Enrollment Packet #2

Please ensure that the following items are scanned and emailed directly to our office at:

enrollment@cocalvertacademy.com. Keep in mind these are school-based and CDE requirements for

online schools and programs. They will serve as your final confirmation that it is your intent to enroll

your child at Academy Calvert K-8 Online School for the 2015/16 school year. Upon receipt of these

forms, we will order your child’s curriculum and have it sent directly to the address we have on file.

Please do not sign or date these documents prior to July 1, 2015.

If you have any questions, please do not hesitate to call us at: 719-258-1550

Checklist

1. Enrollment Information form: One page requiring a parent signature and date

2. Agreement of Exclusive Enrollment: One page requiring a parent signature and date

3. Academy Calvert Agreements: One page requiring student name, a parent signature and

date.

4. Affidavit of Colorado Residency: Two pages: completely fill out with the student’s PHYSICAL

address, a parent signature and date. No item on this form may be left blank.

5. ASD20 Appropriate Use of Technology for Students: Four pages requiring student and

parent signature and date.

Please keep your original copies. As soon as Academy Calvert K-8 Online School has a physical address

where we can reliably receive your mail, we will ask you to mail your originals to the school. We

appreciate your patience during this transition.

Warm Regards, Elizabeth Davis Principal

Academy Calvert Student Enrollment Information 2015-2016Instructions

1. Students not enrolled at any D20 school must begin the enrollment process for Academy Calvert in D20 by going tohttp://www.asd20.org/departments/ls/cr/Pages/Enroll.aspx, selecting New Student Registration, and then contacting Central Registry via email at bethine.stephens@asd20.org.

2. Read the online school handbook at http://www.asd20.org/schools/aconline/Pages/default.aspx.

3. Complete all pages of this enrollment confirmation. Email forms to enrollment@cocalvertacademy.com.

Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th

Final grade placement will be determined by the enrollment team, following completion of the placement test. Please note, your child may be placed in different grades for core and math.

Last Name ________________________________ First Name _____________________________________

Middle Name ______________________________ Birthdate ______________________________________

Address __________________________________ City, Zip ______________________________________

Parent/Guardian Name(s) _______________________________________________________________________

Home Phone __________________ Cell Phone ___________________ Work Phone _____________________

Email(s) ______________________________________________________________________________________

Last school attended ________________________________ Grade ___________________________

Last school address ____________________________________________________________________________

Last school phone/fax ______________________________ Email _____________________________________

Student/Family Information Date

Please print or complete this form electronically. The information below should match the legal information as displayed

on all other student forms.

Academy Calvert Grade Level

Student Signature (if above grade 4) Parent Signature

It is my intent to enroll my student at Academy Calvert K-8 Online School for the 2015-2016 academic year.

Date signed

Agreement of Exclusive Enrollment 

Academy Calvert K-8 Online School is a public school receiving public funding. No child in Colorado can be enrolled simultaneously in more than one public program. For this reason, we require that you complete all required withdrawal paperwork from your child’s previous school upon enrollment at Academy Calvert K-8 Online School. 

Your child may not be enrolled in any of these types of public programs: 

Public virtual program.

Traditional brick and mortar public program.

Any publicly funded part‐time home school enrichment program which is offered by manypublic and charter schools.

Any publicly funded elective or ‘specials’ classes offered by another charter or public school.

Any sports programs offered by or through another charter or public school.

IF THE OTHER PROGRAM is funded through local, state or federal tax dollars, please do not enroll your child. If you have any questions regarding this policy, please contact our office prior to completing your enrollment.   

This item is essential as any duplication of programs for a child will be identified by the Department of Education. If there is a discrepancy, we may ask you to withdraw your student from Academy Calvert K-8 Online School in order to eliminate the discrepancy. At that time, all school materials and computers must be returned to Academy Calvert K-8 Online School. 

By signing this document, you agree that it is your intention to only enroll your child in Academy Calvert K-8 Online School and that you will not enroll your child in any other public program.   

_______________________________________   ___________________________ Parent Signature  Date 

_______________________________ 

_______________________________ 

Names of Enrolled Student(s) in 2015‐2016 

______________________________________   

______________________________________   

______________________________________    _______________________________

Academy Calvert K-8 Online School Agreements

By initialing next to each item below, you indicate that you have read them and are willing and able to support and follow the expectations of Academy Calvert.

Student Parent 1.

We have read and agree to follow the procedures andexpectations detailed in the Academy Calverthandbook.

2. We understand that coursework is delivered online andis best accessed by a newer computer capable ofplaying sound and video, recording sound, and isconnected to the Internet with a high-speed connection.

3. We understand that online students need to commit tofull participation in the online program, includingregular attendance and thorough completion of thecourse work.

4. We understand that enrollment means my student(s) isa public school student and is/are not considered ahomeschooler. We may not enroll in any other publicallyfunded program or take classes at another school.

5. We understand that homework is to be completed byassigned deadlines. If work is going to be late, it is theresponsibility of the student to contact the instructor.

6. For all students enrolled, we understand that onlinestudents are required to log on and be in “attendance”on October 1 in addition to regular course attendance asdirected.

7. We understand that email is one of the primarycommunication tools in online learning and should bechecked regularly through the week.

8. We understand that most digital communications maybe kept and archived and that these communicationsoften support and sometimes function as attendancerecords in courses.

9. We understand that inappropriate onlinecommunications or inappropriate use of online toolsmay lead to disciplinary action. Online bullying,harassment, and/or creating content as another personis subject to appropriate consequences.

10. We understand that online students are subject to thedistrict’s discipline policies and procedures and thosepolicies in the school and district handbooks.

11. We understand that all students in grades K-8 are strongly encouraged to participate in district and state-mandated testing.

Student name: _____________________________

Academy Calvert K-8 Online School Agreements, page 2

By initialing next to each item below, you indicate that you have read them and are willing and able to support and follow the expectations of Academy Calvert.

Parent Student 12. We understand that student enrollment status will be

regularly reviewed and continued enrollment will bebased on evidence that the student is doing his/herbest.

13. We understand that Academy Calvert classes are notself-paced and have regular due dates and deadlines,requiring daily work.

14. We understand that students who struggle withassignment and homework completion in-building maynot be a good fit for online classes and will requireregular extra time and attention to coursework.

15. We understand that school sports, club athletics, andrelated activities can be used to count for workouts forPE classes and we will submit a PE grid/signature sheetas proof of participation.

16. We understand that reading proficiency is a strongindicator of potential success in online classes.

17. We understand that students who are not on grade-levelwill be expected to fully participate in appropriateinterventions. This may require extra weekly timecommitments.

18. We understand that Academy Calvert classes aretrimester-based courses and that Academy Calvertdoes not grant incomplete grades for courses; all workmust be completed by the end of term due dates.

Student name: _____________________________

_______________________________________Parent signature

________________Date signed

Online School or Program Written Statement or Affidavit of Colorado Residency  

(Updated 2/17/15) Information: Pursuant to 1 CCR 301‐71, Section 8.06, Rules for the Administration, Certification and Oversight of Colorado Online Programs, an online school or program “must verify and document student residency in the State of Colorado upon enrollment and annually thereafter and retain a copy of the document or written statement offered as verification in the student’s mandatory permanent record.  Colorado residency is determined by the student and Parent or legal guardian currently residing within the State of Colorado boundaries, except for students of military families.”   

Reasonable evidenced of residency may be established by documentation including, but not limited to, any of the following: (1) property tax payment receipts, (2) rent payment receipts, (3) utility service payment receipts, (4) written “Statement of Residency” executed by the student’s parent/guardian, and/or (5) appropriate residency documentation for a member or dependent of a member of the United States Armed Services. 

Written “Statement of Residency” Colorado school districts submitting students for funding during the Student October Count data submission, pursuant to the Rules for the Administration of the Public School Finance Act of 1994, will be subject to audit.  As part of the audit process, online schools or programs must be prepared to provide evidence of Colorado residency for all students submitted for online funding.  In the event the online school or program decides to accept a “Statement of Residency” or “Affidavit of State of Colorado Residency” as evidence of the student’s Colorado residency, the online school or program must ensure that such statement or affidavit contains the following information.  Absence of any of the information listed below will result in funding adjustments during the pupil enrollment count compliance audit for the district submitting the student(s) for funding. 

1. An indication as to the school year in which the statement or affidavit applies.

A new statement or affidavit must be completed annually.2. Name of the person completing the form, and the relationship of that person to the student(s) for whom

the form is being completed.

The statement or affidavit must be completed by a parent/ guardian OR

By the enrolled student ONLY if:o The student is 18 years or older as of the date the statement/affidavit was completed

(as evidenced by the date on statement or affidavit).o The student is without a parent/guardian AND is in a crisis housing situation as defined

by the McKinney‐Vento Act. More information on this Act can be found at:www.cde.state.co.us/dropoutprevention/homeless_index

3. Name of the online school or program.4. A list of all students for whom the statement or affidavit apply.

All students enrolled in an online school or program must have evidence of Colorado residency

In the event a student is NOT included on a statement or affidavit of Colorado residency, butbelongs to a household that does have a statement or affidavit of Colorado residency, thatresidency statement or affidavit will NOT be allowed for the omitted student(s).  A newstatement or affidavit must be obtained for the omitted or excluded student(s).

5. A physical address for the student(s) listed on the statement or affidavit.

The physical address CANNOT be a post office box or general delivery box at a post office.

In the event a student does not have a physical address (such as incidences of homelessness orcrisis housing situations), the general physical location of residency should be included.  Inaddition, the online program and or school MUST contact the district McKinney‐Vento liaison.Please note that incidences of homelessness or crisis housing situations do NOT preclude astudent from enrollment in an online school or program.

6. Signature of the person completing the statement or affidavit.7. The date in which the statement or affidavit was completed.

A new statement or affidavit must be completed annually.

A statement can be completed as early as the start of the enrollment period for the online schoolor program for the given school year.

A statement or affidavit must be dated by the pupil enrollment count day for the given schoolyear.

*An example of a written “Statement” or “Affidavit” of Residency containing the information noted abovefollows. 

Affidavit of State of Colorado Residency 

Pursuant to 1 CCR 301‐71, Rules for the Administration, Certification and Oversight of Colorado Online Programs, the Colorado State Board of Education must ensure that student residency is documented and verified, both upon initial enrollment and annually thereafter, for all students enrolled in online schools and/or programs. Colorado residency is determined by the student and Parent or legal guardian currently residing within the State of Colorado boundaries, except for students of military families that maintain Colorado as their state of legal residence for tax and voter registration purposes.  Reasonable evidence of residency within the State of Colorado boundaries can be established by a written statement of residency pursuant to Section 8.06.4. 

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Please complete all required fields (*) in order to evidence Colorado residency for those students listed below for purposes of residency status for the Colorado Department of Education.  Failure to complete all required fields (*) will result in an invalid/incomplete Affidavit. 

*Name of Person Completing this Affidavit: _______________________________________________

*Relationship to student(s) listed below:__________   Parent __________    Legal Guardian   __________    Self (student 18 years or older)   __________  Self (student without a parent/guardian AND is in a crisis housing situation as 

defined by the McKinney‐Vento Act) 

*Name of Online School/Program: ______________________________________________________

*List all students for whom this affidavit applies:1. ___________________________________________________________________________2. ___________________________________________________________________________3. ___________________________________________________________________________4. ___________________________________________________________________________5. ___________________________________________________________________________6. ___________________________________________________________________________

(If additional students enroll after the completion of this affidavit, a new affidavit must be completed for those students not listed above). 

*Physical address (cannot be a post office box or general delivery at a post office) for all students listedabove: 

____________  _______________ (*Street)  (Apartment #) 

__ (*City)          (County)          (*Zip) 

I do hereby swear and affirm, under penalty of perjury, that the child(ren) listed above and I are currently, and will continue to be, residents of the State of Colorado for the 2015/2016 school year. 

*Signature: _____    *Date:

Policy

IJND E-2 Appropriate Use of Technology Uses for Students

General Information

The Internet and Academy School District 20 local area and wide area networks are available to students

through Academy School District 20 Information Technology (IT) Services, and are used to conduct

research, complete assignments, and communicate and collaborate with others in support of their education.

Information accessed using district equipment or network should reflect the educational mission and goals

of the district. The district supports the use of Internet and electronic communications to improve teaching and learning.

The Internet is a fluid environment which is constantly changing. The district will make every reasonable

effort to ensure that this educational resource is used appropriately and responsibly, and to comply with

CIPA (Children’s Internet Protection Act) and other applicable laws. Staff and students should work together to develop the necessary skills to be successful in the 21st Century.

Student Responsibility

Students are responsible for their own use of district computers and computer systems.

Exercise good judgment.

Do not reply to electronic communications from people you do not know.

Only communicate things electronically that you would say in person.

Accounts and Passwords

Do not use another person’s login or password, even if you have their permission.

Do not tell anyone your password, or allow another individual to use your password.

Do not leave a computer unattended while you are logged in.

If you change your password (middle and high school student only), make sure it is

secure (e.g. don’t write it on your planner).

Student Use and Privileges

The use of ASD20 property and IT Services is a privilege and not a right.

Inappropriate use or vandalism may result in disciplinary measures, including loss of

computer and network privileges, suspension, expulsion, or civil or criminal liability

under applicable laws.

An account may be closed at any time should inappropriate activity occur, or if directed

by school or district administration.

Each student shall comply with federal and state law, district policy and the schools’

code of conduct and the provisions of this acceptable use agreement.

Students should report any inappropriate content or contact, including harassment,

threats, or hate speech to a responsible adult.

No Expectation of Privacy

The district reserves the right to monitor activity on the district network.

All web email must be accessed "in the clear" (with no encryption) except for password

communications.

E-mail and other electronic messages sent or received over the district network andmay be subject to disclosure under the Colorado Open Records Act.

Prohibited Uses Include:

Using district IT Services to publish, access, download, store, review and/or distribute

any content (text, graphic, photo, audio) that contains material which is defamatory,

abusive, obscene, profane, threatening, or sexually explicit ;

Using district technology in any fashion that violates school code of conduct, federal law

(e.g. copyright violations), state law, or district policy;

Using or attempting to use an Internet proxy server (anonymizer) or proxy software;

Using district technology to send unsolicited bulk email;

Performing tests on the district network to identify security faults;

Configuring a computer as an ad hoc wireless access point while it is connected to the

district network in any district facility, or using a standalone device to achieve the same

end (such as a cellular access point);

Possessing or using software without appropriate registration and payment of fees to the

software owner;

Using encryption to cloak network traffic, data files, or email communications within the

district network;

Possessing or using malicious software, hacking software, proxy software, or devices

used for these purposes on district property, including but not limited to: keystroke

capturing software or devices, network discovery and monitoring software or devices,

password recovery software and devices, and software specifically designed to remove

the evidence of user activity from a computer;

Enabling the remote (Internet) access of any computer on the district network through

Internet third parties (gotomyPC., etc.); and Attempting to bypass the internet filter in any way.

Collaborative Technologies

The district supports the use of collaborative technologies such as blogs, wikis and podcasts for

educational purposes. Students are responsible for the content they publish. Personal information

(such as address, phone number, e-mail address, etc.) should never be published. Electronic

spaces are to be considered the same as classroom spaces, and communications conducted there are to be respectful at all times.

These technologies are considered an extension of the classroom and should be used to:

Communicate with other students, parents, community members, or staff members;

Convey information about educational programs; and

Share information electronically.

Any communications posted to these types of collaborative technologies are district communications, and subject to disclosure under the Colorado Open Records Act.

District Makes No Warranties

The district is not responsible for any damages resulting from loss of data, email routing failures, or

service interruptions. Students who use network services provided by the district understand that their

failure to abide by the standards outlined in this agreement could make them subject to disciplinary

action.

STUDENT ACKNOWLEDGEMENT REGARDING USE OF TECHNOLOGY

1. I agree to abide by all terms and conditions. I further understand that violation of these terms and

conditions may result in the loss of the privilege to use these educational tools, school disciplinary action

including suspension or expulsion, legal action, and/or restitution by the user for costs associated with any

damages caused by such violations. I provide my consent for ASD20 to monitor all computer related

activity for user input, content and routing information including, but not limited to; email, web traffic,

and files stored on ASD20 servers and computers.

_____________________ ___________________________ ________________

Student’s signature Printed Name Date (Not required if approved electronically)

2. As the parent or legal guardian of the above student, I have read and reviewed this agreement with my

student.

If the YES box below is checked, I, the parent or legal guardian of the above student, give my express

consent to his/her use these resources and agree to ensure that my child understands and abides by the

terms and conditions of the “Appropriate Use of Technology Resources for Students” statement. I provide

my consent for ASD20 to monitor all computer related activity for user input, content and routing

information including, but not limited to: e-mail, web traffic, and files stored on ASD20 servers and

computers.

If the NO box is checked, I understand that my child will not be able to use school district technology to

accomplish any of the tasks or activities outlined above in the “Proper and Acceptable Use of All

Technology Resources” section.

YES NO Allow your child to access the Internet from D20 schools using D20 computers

Additional Permissions

YES NO Allow D20 to post your child’s photo on district, school, or classroom web

pages.

YES NO Allow D20 to post your child’s name on district, school, or classroom web

pages.

YES NO Allow D20 to post your child’s work on district, school, or classroom web

pages.

YES NO Allow 20TV (ASD20’s student-run TV station) to film your child for

informational stories for their weekly broadcast (appears weekly on

Comcast cable channel 19,and is downloadable from the district website, as

well as iTunes).

YES NO Military Opt-Out

Colorado Legislature made a change to the laws regarding release of student

information to military recruiters. The change in the law and to district policy

requires that we notify students that their name, home phone number, and

mailing address WILL BE RELEASED TO MILITARY RECRUITERS, UNLESS THE

STUDENT SPECIFICALLY REQUESTS THAT THE SCHOOL DOES NOT RELEASE

THIS INFORMATION. If you wish to opt-out of this program, select Yes.

All students, regardless of age, must have this acknowledgement signed by a parent or guardian in order

to access technology resources at school.

________________________ ____________________________ ___________________

Parent/Guardian signature Printed Name Date