5th & 6th Bilingual/ESL Summer School Application 2015

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We must be the change we seek in others.
Debemos ser el cambio que buscamos en los demás.
SUMMER ENRICHMENT PROGRAM
For Bilingual and ESL Students in 5th/6th Grade
Date: June 10 – July 2, 2015
Location: Ector Junior High
Any Bilingual or ESL student in 5th/6th grades is eligible to participate in the summer
enrichment program which will help improve his/her reading, writing, math, science, and social
studies skills.
LEARN, LEARN, LEARN
Eligibility
Students eligible to attend the Bilingual/ESL Summer Enrichment Program
at Ector Jr. High include the following:
(a) Students who are served in Bilingual/ESL Programs three years
or less
(b) Bilingual/ESL students who scored Beginner or Intermediate
on the 2014 TELPAS
(b) Students who rated at Level 1, 2, or 3 on LAS Links listening
and speaking.
Attendance
Classes will start at 8:00 a.m. end at 3:30 p.m. June 10th-July 2nd.
It is beneficial and highly recommended for your student to attend these
classes every day from Monday through Friday in order to improve his/her
learning skills in the different core content areas provided.
Breakfast/Lunch/Snacks
Breakfast will be served from 7:30 - 7:55 each
morning. Lunch and snacks will be provided.
Instruction
Instruction will begin at 8:00 a.m. and end at 3:30
p.m.
Monday – Friday. During class time,
bilingual/ESL certified teachers will provide
instruction. Teacher instruction and support will
help students increase their knowledge of the
English Language and enhance the reading, writing,
math, science, and social studies skills to improve
their academic performance next school year.
Enrollment
To enroll your son/daughter in the SUMMER ENRICHMENT PROGRAM
FOR BE/ESL STUDENTS in 5th/6th Grade, fill out the attached application
and return it to the school your son/daughter attends before May 1, 2015.
There will be a Meet the Teacher on June 10th, from 3:45 – 4:45 p.m. at
Ector Junior High for qualified students and their parents.
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Classes will start June 10 , 2015
Monday – Friday 8:00 a.m. - 3:30 p.m.
Classes will end July 2, 2015
Breakfast: 7:30 - 7:55 a.m.
Location
Ector Junior High School
809 W. Clements
Odessa, TX 7973
432-456-0479
SUMMER ENRICHMENT PROGRAM FOR 5th /6th GRADE BILINGUAL/ESL STUDENTS
APPLICATION
STUDENT INFORMATION (to be completed by parent or legal guardian)
Student’s Name: ________________________________________________ I.D. #________________
Teacher: ____________________________________________________________________________
Sex: Male ______
Female ______
Will bus transportation be necessary? Yes________ No_______
Student’s Address: ________________________________________
Zip Code: ____________
Parent/Legal Guardian Name:
________________________________________________________
________________________________________________________
School: _____________________________________________
Grade: _______________________
Was your child in an ESL class this year? Yes______________
No_________________
Telephone Number (Home or Cell): ________________ Father’s Telephone Number (Work):_________
Mother’s Telephone Number (Work):______________________________________________________
In case of emergency please contact:
Name: ___________________________________________________
Telephone Number: ________________________________________
STUDENT HEALTH HISTORY
Please indicate student health conditions: _________________________________________________________________________
Special Treatment __________________________________________ Special Needs_____________________________________
Arthritis___________________________
Fainting_______________________________
Asthma___________________________ Hearing_________________________
Ear Tubes/Date_________________________
Bladder Problem_______________
Past Sugeries/Hospitalizations__________________________________________________________________________________
Blood Disorder/ Anemia__________
Heart Problems___________ Intestinal Problems___________ Hepatitis__________
Other Probelems/Disabilities/Handicaps_________________________________________________________________________
Bronchitis__________ Meningitis____________
Convulsions_________ Diabetes__________
Cancer____________ Nosebleeds_____________ Headaches____________
Insulin dependent ___________
Stomach__________ Scoliosis____________
Eye Problems___________ Treatment___________ Glasses/Contacts___________ Allergies___________
Medication brought to school must be in the original container and prescribed by a physician/dentist. Make a list of all medication
your student takes regularly:
_________________________________
Medicine
Dosage/Time
__________________________________
Medicine
Dosage/Time
_______________________________
Medicine
Dosage/Time
PLEASE CHECK THE APPROPIATE STATEMENT AND SIGN BELOW:
□ In case of accident or sudden illness to the above named student and in the event that I cannot be reached, contact the following
physician for treatment. _________________________________________ Telephone Number____________________________
□ We have no family physician and hereby authorize a representative of the Ector County Independent School District in case of
accident or sudden illness to the above named student, and in case I cannot be reached by telephone, to refer the above named
student to available medical service.
Hospital Preference _________________________________________________________________________________________
SIGNATURE PARENT/GUARDIAN: _________________________________________________________________________
DATE:______________________________________________
CONTACT THE BILINGUAL/ESL OFFICE @ 456-8759 FOR ADDITIONAL INFORMATION
ECTOR COUNTY INDEPENDENT SCHOOL DISTRICT
FIELDTRIP/ACTIVITIES PERMISSION FORM
To:
The Parents of BE/ESL Students in 5th/6th Grade
From:
Summer Enrichment Program for ESL Newcomer Students
Subject:
School Sponsored Fieldtrips/Activities
I give permission for my son/daughter ______________________________ to participate in the fieldtrips/activities
sponsored by the BE/ESL summer program.
I understand if students participate in a fieldtrip, the group will travel by bus. The regular precautions will be taken in
the interest and well-being of the students. However, it is understood that Ector County Independent School District
employees will not be responsible for any accident, damage or illness that might occur.
The expectation for participating in a fieldtrip/activity is that students need to display appropriate behavior at all times
during the trip/activity and wear proper attire for the occasion.
In case of accident or illness I authorize an Ector County ISD representative to refer my son/daughter to medical
service.
________________________________________________________________________________________________
Parent or Legal Guardian Signature
Date
Phone Number: ______________________________
(Home)
__________________________________________
(Work)
Please check the boxes if you give permission for your son/daughter to participate in the following activities:
Yes No
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I give permission to have my son/daughter videotaped for school related activities.
I give permission for audiovisuals to videotape my son/daughter for school related activities.
I give permission to have my son/daughter photographed for school related activities.
I give permission for my son/daughter to participate in any ESL summer program fieldtrips or
activities.
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