Kindergarten Enrollment Packet 2015-16 by Edina Public Schools

Welcome CLASS OF

2028 Kindergarten Enrollment Packet

2015-2016

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WELCOME TO KINDERGARTEN! REGISTRATION CHECKLIST o Enrollment Form o Parent Input Form for Student Placement o Child’s birth certificate (original and copy)

ENROLLMENT REQUIREMENT

HEALTH CHECKLIST o

Immunization Form

Physical Exam/Health History Form

Make special arrangements with the health office as needed

KINDERGARTEN TIMELINE Enclosed please find important information for all Edina Public Schools (EPS) incoming kindergarten families pertaining to the upcoming school year. Included you will find information about:

Program Preference Form Due Monday, January 12, 2015 at 6 p.m. Applications Due for Open Enrollment Thursday, January 15, 2015

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Kindergarten Enrollment – overview of enrollment options as well as a list of frequently asked questions;

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Student Health Requirements – information on the health services department and student immunization requirements;

Kindergarten Registration Day Thursday, January 29, 2015

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Transitioning to Kindergarten – information and resources on how families can support their child to make a successful transition;

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Early Childhood Developmental Screening – information on student screening requirements; and

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Community Education programming – information on before and after school and non-school day care options through Edina KIDS Club and Edina Community Education Services.

Concord Countryside Cornelia Creek Valley Highlands Normandale

Additional information about district programs and services can also be found online at edinaschools.org. Thank you for your partnership in making 2015-16 a great year! Concord Elementary Rick Sansted, Principal 952-848-4300

Countryside Elementary Karen Bergman, Principal 952-848-4700

Highlands Elementary Peter Hodne, Principal 952-848-4500

Cornelia Elementary Lisa Masica, Principal 952-848-4600

Creek Valley Elementary Kari Dahlquist, Principal 952-848-3200

Normandale Elementary Chris Holden, Principal 952-848-4100

3:30 - 5 p.m. 4:15 - 5:45 p.m. 4 - 5:30 p.m. 4 - 5:30 p.m. 4:15 - 5:45 p.m. 3:30 - 5 p.m.

Teacher Assignments Information will be available in August Elementary School Open Houses Held prior to the start of school First Day of School for Kindergarten Tuesday, September 1 , 2015

ENROLLMENT INFORMATION ENROLLMENT OPTIONS Kindergarten families have three educational options available: Neighborhood Schools, French Immersion, and Continuous Progress. Families who are interested in French Immersion or Continuous Progress must submit a Program Preference Form by Jan. 12, 2015. FRENCH IMMERSION French Immersion has been an educational option for EPS families since 1991. The program is held at Normandale Elementary School (adjacent to the Edina Community Center). Normandale students receive the same curriculum as all Edina Public School students, but are instructed in the French language. Because of the advancing French proficiency level of the curriculum and students, entrance to the program is most successful when children begin in kindergarten. If you received notice that your child has been accepted into the French Immersion Program, please attend the Normandale Kindergarten Registration event. CONTINUOUS PROGRESS PROGRAM Continous Progress is offered at Highlands and Countryside schools. Students work in multi-age families and stay with a teacher for three to five years. Continuous Progress (CP) begins in first grade, and students may enter the program at any grade level. However, due to limited space, families are encouraged to enroll their child in kindergarten. The program is located at both Countryside and Highlands Schools. If you received notice that your child has been accepted into the CP program at Highlands or Countryside, please attend that respective school’s Kindergarten Registration event.

FREQUENTLY ASKED QUESTIONS (FAQ) What is the age requirement to enter kindergarten? Children who are five years old on or before Sept. 1, 2015 are eligible to begin kindergarten. Please bring your child’s official birth certificate with embossed seal to Kindergarten Registration. When is registration? Kindergarten registration will be held on Thursday, Jan. 29, 2015. Please bring your completed registration materials to this event. What immunizations are required? Minnesota Statute 121.15 requires that all children must be immunized against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B series and varicella (or a record of chicken pox.). Additional information is located later in this packet. Do I need to have my child screened prior to kindergarten? State law requires completion of a developmental screening (i.e. Early Childhood Screening) prior to entrance into kindergarten. Please refer to additional information later this packet for details on screening requirements and processes. What if my child is not attending EPS kindergarten in the fall? Please let your neighborhood school or the Student Enrollment Office (952848-4585) know if you are not planning to enroll your child in 2015-16.

When will I find out who my child’s teacher will be? Because of staffing and enrollment changes made throughout the summer, class lists are not finalized until early to mid-August.

How can I get involved at my school? Edina Public Schools celebrates the partnership between home and school. Each class and school have several opportunities for families to be involved. You will begin to receive some of this information at Kindergarten Registration, throughout the spring, and again in the fall. How can I learn more about my child’s school? Specific questions about your child’s school can be answered during the orientation session or by contacting the school directly. What are the benefits of all-day kindergarten? Having a full day of instruction means students will experience an enhanced kindergarten experience that prepares them for future education. What if I want my child to attend half day? Since the district will only be offering a full-day program option, families who wish to have their child attend for half of the day can do so under current law. However, midday transportation would be the responsibility of the parent/guardian, and curriculum and activities will be based on a full-day program model. What if my child is not ready for a full-day experience? EPS is committed to working with families on an individual basis to help their child transition to school. Our principals have and will continue to work hard in partnership with families during this time to ensure all students can be successful.

EARLY CHILDHOOD DEVELOPMENTAL SCREENING

As you begin to prepare your child for enrollment in kindergarten, there are certain requirements that must be met according to State law. Early Childhood Developmental Screening is one of the required components for entrance into kindergarten. If your child has already completed Early Childhood Developmental Screening through the Edina Public Schools, no further action is required. Your child’s screening record will be delivered to his/her elementary school at the start of the kindergarten school year. If your child has not been screened, you will need to schedule an appointment and complete the screening before your child can start school. Information regarding screening can be found online at www.edinaschools.org/screening. From the main screen, click the “Schools” section, then “Early Education,” then “Early Childhood Developmental Screening.” Screenings are conducted throughout the school year on an appointment basis and take approximately one hour. • Screening should be done when your child is three-and-a-half years old. • Screening is a FREE check of your child’s development, including speech and language skills, motor skills and concepts, height, weight, vision and hearing. • The purpose is to help identify health or learning concerns that may require special attention before a child enters kindergarten. It is not beneficial to wait until your child is older to complete this screening. • Screening does not determine kindergarten readiness. You may choose to not have your child participate in this screening. If you do not want your child screened, you must provide us with a signed, dated statement noting that you are a conscientious objector to the Early Childhood Screening program. If your child has been screened in another school district, or if your medical doctor has completed a standardized assessment, submit the records by Dec. 12, 2014 to: Lisa Hawthorne Early Childhood Developmental Screening, Room 163 Edina Public Schools 5701 Normandale Road Edina, MN 55424 If you would like additional information or have any questions, please contact the Early Childhood Screening office at 952-848-4299. 3

For Kindergarten 2015-2016 Edina KIDS Club is a fun, stimulating learning environment for your child that will complement and enrich your child’s kindergarten experience in Edina Public Schools. We provide quality enrichment and care before and after school and on release days. Children learn through a wide variety of activities such as art, music, science projects, cooking, games, writing, reading, crafts, outdoor play, computers, practicing social skills, gym time, dramatic play, and much more! There is a balance of activity options that includes large group, small group, and individual choices. KIDS Club is a great place for children to develop friendships, and grow their confidence, independence and respect for themselves and others.

REGISTRATION KIDS Club registration materials will be available on our website in May. Please watch for an email reminder in the spring. For questions, contact 952-848-3947 or ecc.kidsclub@edinaschools.org. Program Fees (subject to change): • KIDS Club 5 days/week schedule: $11.50/morning and $11.50/afternoon • KIDS Club 4 days/week or less schedule: $12.50/morning and $12.50/afternoon • KIDS Club Extra Time: $15/morning or afternoon • Non-School Days: $42/day ($39/day if added by 15th of preceeding month)

• Located at each elementary school • Program operates before school, after school and on non-school days • Visit our website to learn more: edinacommunityed.org

PROGRAM OPTIONS 1. BEFORE SCHOOL KIDS CLUB KIDS Club programming is available for all students in grades K-3 and is offered at your elementary school before school from 6:45 a.m. to the start of school. 2. AFTER SCHOOL KIDS CLUB KIDS Club programming is available for all students in grades K-3 and is offered at your elementary school after school from school dismissal to 6:00 p.m. 3. NON-SCHOOL DAY Non-school day programming is available on days when school is not in session. It is located at your child’s school and is available all day, from 6:45 a.m. to 6:00 p.m. The program often includes a field trip and additional enrichment opportunities.

KIDS Club is a program of Edina Community Education Services of Edina Public Schools 5701 Normandale Road | Edina, MN 55424 | edinacommunityed.org | 952-848-3947 | ecc.kidsclub@edinaschools.org

EDINA FAMILY CENTER 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.

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-of-school time care. Classes and camps offer new and favorite enrichment subjects. Youth Serving Youth (YSY) at Edina High School provides student leadership and service activities.

ADULT EDUCATION Edina Center for Adult Education engages adults of all ages with extensive learning opportunities, ranging from cooking, fitness and world language courses, 21st century technology and career exploration, and metro-area field trips and world travel.

VOLUNTEER Edina’s Community Volunteer Program invites community members to share their time, talents, and passion for learning with Edina students. Volunteers work across all schools and programs to offer assistance with basic skills help, homework help, and serve as speakers and resources.

Enriching Lives to Strengthen Community

For more information on resources and services in Edina, contact the Edina Resource Center. All services are free and confidential.

edinaresourcecenter.com RESOURCE LINE: (952) 848-3936

LATE START/EARLY RELEASE INFORMATION Late Starts and Early Releases were introduced during the 2013-14 school year to provide critical collaboration time allowing teachers to better customize the learning experience for each student. Having this additional planning time periodically during the school year allows teachers to provide timely modifications or change instruction in ways that best meet the needs of their students.

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

WHAT TIME DOES SCHOOL START/END?

• Elementary Program - Elementary students can enroll in enrichment programs at their home elementary school for one, two, three or all four of the late start and early release days.

• Late Start means that the student school day begins two hours later than usual • Early Release means the student day will end two hours earlier than usual WILL THERE BE BUSING ON THESE DAYS? District transportation will be adjusted for the two hour late start or early release. That is, on late start days, the bus will arrive two hours after their usual pickup time; on early release days, students will be dropped off two hours earlier than their usual time. After school activity buses will operate as usual.

• Middle School Program - Middle School students can enroll in the CES enrichment program on early release days only. (NOTE: There will be no middle school enrichment program program offered on late start days.) The Middle School program will be held at South View Middle School. Valley View students interested in participating in the program will be bused to South View for the afternoon program. • 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 http://edina.thatscommunityed.com.

HEALTH SERVICES INFORMATION The Edina Public Schools Health Services department is pleased to welcome your kindergartener and you! The mission of Edina Schools Health Services is to promote optimal health for optimal learning. HEALTH SERVICES STAFFING Each elementary school has a health office that is staffed during the day when students are in school. A team of Licensed School Nurses and Health Services Associates work closely with one another and other school staff to support all district students, prevent communicable diseases, and promote healthy learning environments. •

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The Health Services Associate (HSA) is trained in first aid and CPR. The HSA provides basic medical attention, gives medications under the direction of the Licensed School Nurse, assists with vision and hearing screening, and helps track student immunization records. A Licensed School Nurse (LSN) is a Registered Nurse with a Bachelor’s Degree in nursing and certification as a public health nurse. The LSN works with parents, students and teachers to help students participate fully in the school program. Examples of the LSN’s work include setting up health plans for students with chronic health or disabling conditions, performing prescribed medical treatments, and teaching students about healthy behaviors.

As some sites have special programs that require additional health services staff, the following are the staffing assignments for EPS elementary schools: •

Concord, Creek Valley, Highlands and Normandale Each of these elementary schools has a Health Services Associate who provides care during student hours. One LSN serves all four of these schools and consults regularly with the HSAs.

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Cornelia and Countryside Cornelia school has a full time LSN and a part-time HSA; Countryside has a full time LSN.

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 LSN. Please contact your school health office to obtain medication authorization forms.

IMMUNIZATION REQUIREMENTS It is important for parents to understand the immunization requirements for enrollment in Edina Public Schools. Minnesota Statute 121A.15 states “...no person over two months old may be allowed to enroll or remain enrolled in any elementary or secondary school…” without proof that he/she has received the immunizations appropriate for age or that the student should not have shots for medical reasons or because of parent beliefs. For your reference, please see the “Are Your Kids Ready for School?” fact sheet (right) on the Minnesota School Immunization Law. 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. ILLNESS Sick children can spread illness to other students and staff. Your child should not come to school if he/she has had: • a fever of 100 degrees F or more in the past 24 hours; • vomiting or diarrhea in the past 24 hours; or • a skin rash that has not been diagnosed by a health care provider. Call the Absence Line at your child’s school when your child is absent due to illness. Please notify your school 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 emergency card. Students will not be released unless accompanied by a responsible adult. It is an expectation that students will be picked up within one hour of the call to the parent/guardian. FIRST AID/EMERGENCY If a student requires more than basic first aid, 911 will be called and the parent/guardian will be contacted. STAY-IN REQUESTS FOR RECESS The district’s position is that children who are well enough to attend school are well enough to take part in gym and outdoor recess. A request to stay inside will be honored if made by the child’s physician in writing and filed with the school health office. SCREENING Vision and hearing are important to a student’s ability to learn. Health services staff screen students in select grade levels to identify potential vision and hearing difficulties. All kindergarten students are screened for hearing difficulties.

Welcome CLASS OF

2028 The enclosed forms need to be filled out and returned to the school your child will be attending in 2015-16.

ENROLLMENT CHECKLIST:

Please bring completed forms and materials to Kindergarten Registration Day on Thursday, January 29, 2015. ¨ Enrollment Form (3 pages) ¨ Birth Certificate (orginal and copy) ¨ Parent Input Form (2-sided)

ENROLLMENT REQUIREMENT

HEALTH REQUIREMENT CHECKLIST:

All health forms must be submitted prior to the start of school. ¨ Immunization Records (one of the following) • Completed Pupil Immunization Record (see form) that includes the month, day and year of each immunization; or • Copy of immunization records from physician or clinic; or • Pupil Immunization Record signed by a physician that the child should not receive the vaccine OR signed by the parent and notarized that the child has not been immunized as prescribed because of the conscientiously held beliefs of the parents.

¨ Physical Exam (provided and signed by primary care provider) ¨ Health History Form (see page 17) ¨ Special Arrangements (if applicable) • Parents of students with chronic health conditions and special health needs should contact the Health Office staff this spring before school is out to ensure adequate planning and care for fall. This includes students with diabetes, asthma, seizures and severe allergies. • Any student requiring medications at school should contact the Health Services staff this spring to discuss medication policy/procedure requirements. 8

ENROLLMENT FORM OFFICE USE ONLY

Student ID#

SCHOOL # Last Location

Dwelling #

EDINA Public School District #273 — Registration Form 5701 Normandale Road, Edina, MN 55424 ENROLLMENT Phone: 952.848.4585 FAX: 952.848.3937 REQUIREMENT

Student’s Last Name (Legal only)

Student’s First Name (Legal only) Gender

Birth Date Start Date:

GRADE ENTERING - Kindergarten Has your child been through the Early Childhood Developmental Screening?

Does your child receive Special Services or have an Individual Education Plan (IEP)? YES NO

YES

Has your child attended a nursery school, day care center, Montessori or other Pre-K option? YES NO

If yes, where was your child screened? If YOUR CHILD WAS NOT SCREENED IN EDINA, PLEASE ATTACH A COPY OF THE SCREENING REPORT SUMMARY

Res Dist Number of years:__________ Days per week:____________ Hours per day:____________

Proof of legal guardianship is needed if student is living with someone other than the parent.

Family #

Resident District if not Edina

__________________

Name of School or Center:

State Aid Cat

Middle Name

Is this student in foster care? YES

In the definition used for this research, a homeless person is anyone who (1) lacks a fixed, regular, and adequate nighttime residence; and (2) has a primary nighttime residence that is a supervised, publicly- or privately-operated temporary living accommodation, including emergency shelters, transitional housing, and battered women’s shelters; or 3) has a nighttime residence in any place not meant for human habitation, such as under bridges or in cars. This is based on the definition established by the U.S. Congress.

Is this student homeless?

YES

HOME LANGUAGE INFORMATION

Family #

This information is used to determine if your student is eligible for the English Language Learner (ELL) program. In order to help your student learn, your student’s teachers need to determine which language your student uses most.

1. Which language did your child learn first? 2. Which language is most often spoken in your home? 3. Which language does your child usually speak? Do you need an interpreter for conferences, etc.? YES

Trans Code

What language do the student’s parents speak? I certify that the registration information in this packet is correct.

Signature of Legal Parent/Guardian

Bring this completed form to Kindergarten Registration Day on Thursday, January 29, 2015

Date

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ENROLLMENT FORM (PAGE 2) ENROLLMENT REQUIREMENT

Bring this completed form to Kindergarten Registration Day on Thursday, January 29, 2015

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ENROLLMENT FORM (PAGE 3) ENROLLMENT REQUIREMENT

Bring this completed form to Kindergarten Registration Day on Thursday, January 29, 2015

BIRTH CERTIFICATE INFORMATION ENROLLMENT REQUIREMENT

ON KINDERGARTEN REGISTRATION DAY: 1. Please present an original birth certificate with embossed seal to the school that your child will be attending. It will be returned upon presentation. 2. We request that you also bring a copy of the original birth certificate with for the school to keep on file.

A child is not permitted to enter school until an official birth certificate is presented. A hospital certificate cannot be accepted. The following information will help you obtain a certified birth certificate:. • A written request is preferred and all requests must be made by mail, fax or online. • List father’s name, mother’s maiden name, the child’s name, date, and place of birth. • Enclose $26 per certificate and a self-addressed, stamped envelope.

WHERE TO REQUEST YOUR CHILD’S BIRTH CERTIFICATE For all children born in Minnesota, contact: MINNESOTA DEPARTMENT OF HEALTH Central Cashiering – Vital Records P.O. Box 64499 St. Paul, MN 55164-0499 Fax: 651-201-5740 or 651-201-5750 Website: www.health.state.mn.us Make checks payable to: Minnesota Department of Health

For children born in Minneapolis Hospitals or Suburban Hennepin County Hospitals, contact: VITAL RECORDS Hennepin County Government Center 300 South 6th Street, Suite A025 Minneapolis, MN 55487-0026 Phone: 612-348-8240 (use prompts) Fax: 612-348-2010 Website: www.hennepin.us Cost: $26 per certificate Make checks payable to: Hennepin County Treasurer You may also request a birth certificate in person at the Southdale Hennepin County Service Center in Edina (7009 York Avenue South).

Bring this completed form to Kindergarten Registration Day on Thursday, January 29, 2015

PARENT INPUT FORM FOR STUDENT PLACEMENT ENROLLMENT REQUIREMENT

We welcome you and your child to our school! There will be many different kinds of things for our students to do and we hope your child will be interested in the activities from the very first day. Because children have so many different interests, it takes a few weeks for us to get to know each child. This information will help your child’s teacher become better acquainted with your child. Each spring, Edina Public Schools staff work to develop class lists for the coming year, striving to create classes where optimum learning for all students can take place. We value a strong family-school partnership. It is our goal to have balanced classes across each grade level. If you have specific information about your child that should be taken into consideration, please complete this form. We consider many factors as we try to stabilize our classes and accommodate individual needs: • • • • • •

Gender balance Emotional/social combinations Balance of performance levels Special learning needs Teaching/learning styles Behavior factors

Families will receive information on their classroom placement during school open house nights in August.

STUDENT PLACEMENT INFORMATION (Please Print): Child’s Name: _____________________________________________________ Birth Date: _______________________ Parent(s) Name: ___________________________________________________ Phone Number: ___________________ Has your child attended a nursery school, day care center, Montessori or other Pre-K option?

¨Yes

¨No

Name of School/Center: _____________________________________________________________________________ Number of Years: __________________________ Days per week: ____________________ Hours per day: _________

CONTINUES ON NEXT PAGE

Bring this completed form to Kindergarten Registration Day on Thursday, January 29, 2015

PARENT INPUT FORM FOR STUDENT PLACEMENT (PAGE 2) Childâ&#x20AC;&#x2122;s Name: _____________________________________________________ PHYSICAL AND HEALTH FACTORS Consider: vision and hearing, speech, previous major illnesses, etc.

ACADEMIC INTERESTS AND ABILITIES Consider: reading, writing, math, and science

EMOTIONAL AND BEHAVIORAL DEVELOPMENT Consider: social awareness or interpersonal skills, cooperation, leadership, dependability, stability and respect for others.

SPECIAL AND/OR UNIQUE INFORMATION WHICH YOU THINK WOULD HELP US PLAN FOR YOUR CHILD Consider: What does a teacher really need to understand about your child?

Parent Signature: ____________________________________ 16

Bring this completed form to Kindergarten Registration Day on Thursday, January 29, 2015

HEALTH HISTORY This form is a quick overview of identified health conditions. Follow up will occur closer to the start of kindergarten. Please remember to also include a physical examination form provided and signed by your primary care provider.

ENROLLMENT REQUIREMENT

No identified health concerns Identified health concerns ADHD/ADD/Other learning disabilities (describe): Allergies, life threatening (describe): Dairy Nuts Soy Wheat, gluten Food intolerance (describe): Asthma or other breathing problems (describe): Bladder problems/Bowel problems (describe): Diabetes: __ Type 1 __ Type 2 Managed by: __ Diet only __Oral meds __ Insulin injections __ Insulin pump Heart problems (describe): Seizures: Type (describe):

Date of last seizure

Social/Emotional/Behavioral mental health concerns (describe): Anxiety Depression Vision deficit that requires preferential seating (describe): Hearing deficit that requires preferential seating (describe): Other health concerns or restrictions (describe): Surgeries or hospitalizations in the last year (describe):

ENROLLMENT REQUIREMENT

IMMUNIZATION CLINIC

Bloomington Public Health Department Immunizations that are required for entrance into Minnesota schools are available at the Bloomington Health Department. Parents must bring previous immunization records. No immunization will be given without the signature of the parent or guardian. If you have questions in advance of your visit, you may call the clinic at the number below. 1900 West Old Shakopee Road Bloomington, MN 55431 952-563-8900 Clinics are held on the first and third Tuesday of each month from 3 â&#x20AC;&#x201C; 5:30 p.m. Cost: $10 donation per immunization (for those without insurance coverage for immunizations)

Pupil Immunization Record Student Name _________________________________________________ Birthdate _____________________Student Number __________________

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

Minnesota law requires children enrolled in school to be immunized against certain diseases or file a legal medical or conscientious exemption. Parent: Enter the MONTH, DAY, and YEAR for all vaccines your child received, MED for vaccines that are medically contraindicated, or CO for vaccines that are conscientiously opposed. Sign appropriate signature boxes on reverse. MED: Medical contraindication to immunization, history of disease, or laboratory evidence of immunity. CO: Immunizations are contrary to parent or guardian’s conscientiously held beliefs. 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.

Type of Vaccine

DO NOT USE () or ()

1st Dose Mo/Day/Yr

2nd Dose Mo/Day/Yr

3rd Dose Mo/Day/Yr

4th Dose Mo/Day/Yr

5th Dose 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.) Diphtheria, Tetanus, and Pertussis (DTap, DTP) Diphtheria and Tetanus (DT) • for 6-year-olds and younger Tetanus and Diphtheria (Tdap, Td) • for 7-year-olds and older Polio (IPV, OPV) Measles, Mumps, and Rubella (MMR) • minimum age: on or after 1st birthday • required for kindergarten and 7th grade Hepatitis B (hep B) • required for kindergarten and 7th grade Varicella (chickenpox) • minimum age: on or after 1st birthday • vaccine or disease history required for kindergarten and 7th grade

Recommended Meningococcal (MCV, MPSV) Human Papillomavirus (HPV) Hepatitis A (hep A)

Additional exemptions: • Children less than 7 years of age: The 5th dose of DTaP/DTP/DT (similarly, the 4th dose of polio vaccine) is not necessary if the 4th DTaP/DTP/DT (3rd dose of polio) was administered after the 4th birthday. • 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 Td or Tdap booster at age 11 years or later is not required for students in grades 7-12 whose most recent Td was given after their 7th birthday but before their 11th birthday. Instead, it will be required 10 years after the date of the most recent dose. • 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 10 years or older: May receive Tdap to fulfill the Td requirement for students in grades 7-12. • 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

(11/11) #140-0155

BOX 1: Certifying Immunization Status BOX 3A: Medical Exemptions

BOX 2: Consent to Share Immunization Information BOX 3B: Conscientious Exemptions

1. Choose one of the following to indicate student’s immunization status and the source of the information above: A. I certify that this student has received all immunizations required by law. ____________________________________________________________________________________________ Signature of parent/guardian or physician/public clinic Date B. I certify that this student has received at least one dose of vaccine for diphtheria, tetanus, and pertussis (if ageappropriate), polio, hepatitis B (K and 7th), varicella (K and 7th), 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. Parental/Guardian Consent to Share Immunization Information: Your child’s school is asking your permission to share your child’s immunization record with Minnesota’s immunization registry to help us better protect students from disease. 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 record with Minnesota’s immunization registry: ______________________________________________________________________________________________ Signature of parent or legal guardian Date 3. Exemptions to School Immunization Law 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.) Exempted immunization(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 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 parent or legal guardian Date Subscribed and sworn to before me this _______ day of ______________________ 20______ ___________________________________________________________ Signature of notary Developed by the Minnesota Department of Health - Immunization Program www.health.state.mn.us/immunize

(11/11) #140-0155

TRANSITIONING TO KINDERGARTEN “Is my child ready for kindergarten?” Does “ready” mean being able to count to ten, say the alphabet, sit for storytime, or identify colors?” Perhaps! These things could mean that your child is “ready” for kindergarten, but the real question is: Is your child excited, curious and eager to keep learning in a kindergarten classroom? To help you prepare your child to make the transition into kindergarten, we’ve provided some information and resources that could be helpful. The district will also send out a Countdown to Kindergarten eNewsletter starting in January 2015, with helpful tips, advice and activities to help prepare your family for kindergarten. Parents are a child’s first teacher and every child develops at a different pace. In Minnesota, all children who are five years of age on or before Sept. 1 are encouraged to attend kindergarten. If you have concerns or needs for your family or young children and are not eligible for services from other local programs, the Edina Family Center School Readiness program may be for you. School Readiness helps families with children, 3-1/2 to 5 years old, prepare for a successful school experience. For more information, please contact Mary Streier, school readiness coordinator at 952-848-3985 or mary.streier@edinaschools.org.

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

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

EPS SCHOOL BOARD SchoolBoard@edinaschools.org Randy Meyer, Chair Cathy Cella, Vice Chair Regina Neville, Clerk

ELEMENTARY SCHOOLS Concord Elementary (K-5) 5900 Concord Avenue S. Edina, MN 55424 952-848-4300 edinaschools.org/concord

Countryside Elementary (K-5) 5701 Benton Avenue S. Edina, MN 55436 952-848-4700 edinaschools.org/countryside

Highlands Elementary (K-5) 5505 Doncaster Way Edina, MN 55436 952-848-4500 edinaschools.org/highlands

Cornelia Elementary (K-5) 7000 Cornelia Drive Edina, MN 55435 952-848-4600 edinaschools.org/cornelia

Creek Valley Elementary (K-5) 6401 Gleason Road Edina, MN 55439 952-848-3200 edinaschools.org/creekvalley

Normandale Elementary (K-5) French Immersion School 5701 Normandale Road Edina, MN 55424 952-848-4100 edinaschools.org/normandale

SECONDARY SCHOOLS South View Middle School (6-9) 4725 South View Lane Edina, MN 55436 952-848-3700 edinaschools.org/southview

Valley View Middle School (6-9) 6750 Valley View Road Edina, MN 55439 952-848-3500 edinaschools.org/valleyview

Edina High School (10-12) 6754 Valley View Road Edina, MN 55439 952-848-3800 edinaschools.org/edinahigh

Leny Wallen-Friedman, Treasurer Sarah Patzloff, Assistant Treasurer David Goldstein, Assistant Clerk Lisa Oâ&#x20AC;&#x2122;Brien, Assistant Clerk

2015-16 Start/End Times: Elementary Concord 8:30 a.m.-3:05 p.m. Cornelia 9:15 a.m.-3:50 p.m Countryside 9:15 a.m.-3:50 p.m. Creek Valley 9:15 a.m.-3:50 p.m. Highlands 9:15 a.m.-3:50 p.m. Normandale 8:30 a.m.-3:05 p.m. Middle School South View M.S. 7:40 a.m.-2:40 p.m. Valley View M.S. 7:40 a.m.-2:40 p.m. High School Edina H.S. 8:25 a.m.-3:10 p.m. Zero Hour 7:25 a.m.-8:20 a.m.