2014 SUMMER SERVICES FORMS - Miami-Dade County Public...
Transcript of 2014 SUMMER SERVICES FORMS - Miami-Dade County Public...
APPENDIX D
2014 SUMMER
SERVICES FORMS
ADVANCED ACADEMIC PROGRAMS - DUAL ENROLLMENT Dual Enrollment Authorization Request Form (FM-6477) DIVISION OF SPECIAL EDUCATION - EXTENDED SCHOOL YEAR 2014 Extended School Year (ESY) and Summer Services Information Worksheet 2014 Extended School Year (ESY) Transportation List (FM-7042)
School-Based Extended School Year (ESY) Services Log: 2014 (FM-6574) HUMAN RESOURCES Probationary/Annual Contract Waiver Request for Summer 2014 PAYROLL Application for Short Term Leave Form (FM-5949)
DUAL ENROLLMENTAUTHORIZATION REQUEST FORM
Student Signature Date P arent/Guardian's Signature Date
Counselor's Signature Principal's Signature
Any questions, please call Advanced Academic Programs at (305) 995-1934.
DUAL ENROLLMENT BOOK VOUCHER
To the student: When available. students will be siven a used book. Students are responsible for returning all textbooksissued during each semester of study. Students will be held financially responsible for any textbook(s) not returned to theirhigh school. Textbook alfiliated costs for licensing fees or electronic media access which are password protected and cannot be
returned to the District as its ofthe student.
Representative's Tille DATE
Gold Copy - School
FM-6477 Rev. (08-13)
PLEASE PRINT CLEARLY
Student Name Date of Birth Student ID# Post-Secondarv Institution
M-DCPS #
MDC/FIU #
! FIU
! MDC
TO BE COMPLETED BY STUDENT'S COLTNSELOR
BOOK TITLBCOURSE NAME
TOTAL: $
White Coy - District Ofice; Yellow Copy - Student; Pink Copy College/University;
Pag
e 1 o
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2014 E
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Pag
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SE
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der:
Cur
rent
Sch
ool:
Dat
e:
ES
Y D
urat
ion
Per
iod:
(Sta
rt d
ate
- en
d da
te)
E =
Ent
ered
Exc
= E
xcus
edE
arly
(tim
e)/ =
Tar
dyX
= A
bsen
tP
C =
Par
ent
Con
tact
*IV
S =
No
sery
ices
bas
ed o
nin
divi
dual
ES
Y f
requ
ency
Tot
al#o
f da
ysin
atte
ndan
ce:_
A
bsen
ces:
D
ayso
f w
eekE
SY
serv
ices
sche
dule
d:tr
M
trT
trW
trR
trF
*Par
ent
Gon
tact
Log
(dat
e, p
urpo
se,
resp
onse
):
Atta
ch o
rigin
alto
the
IE
P a
nd p
lace
in t
he c
umul
ativ
e re
cord
.
Pag
e 1
of2
FM
-657
4 R
ev.
(04-
14)
Stu
dent
:
ES
Y P
artic
ipat
ion
Not
es:
2014
tD #
:
Ser
vice
Pro
vide
r:(N
ame)
(T
itle)
ES
Y s
ervi
ces
are
prov
ided
for
the
mai
nten
ance
of
criti
cal l
ife s
kills
as
docu
men
ted
in t
he lE
P.
The
fol
low
ing
is a
sum
mar
y of
the
IEP
goa
ls d
esig
nate
d fo
r E
SY
ser
vice
s; t
he s
tude
nt's
pro
gres
s (s
tatu
s re
port
) on
the
goal
s an
d pr
ogre
ss t
owar
ds m
aint
enan
ce o
f th
e go
als;
and
the
cla
ssro
om a
ctiv
ities
and
par
ticip
atio
n no
tes.
* S
tatu
s R
eoor
t C
odes
:1,
MA
ST
ER
ED
2.
AD
EQ
UA
TE
PR
OG
RE
SS
4. I
NS
UF
FIC
IEN
TP
RO
GR
ES
S
FM
-657
4 R
ev.
(04-
14)
3. S
OM
E P
RO
GR
ES
S
Pag
e2 o
l 2
Sum
mar
y of
the
Spe
cial
ized
Ins
truc
tion,
Sup
plem
enta
ry,
and/
or R
elat
edS
ervi
ces
as d
ocum
ente
d on
the
stu
dent
's lE
P.
Pre
-Sta
tus
Rep
ort
(5/1
4)*
Pos
t-S
tatu
sR
epor
t (8
/14)
*
Act
iviti
csP
artic
ioat
ion
Not
esW
eek
1
Wee
k 2
Wee
k 3
Wee
k 4
Oth
er _
(s
peci
fy)
Office of HumanProbationary/An n ual Contract
Capital ManagementWaiver Request for Sum mer 2014
TO BE COMPLETED BY SUMMER SCHOOL PRINCIPAL
Instructions: Complete the information below for Probationary/Annual Contract teacher you wish to submit a waiverrequest, sign the form, and scan and email form to [email protected] The teacher must hold a valid
teaching certificate and not have any additional summereligibility lockoutflags (i.e., Certification, META,
Professional Standards) to be considered for waiver. The teacher may not be hired for summerem ployment until approvalfrom Office of Human Resources, Recruiting, Performance Managementand Labor Relations.
Name of Teacher: Employee Number:
Summer Waves of Learning Location Number: Name:
Job Gode: Job Title:
I certify that all eligible instructional staff mem bers from the SummerWaves of Learning site and the feeder schools,who are properly certified and/or are on professional service or continuing contract have been offered summeremployment.
Principal Name/Siganture DATE
Office of Human Capital Management
Instructions: Office of Personnel Actions will review Probationary/Annual Contract teacher for any summereligibilitylockout flags and ensure eligible Professional Services and Continuing Teachers at Summer Waves ofLearning site are exhausted for subject area requested.
Lockout Flags: META(circle flags active for teacher)
CERTIFICATION LEAVE
YES
OPS
All eligible Professional Services and Gontinuing Contract Teachersfor Job Title are exhausted from Summer Eligibility Roster? NO
COMMENTS:
Employment and Staffing
Mariaelena Vidal, Employment and Staffing Officer Date
Return to Office of Personnel Actions to remove PROBATIONARY/ANNUAL CONTRACT Lockout Flag.
SCHOOL CONTACTED: Flaq Removed:
FM Temp. Auth; Exp. Date: Aug 31, 2014
SAP PERIOD #
r-T_l
Week AM
THE SCHOOL BOARD OF MIAMI-DADE COUNTY, FLORIDA
APPLICATION FOR SHORT TERM LEAVE
COST CENTER
PAY PERIOD BEGIN DATE
MONTH DAY YEAR
THE SCHOOL BOARD OF MIAMI-DADE COUNW, FLORIDA
APPLICATION FOR SHORT TERM LEAVE
COST CENTER
PAY PERIOD BEGIN DATE
MONTH DAY YEAR
Week 2 AM PMPM
CHECK
*These codes will interface from "legacy" to SAP, and can g!59 be used on
the "Report Miscellaneous Payroll Transactions" input screen.**These codes will not interface from "legacy" to SAP, and can onlv be used on
the "Report Miscellaneous Payroll Transactions" input screen.
COMMENTS:
I certifv that the above information is correct and in accordancewith the School Board of Miami-Dade County, Florida, policies and
regulations.
EMPLOYEE NAME:
EMPLOYEE SIGNATURE:
CHECK
*These codes will interface from "legacy" to SAP, and can qlgg be used on
the "Report Miscellaneous Payroll Transactions" input screen.**These codes will not interface from "legacy" to SAP, and can gly be used on
the "Reoort Miscellaneous Pavroll Transactions" input screen.
COMMENTS:
I certifv that the above information is correct and in accordance
with the School Board of Miami-Dade County, Florida, policies and
regulations.
EMPLOYEE NAME:
EMPLOYEE SIGNATURE:
PERSON lD or PERS ASSIG PERSON ID or PERS ASSIG
SAP PERIOD
t--T_l
Week 2 AM PM Week AM PMFRI
)Al
SUN
MON
TUE
WED
THURS
FRI
SAT
SUN
MON
TUE
WED
THURS
FRI
SAT
SUN
MON
TUE
WED
THURS
FRI
SAT
SUN
MON
TUE
WED
THURS
ONIY ONE (1) WP E OF IEAVE PER FORM:
TYPE OF TEAVE
Reg.
YearSummer10-MOONtY
PfiHrly
Bus Drvrs.& Bus Aides
ONLY
lllness of Self 0200 0230 0203*
lllness/Death of Relative 0201 0237 0204*
Personal 0282 0232 0205'
Injury at Work (Explain) 0285 0285 0207 0207*
Contagious Disease(Contracted at Work)
0286 0286 0208 0208.
Vacation 0283
Temporary Duty(Explai n)
0287 0287 0209*
LWOP, Auth (Explain) 0400 0400 0403*
LWOP, Unauth (Explain) 0401 0401 0404*
OTHER: 0219*
COMPENSATORY TIME 0284 0284
JURY
DUTY/SUBPOENAED
0288 0288 oz70 02 10*
OPT DAY 0289
ELECTED OFFICIAL 0294 0294 02 15*
MILITARY TRAINING 0296 o296 o2r7**
UNION
REPRESENTATIVE
0290 0290 Q211,
UNION OFFICIAL
BUSINESS
0297 o29r 0272**
UNION POOL DAY 0292 0213*'
oNtY oNE (11 rYF 'E OF LEAVE PER FORM:
TYPE OF LEAVE
Reg.
YearSummer10-MOONtY
PltHrly
Bus Drvrs.
& Bus AidesONtY
lllness of Self 0200 0230 0203*
lllness/Death of Relative 0207 0237 0204'
Persona I 0282 o232 0206*
Injury at Work (Explain) 0285 0285 0207 0207*
Contagious Disease(Contracted at Work)
0286 0285 0208 0208*
Vacation 0283
Temporary Duty{Fxnlain}
0287 0287 0209*
LWOP, Auth (Explain) 0400 0400 0403
LWOP, Unauth (Explain) 0407 0401 0404*
OTHER: o2L9*
COMPENSATORY TIME 0284 0284 0500*
JURY
DUTY/SUBPOENAED
0288 0288 0210 0210*
OPT DAY 0289
ELECTED OFFICIAI. 0294 0294 0215**
MILITARY TRAINING 0296 0296 0217**
UNIONREPRESENTATIVE
0290 0290 021 1*
UNION OFFICIAL
BUSINESS
0297 0291 0272*
UNION POOL DAY 0292 oz92 0213*
PRI NCIPAL/ADMI N ISTRATOR SIG NATU RE
FM-s949(05-12)PRI NCI PAL/ADM INISTRATOR SIG NATURE
FM-s949(06-12)