or older: Do not need polio vaccine.

Developed by the Minnesota Department of Health - Immunization Program

www.health.state.mn.us/immunize

(12/13) #140-0155

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Student Name _______________________________________________

Instructions, please complete: Box 1 to certify the child’s immunization status Box 2 to file an exemption (medical or concientious) Box 3 to provide consent to share immunization information (optional)

1. Certify Immunization Status. Complete A or B to indicate child’s immunization status.

A. Received all required immunizations:

I certify that this student has received all immunizations required by law.

Signature of Parent / Guardian OR Physician / Public Clinic _______________ Date

B. Will complete required immunizations within the next 8 months: I certify that this student has received at least one dose of vaccine for diphtheria, tetanus, and pertussis (if age-appropriate), polio, hepatitis B, varicella, measles, mumps, and rubella and will complete his/her diphtheria, tetanus, pertussis, hepatitis B, and/or polio vaccine series within the next 8 months.

The dates on which the remaining doses are to be given are:

Signature of Physician / Public Clinic _______________ Date

2. Exemptions to School Immunization Law. Complete A and/or B to indicate type of exemption.

A. Medical exemption: No student is required to receive an immunization if they have a medical contraindication, history of disease, or laboratory evidence of immunity. For a student to receive a medical exemption, a physician, nurse practitioner, or physician assistant must sign this statement: I certify the immunization(s) listed below are contraindicated for medical reasons, laboratory evidence of immunity, or that adequate immunity exists due to a history of disease that was laboratory confirmed (for varicella disease see * below). List exempted immunization(s):

B. Conscientious exemption: No student is required to have an immunization that is contrary to the conscientiously held beliefs of his/ her parent or guardian. However, not following vaccine recommendations may endanger the health or life of the student or others they come in contact with. In a disease outbreak schools may exclude children who are not vaccinated in order to protect them and others. To receive an exemption to vaccination, a parent or legal guardian must complete and sign the following statement and have it notarized: I certify by notarization that it is contrary to my conscientiously held beliefs for my child to receive the following vaccine(s):

Signature of physician/nurse practitioner/physician assistant _______________ Date *History of varicella disease only. In the case of varicella disease, it was medically diagnosed or adequately described to me by the parent to indicate past varicella infection in ___________ (year) Signature of physician/nurse practitioner/physician assistant (If disease occured before September 2010, a parent can sign.)

Signature of parent or legal guardian _______________ Date Subscribed and sworn to before me this: _______ day of ______________________ 20______ Signature of notary

3. Parental/Guardian Consent to Share Immunization Information (optional):

Your child’s school is asking your permission to share your child’s immunization documentation with MIIC, Minnesota’s immunization information system, to help better protect students from disease and allow easier access for you to retrieve your child’s immunization record. You are not required to sign this consent; it is voluntary. In addition, all the information you provide is legally classified as private data and can only be released to those legally authorized to receive it under Minnesota law.

I agree to allow school personnel to share my student’s immunization documentation with Minnesota’s immunization information system:

Signature of parent or legal guardian Developed by the Minnesota Department of Health - Immunization Program

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Date www.health.state.mn.us/immunize

(12/13) #140-0155

NON-PROFIT ORGANIZATION US POSTAGE PAID PERMIT NO. 91349 TWIN CITIES MN

ISD 273 5701 Normandale Road Edina, MN 55424 edinaschools.org

info@edinaschools.org /photos/edinapublicschools

@edinaschools /EdinaPublicSchools EdinaPublicSchools Great stories happen everyday.

Sign-up for the EPS In the Know weekly eNewsletter at edinaschools.org/know and stay connected.

CONTACT US ELEMENTARY SCHOOLS

SECONDARY SCHOOLS

Concord Elementary (K-5) 8:30 a.m. - 3:05 p.m.

5900 Concord Avenue S. Edina, MN 55424 952-848-4300 Tony Washington, Principal edinaschools.org/concord

Creek Valley Elementary (K-5) 9:15 a.m. - 3:50 p.m.

6401 Gleason Road Edina, MN 55439 952-848-3200 Kari Dahlquist, Principal edinaschools.org/creekvalley

South View Middle School (6-9) 7:40 a.m. - 2:40 p.m.

4725 South View Lane Edina, MN 55436 952-848-3700 Beth Russell, Principal edinaschools.org/southview

Cornelia Elementary (K-5) 9:15 a.m. - 3:50 p.m.

7000 Cornelia Drive Edina, MN 55435 952-848-4600 Lisa Masica, Principal edinaschools.org/cornelia

Highlands Elementary (K-5) 9:15 a.m. - 3:50 p.m.

5505 Doncaster Way Edina, MN 55436 952-848-4500 Peter Hodne, Principal edinaschools.org/highlands

Valley View Middle School (6-9) 7:40 a.m. - 2:38 p.m.

6750 Valley View Road Edina, MN 55439 952-848-3500 Shawn Dudley, Principal edinaschools.org/valleyview

Countryside Elementary (K-5) 9:15 a.m. - 3:50 p.m.

5701 Benton Avenue S. Edina, MN 55436 952-848-4700 Karen Bergman, Principal edinaschools.org/countryside

Normandale Elementary (K-5) French Immersion School 8:30 a.m. - 3:05 p.m.

5701 Normandale Road Edina, MN 55424 952-848-4100 Chris Holden, Principal edinaschools.org/normandale

Edina High School (10-12) 8:25 a.m. - 3:10 p.m.

Zero Hour: 7:25 a.m. - 8:20 p.m.

6754 Valley View Road Edina, MN 55439 952-848-3800 Bruce Locklear, Principal edinaschools.org/edinahigh

WELCOME CENTER 5701 Normandale Road Edina, MN 55424 952-848-3900 info@edinaschools.org

STUDENT ENROLLMENT 5701 Normandale Road Edina, MN 55424 952-848-4585 enrollment@edinaschools.org

EPS SCHOOL BOARD

Randy Meyer, Chair Leny Wallen-Friedman, Vice Chair Regina Neville, Clerk Cathy Cella, Treasurer Sarah Patzloff, Assistant Treasurer David Goldstein, Assistant Clerk Lisa O’Brien, Assistant Clerk SchoolBoard@edinaschools.org