Amharic Chancellor Enrollment letter.Final work file 2014 ... · ñ½ [ 2014-2015 Õp 0p Á p...

18
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Transcript of Amharic Chancellor Enrollment letter.Final work file 2014 ... · ñ½ [ 2014-2015 Õp 0p Á p...

  • 1200 Firs t Street NE | Washington, DC 20002 | T 202.442.5885 | F 202.442.5026 | www.dcps.dc.go

    (April) 1, 2014

    2014-2015 (DCPS)

    (“Nation’s Report Card”)

    (PWP) $5

    $ 50

    ?

    (April) 1:(May) 1:

    June) 20: 2013-2014

    (Office of StudentEnrollment and School Funding) 202-478-5738

    2014 – 2015

    Kaya Henderson

    Letter to Parents - Enroll Early (Amahric)

  • 1200 Firs t Street, NE | Washington, DC 20002 | T 202.478.5738 | F 202.442.5026 | dcps.dc.gov

    2014-2015 !

    www.dcps.dc.gov/enroll

    www.dcps.dc.gov/enroll

    (Chancellor’s Response Team) 202-478-5738

    _________________________________________ _________________________________________________

    /

    2014-20152014-2015 “ ”

    (required) 2014-2015

    /

    (June) 20, 2014 ( (May)) 1, 2014

    2014-2015

    ( )................................................................................................... 3

    ( ................................................................................... 4

    ( )………………………………………….……………………..……………………….……. 5

    ...................................................................................................................................... 7

    ( )

    ( 7-12 )

    “ ”

    ............................................................................................................. 9

    2014-2015 ...................................................................................................... 10( ...................................................... 12

    ( ..................................................................................... 16Human Papilloma

    Virus (HPV)) ( 6-11 )........................................................................................................ 18HPV ( )...................................................................... 19

    (FARM) ................................................................................... 20................................................................................................... 21

    FERPA ..................................................................................................................................…… 22

    2014-15 Enrollment Packet Check list (Amharic)

  • 2014 - 20152014 – 2015 2014 – 2015 _____________________

    #: ________________

    *(April) 1

    _____________________________________________________________________ _____________________________________* / 18

    STUDENT INFORMATION)1. 2. 3. Middle Name 4. 5.

    6. 7. . 8.

    9. 10. 11.

    12. 13.

    14.

    / /

    ___________ - ___________15.

    __________________________ _______________IEP

    IEP_________________

    504

    16. .. . .

    17. 17b. -

    *

    18. 19.

    .

    *20.

    @ ( )

    21.( ) ( )

    ( ))

    22.)

    23.

    2014-15 Enrollment Form (Amharic)

  • (primary caregivers)2014 – 2015

    October) 5, 2014 10

    (April) 1 (April) 1, 2014)

    parent/guardian/caregiver whose residency documents are submitted at the time of enrollment.

    1)

    1. 5.

    2. 6. D-403. 7.

    4.

    2)1 (2)

    1. 3.

    2. 4. (2

    Student Residency Office 1200 First St.NE, 9th Floor (202) 442-5215

    1200 First Street, NE | Washington, DC 20002 | T 202.478-5738 | F 202.442.5024 | www.dcps.dc.gov

    (1) (2)

    www.dcps.dc.gov/enroll.

    Residency Verification Guideline (Amharic)

  • DCPS Home Language Survey (HLS) FormComplete this Home Language Survey at the Student’s initial enrollment in a DC Public School.This form must be signed and dated by the Parent or Guardian. This form must be kept in the student’s file.

    School: ________________________________________ Student ID #: ___________________________________

    Student’s Last Name: _____________________________ Student’s First Name_____________________________

    English1. Is a language other than English spoken in your home?

    No Yes ___________________________ (specify language)2. Does your child communicate in a language other than English?

    No Yes ___________________________ (specify language)3. What is your relationship to the child?

    Father Mother Guardian Other (specify)___________

    If the answer to question 1 or 2 is “Yes”, the law requires your child’s English languageproficiency to be assessed.

    Español (Spanish)1. ¿Se habla otro idioma que no sea el inglés en su casa?

    No Sí _________________________(idioma)2. ¿Habla el estudiante un idioma que no sea el inglés?

    No Sí ________________________(idioma)3. ¿Cuál es su relación con el estudiante?

    Padre Madre Guardián Otro (especifique)_________

    Si la respuesta a la pregunta 1 ó 2 es “ Sí “, la ley requiere que se evalúela fluidez de su hijo/a en el idioma inglés.

    Français (French)1. Parlez vous une langue autre que l'anglais à la maison ?

    Non Oui ______________________ (spécifiez la langue)2. Votre enfant communique t il dans une langue autre que l'anglais ?

    Non Oui ______________________ (spécifiez la langue)3. Quel est votre relation avec l'enfant ?

    Père Mère Tuteur Autre (spécifiez) __________

    Si la réponse à la question 1 ou 2 est “ Oui “ , la loi exige que lescompétences de votre enfant en anglais soit évaluées.

    (Chinese) 1.

    _________________________ ( )

    2. ________________________ ( )

    3.

    ( ) ____________

    Ti ng Vi t (Vietnamese) 1 Có ngôn ng nào khác ngoài ti ng Anh c nói nhà quý v không? Không Có __________________________ (xin ghi rõ ngôn ng nào) 2 Con em quý v có nói m t ngôn ng nào khác ngoài ti ng Anh không? Không Có __________________________ (xin ghi rõ ngôn ng nào) 3. Xin cho bi t liên h c a quý v v i con em? Cha M Giám h Liên h khác (xin ghi rõ) ________________________________________________________

    N u tr l i c a câu h i 1 ho c 2 là “ Có ”, lu t l òi h i con em quý v ph i

    c th m nh trình thông th o Anh ng .

    (Amharic)

    1. ? __________________________ ( )

    2. ? __________________________ ( )

    3. ? ___________ ( )

    1 2 ”

    School Official’s Comments:

    ___________________________________________________ __________________________________________________School Official Signature Date Parent/Guardian Signature Date

    REGISTRAR PROCESS:

    If a parent/guardian does not speak English and yourschool does not have staff that speaks theparent/guardian’s language, please use the LanguageLine for communication.

    If the HLS indicates a language other than English isspoken in the home, give the family the Referral Letterand refer the family to the Intake Center forassessment and orientation.

  • 1200 First Street, NE | Washi

    /

    /

    _____________________________________ ___________________________________________[ ]

    __________________ ______________________________________________

    ___________________________________________________________________________________________________

    7–12

    _____

    _____ 18

    _______________________________________

    __________________________________________

    http://dcps.dc.gov/DCPS/About+DCPS/Human+Resources/Notice+of+Non

    1200 First Street, NE | Washington, DC 20002 | T 202.478-5738 | F 202.442.5024 | www.dcps.dc.gov

    /

    (DCPS)

    (DCPS)

    ( ).

    _____________________________________ ___________________________________________

    ______________________________________________

    ___________________________________________________________________________________________________

    LEA)

    30

    __________ _____________________

    __________________________________________ _______________________

    CPS/About+DCPS/Human+Resources/Notice+of+Non-Discrimination

    Consent & Release for Student to be filmed/photographed/intervi

    | www.dcps.dc.gov

    /

    (DCPS)

    .

    _____________________________________ ___________________________________________

    ____________________

    ___________________________________________________________________________________________________

    _____________________________________________

    __________________________________________

    Consent & Release for Student to be filmed/photographed/interviewd & Use of Image/Voice (Amharic)

  • 1200 First Street, NE | Washington, DC 20002 | T 202.478.5738 | F 202.442.5024 | www.dcps.dc.gov

    2014-2015

    -12PK3 -12th)) 365

    365

    ( ?http://dhcf.dc.gov/service/dc-healthy-families)

    (12

    (PK3-12)10 DC Department of Health Immunization

    Division) 202-576-9325

    PK3 -12th))(

    http://www.insurekidsnow.gov/state/dc/district_oral.html)

    ? 1-866-758-6807 http://dhcf.dc.gov/service/dc-healthy-families)

    HPVHPV

    (2 )

    6-11 6-11 HPVHPV

    www.dcps.dc.gov

    http://tinyurl.com/qhibhms.

    anaphylaxis)http://tinyurl.com/qzisu6t

    http://tinyurl.com/kwf8386. anaphyla-xis)

    medication actionplan)

    Diana Bruce [email protected].

    2014-15 School Health Checklist (Amharic)

  • 2

    (Preschool)Head Start

    4 (Diphtheria/Tetanus ( )/Pertussis (DTaP)

    3 (Polio)1 Varicella, (chickenpox )) –

    2

    1 Measles ( ), Mumps ( ) Rubella (MMR))3 (Hepatitis) B2 (Hepatitis) A3 4 Hib (Haemophilus Influenza ( ) Type B 34 (PCV (Pneumococcal))

    4

    (Pre-Kindergarten)

    5 (Diphtheria/Tetanus ( )/Pertussis (DTaP)

    4 (Polio)2 Varicella, (chickenpox )) –

    2

    2 Measles ( ), Mumps ( ) Rubella (MMR)3 (Hepatitis) B2 (Hepatitis) A3 4 Hib (Haemophilus Influenza ( ) Type B 34 (PCV (Pneumococcal))

    5 (Diphtheria/Tetanus ( )/Pertussis (DTaP)

    1

    2014 – 2015/

    /

    ONECITY

    (Amharic)

    5 – 10

    11

    12

    /Pertussis (DTaP)

    4 (Polio)2 Varicella, (chickenpox )) –

    2

    2 Measles ( ), Mumps ( ) Rubella (MMR)3 (Hepatitis) B2 (Hepatitis) A ( 01/01/05 )

    5 (Diphtheria/Tetanus ( )/Pertussis (DTaP)

    1 Tdap (if five years since last dose of DTP/DTaP/Td)4 (Polio)2 Varicella, (chickenpox )) –

    2

    2 Measles ( ), Mumps ( ) Rubella (MMR))3 (Hepatitis) B1 Meningococcal3 Human Papillomavirus (HPV) – 6-11

    www.doh.dc.gov

    1

    2 Varicella/chickenpox ( ) (MD, NP, PA, RN) /

    3

    Rev 02-14

  • www.doh.dc.gov

    February) 24, 2009 (DCUHC)

    Child Care) (Head Start) parochial schools) .

    EPSDT DCUHC 21

    the American Academy of Pediatrics (AAP))

    1974 (FERPA)1996 Health Insurance Portability and Accountability Act of 1996 (HIPAA))

    1:

    “other” (“ ”)

    “none”( 5

    2:

    AAP

    WT: (LBS) (KG); HT: (IN) (CM).

    BP:

    2 A

    Body Mass Index (BMI)) 2 BMI

    HGB/HCT:Hemoglobin (HGB) Hematocrit (HCT) Head Start AAP

    (anemia) HGB, HCT

    “ “ ”

    (Rx)

    “ ”‘ ”

    “ ” – 12

    “ ”

    :

    “NONE” (

    :

    “NONE” (

    :

    NONE”

    2 : Section C

    .

    3:

    (TB) AAP Tuberculin 2006 AAP RED BOOK, 27th Ed., 682.TST ( child care)

    TST (negative ( positive (

    .TST positive( X-Ray ( (CXR) TSTs

    DCT.B ( 202-698-4040

    6 14 22 26 26

    6

    “Pending” )

    DCChildhood Lead Poisoning Prevention Program. 202 -654-6036/6037202-481-3770

    4

    “Yes” ( “No” (

    AAP Physical

    Evaluation 2ndEd. (1997; AAP and EPSDT “No”

    (

    5

    DC Universal Health Certificate Instructions (Amharic)

  • 6

    1: –

    D.C. Law 3-20, Immunization of School Students Act of 1979” DCMRTitle 22, 1( May) 2, 2008

    “ ”

    21,2

    //

    (DtaP/DTP

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    1, 1,2

    //

    (DtaP/DTP

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    28

    2 (Exemptions) 2)

    Blood titers) 3)

    3DTP/DTaP: (5) DTP/DTaP 4 4

    DTP/DTaP 4 5 6

    4Td/Tdap: 7 (3) Td 11 tetanus), diphtheriapertussis (Tdap) tetanus) diphtheria Tdap

    Td 10

    5Tdap: DTP/DTaP Tdap (1) 4 5

    6 Polio) 4 IPV OPV 3

    4 IPV/OPV

    18 Polio)

    7HIB: Hib 12

    (1) 15 5

    8MMR: 4

    MMR Varicella 28

    9Varicella: 4 12

    12 3 13 2

    Varicella (chicken pox)

    10 Hepatitis B) monovalent hepatitis B DTaP-IPV-Hepatitis B, hepatitis B

    24 8 monovalent hepatitis B 16

    2 3 11-15 2 hepatitis B (Recombivax) 2 8

    11Hepatitis A: (January) 1, 2005

    12Pneumococcal: pneumococcal

    24 59 1 5

    13Meningococcal: 11

    14HPV: papillomavirus (HPV) HPV

    “ ”

    2 D.C. Law 3-20& ACIP

    3 blood titer)

  • (DISTRICTOFCOLUMBIAUNIVERSAL HEALTHCERTIFICATE)

    1: 1 5/ :

    ( .)

    (PCP):

    2: (Recommendations):(>3 yrs) `

    x (>2 yrs) (BMI)%

    HGB / HCT( Head Start )

    20/ 20/ ______________________ ____________________

    :

    Under Rx) (Under Rx)

    (Under Rx/

    (Under Rx)

    (Under Rx) (Under Rx)( 3 )

    .

    .

    ___________________________________________________________________________________

    . (OTC)(

    3:TB) - *

    Tuberculin Skin Test(TST) :

    TSTCXRCXR PCP

    202-698-4040

    *1 (LEAD TEST DATE:) 202-481-3770

    4:

    ___________________________________________________________________________________________

    MD/NP

    5:

    DC Universal Health Certificate (Amharic)

  • (DISTRICT OF COLUMBIA UNIVERSAL HEALTH CERTIFICATE)

    / / ____/_____/________/ /Middle

    1:

    ( )

    Diphtheria,Tetanus, ( Pertussis (DTP,DTaP)

    1 2 3 4 5

    DT (7 yrs.)1 2 3 4 5

    Tdap Booster)1

    Haemophilus influenza ( ) Type b (Hib )1 2 3 4

    (Hepatitis B) (HepB)1 2 3 4

    Polio (IPV, OPV))1 2 3 4

    Measles, Mumps, Rubella) (MMR)1 2

    (Measles)1 2

    (Mumps)1 2

    (Rubella)1 2

    (Varicella) 1 2

    ( )

    (Pneumococcal Conjugate)1 2 3 4

    A (HepA) ( 01/01/2005 )1 2

    Meningococcal1

    Human Papillomavirus (HPV)1 2 3

    ( ) (Influenza) (Recommended)1 2 3 4 5 6 7

    Rotavirus) (Recommended)1 2 3

    2:

    ( )

    Diphtheria) (__) (__) Pertussis): (__) Hib: (__) HepB: (__) (__) (Measles): (__) (Mumps): (__)

    (Rubella): (__) (Varicella): (__) Pneumococcal): (__) HepA: (_J) (Meningococcal:) (__) HPV: (__)

    ( ) ( ) ____/____/____.

    3:

    (

    (Diphtheria) (__) (__) (Pertussis): (__) (Hib) (__) HepB: (__) (__) Measles): (__) Mumps): (__)

    (Rubella (__) (Varicella): (__) (Pneumococcal): ( _) HepA: (__) (Meningococcal:) (__) HPV: (__)

    ___________________________________________ _____________________________________ ______________________

  • ( ) (District of Columbia Oral Health (Dental Provider) Assessment Form) (Amharic)

    / 1:

    “ ” 2:

    / /

    ONE CI TY

    1: ( / ) (Last Name): (Middle Name): / / :

    0 0 /

    / 1: 1: 0 0 0

    / 2: 2: 0 0 0

    : :

    : 0 - 0 - 0 0 0 ( ) (Primary Care Provider (Medical): /

    :

    0 0 0 0 2: / /

    /

    / /

    3: 4

    3: ( )

    Gingival inflammation ( ) (Y) , (N)

    Plaque and/or calculus ( / ) (Y) , (N)

    Abnormal gingival attachments ( (Y) , (N)

    (Malocclusion) (Y) , (N)

    Treated Dental Caries ( ) (Y) , (N)

    Untreated dental caries ( ) (Y) , (N)

    0

    Sealants on permanent molars ( ) (Y) , (N)

    Cleft lip and palate ( ) (Y) , (N)

    Preventative services completed ( ) (Y) , (N)

    ?

    0 Prophy 0 Fluoride 0 Oral Hygiene

    4: / 0 0 0 0 0 0

    0 0 0

    DDS/DMD :

    : :

    ((District of Columbia Health Certificate): Head Star ( ) (version) (AAPD) AAPD 6 3

    (Portability) 1996 (Act of 1996 (HIPAA)) ( Family Education Rights and Privacy Act (FERPA))

  • HUMAN PAPILLOMAVIRUS

    (Genital) human papillomavirus (HPV)100 HPV

    HPV (cervical cancer)

    (upper respiratory tract) (warts) HPV

    20 6 HPV50%

    HPV 12,000

    4,000

    HPV70%

    90% (genital warts) HPVHPV (genital warts) (cervical cancer)

    (cervical cancer)

    HPV 11-12 9HPV

    HPV

    HPV HPV

    HPVvulvar cancer)

    (genital warts) (anal cancer)

    13-26 13-2126

    HPV

    1

    2 1

    3 1

    yeast

    D.C.

    Department of Health Immunization Program (202) 576-9342 the Centers for

    Disease Control and Prevention (CDC) 1-800-CDC-INFO (1-800-232-4636)

    Updated January 2014 (SY 2014-15)

  • GOVERNMENT OF THE DISTRICT OF COLUMBIA

    Department of Health)

    Human Papillomavirus (HPV)

    1:

    2: (18 HPV

    1:

    2009 17-10 (D.C. Law 17-10 (Human Papillomavirus Vaccinations and Reporting Act of2007) 6 11

    1. Human Papillomavirus (HPV)

    2. HPV

    2:

    Human Papillomavirus (HPV)

    (to preteen) HPV(cervical cancer) (genital warts)

    human papillomavirus` HPV HPV(genital warts)

    HPV

    ______________________________________________________ ____________________________

    ( > 18

    _______________________________________________________

    (> 18

    Updated January 2014 (SY 2014-15)

    HPV Vaccination Opt-Out Certificate (Amharic)

  • 1200 Firs t Street, NE | Washington, DC 20002 | T 202.478.5738 | F 202.442.5024 | www.dcps.dc.gov

    Office of Food and Nutrition

    Services (OFNS) (Amharic)

    (FARM)2014-15

    75

    (Community Eligibility Provision (CEP)) CEP

    2014-15 FARM CEP

    FARM

    FARM

    2014-15 FARM June) 2014 (July) 1, 2014CEP

    (July) 1, 2014

    1. ( CEP

    2. e-form

    3.

    Office of Food and Nutrition Services 1200 First St. NE, 11thFloor, Washington, DC

    20002

    2013-14 (Sept.) 30, 2014

    (Oct.) 1, 2014 CEP

    Allergies) (Dietary Accommodations)

    (“Students with Special Dietary Needs Form”)

    1. ( (lactose)

    2.

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    (Office of Food and Nutrition Services)

    (“Reli-

    gious/Philosophical Dietary Accommodations Application”) dcps.dc.gov/DCPS/Beyond+

    the+Classroom/Food+Services/Food+Accommodations

    (Office of Food and

    Nutrition Services) [email protected], (202) 442-5112, dcps.dc.gov/DCPS/Beyond+

    the+Classroom/Food+Services

  • 1200 First Street , NE | Washington, DC 20002 | T 202.478.5738 | F 202.442.5024 | www.dcps.dc.gov

    Office of Food and NutritionServices (OFNS)

    2014-2015(Students with Special Dietary Needs Form

    School Year)

    (IEP)(IEP)

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    (disability) ?

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    __________________________________ __________________________

    __________________________________ __________________________

    (Office of Food & Nutrition Services)

    (Amharic)

  • Notification of Rights Under FERPA (Amharic)

    FERPA(The Family Educational Rights and Privacy Act (FERPA)) 18

    (1) (DCPS) 45

    (2) FERPA

    (3) FERPA

    FERPA

    (thera-

    pist) )

    (4)

    “ ” (“directory information”) FERPA

    (i) www.dcps.dc.gov/enroll

    “Release of Student Directory Information”

    1200 First St. NE, 12th Floor, Washington, DC 20002

    Office of Data and Accountability (ii) 30

    (5) FERPAFERPA Family Policy Compliance Office, U.S. Department of Education, 400Maryland Ave. SW, Washington, DC 20202

    1200 First Street, NE | Washington, DC 20002 | T 202.478-5738 | F 202.442.5024 | www.dcps.dc.gov