100 Academy School of Engineering and Technology 2341Comstock Dr.

North Las Vegas, NV 89032 www.100academyset.org

Phone: (702) 636-2551 Fax: (702) 636-9475

2021-2022 Enrollment Packet

Welcome To 100 Academy School of Engineering and Technology!

A PTAA Charter School

100 Academy SET is a fully accredited, tuition-free public charter school educating students' grades Kinder to 8th grade

The mission of 100 Academy SET is to partner with parents and guardians in the education of their children

by providing a high quality academic foundation that prepares students for lives of leadership, accomplishment and

exemplary character. We searched all over to find the most talented, passionate, student-focused teachers who have a track

record of building strong relationships and classroom cultures while holding students accountable to high expectations.

At 100 Academy SET, we believe that the level at which a student starts academically does not dictate what he or she

ultimately can accomplish. To achieve that process we practice Six Measures of Excellence: 1. Parental Choice, 2. Shared

Values; Include Justice, Integrity, and Fun; 3. High Academic Achievement, 4. Positive Character Development, 5,

Economic Sustainability and 6. School Development.

Enrollment Application:

Complete the following steps for the enrollment process and return to the registration office along with the required

documents listed below:

1. Fill out the Enrollment Application. The applications can be filled out or printed from our website

www.100academy.org or you can pick one up in our office

2. For multiple students, fill out an additional Enrollment Application per child.

3. Once complete, sign, and you are able to submit your packet along with the required documents.

4. Complete Enrollment Registration on the Campus Portal @ http://www.ccsd.net/parents/enrollment/

Required Documents:

1. Original Birth Certificate (copies will not be accepted)2. Current Immunization Records

3. Driver’s License, passport o r picture ID Card (parent or guardian)

4. Copy of Utility Bill (address verification)

5. Report Card, Progress Report, and/or Transcripts

Important:

To be eligible for Kindergarten applicants must be 5 years old by September 30, 2021.

First Grade applicants must be 6 years old by September 30, 2021.

Office Use Only

Packet and Documents Received by ________________________________ Date Time Stamped___________________________

Student Name (last, first, MI): ______________________________________________________Gender: ❑Male ❑Female

Grade Entering: ❑Kindergarten ❑1st Grade ❑2nd Grade ❑3rd Grade ❑4th Grade ❑5th Grade

❑6th Grade ❑7th Grade ❑8th Grade

Registration Information Form 2021-2022

(PLEASE PRINT CLEARLY)

NRS 392.165: STATE LAW REQUIRES ENROLLMENT OF STUDENT BY LEGAL NAME

Student must be enrolled as per birth certificate or other legal document.

FOR SCHOOL USE ONLY

Is the student in the physical custody of a parent or permanent legal guardian? (Unaccompanied Youth) ❏ Yes ❏ No

REQUIRED & SUPPLEMENTAL DOCUMENTS:

ALL STUDENTS: ❏ Proof of Address ❏ Zone Variance ❏ Residential Affidavit

Custodial Papers/Legal Documents: ❏ Yes ❏ No ❏ Pending

NEW STUDENTS: ❏ Birth Certificate ❏ Immunizations ❏ Records Requested

❏ 30 Day Provisional Enrollment ❏ Underage Student Proof ❏ Military Compactfor Title I HOPE of Promotion (K, 1st, & 2nd Grades)

SCHOOL INFORMATION:

Student ID: Homeroom Teacher: Room No:

Attendance Permit Code: Attendance Permit Date:

STUDENT INFORMATION (Must Be Completed and Signed By Parent/Legal Guardian)

Student Last Name: First Name: Middle: Apndg: Gender: Date of Birth:

/ /

Grade:

Residence Address: Zip Code

Has the student ever been enrolled in a CCSD School? ❏ Yes ❏ No

Name of Last School Attended: Address: City: State: Zip Code:

Last School Attended: ❏ CCSD ❏ Public ❏ Private ❏ Charter

Has the student ever received Special Education Services? ❏ Yes ❏ No

Does the student have a current Section 504 Accommodation Plan? ❏ Yes ❏ No

Is student ¼ (25%) American Indian or enrolled in a tribe? ❏ Yes – Tribal Name: ❏ No

Has the student ever been expelled? ❏ Yes ❏ No Has your student been Retained ❏ Yes ❏

NoHOME LANGUAGE SURVEY (Must Be Completed By Parent/Guardian):Enter Language Below:

First language(s) Learned By Student: ❏ English ❏ ASL/Deaf ❏ Other:

Language(s) Spoken By Student With Friends: ❏ English ❏ ASL/Deaf ❏ Other:

Language(s) Used In Home: ❏ English ❏ ASL/Deaf ❏ Other:

Language For School Correspondence: ❏ English ❏ Spanish

PARENT/GUARDIAN INFORMATION

Parent name (Last, First) : ________________________ Phone Number: _________________ Email:_____________________ Resides with: Yes/No

TITLE I HOPE SURVEY:Is the student living in one of the following temporary situations due to economic hardship?

❏ Shelter, Transitional Housing or Awaiting Foster Care ❏ Doubled Up Living With a Friend, Relative, or Someone Else

❏ Unsheltered Living In a Car, Park, RV, or On The Street ❏ Weekly Hotel or Motel

If the student’s living situation does not meet one of the above temporary situations STOP HERE.

If the student is living in one of the above temporary situations, would you like to accept Title I HOPE services? ❏ Yes ❏ No

Parent/Guardian Name:_____________________________________Signature:______________________________Date:_________________________

Parent name (Last, First): ________________________ Phone Number: _________________ Email: _____________________ Resides with: Yes/No

Registration Information Form 2021-2022

I authorize the following individuals to collect my child from the facility in case of an emergency if I cannot be contacted:

Name: ________________________________________________ Relationship_________________________________

Contact Phone Number:__________________________________ Phone Type: ❏ Cell ❏ Home ❏ Work

Name: ________________________________________________ Relationship_________________________________

Contact Phone Number:__________________________________ Phone Type: ❏ Cell ❏ Home ❏ Work

Name: ________________________________________________ Relationship_________________________________

Contact Phone Number:__________________________________ Phone Type: ❏ Cell ❏ Home ❏ Work

Name: ________________________________________________ Relationship_________________________________

Contact Phone Number:__________________________________ Phone Type: ❏ Cell ❏ Home ❏ Work

Name: ________________________________________________ Relationship_________________________________

Contact Phone Number:__________________________________ Phone Type: ❏ Cell ❏ Home ❏ Work

The following person(s) MAY not pick up my child (Any legal documents should be on file in school office) Last Name: _________________________________________ First Name:______________________________________

Last Name: _________________________________________ First Name:______________________________________

Last Name: _________________________________________ First Name:______________________________________

Please indicate how your child should be dismissed after school:

❏ 21st Century

❏ Children’s Learning Adventure

❏ Other (Please Explain) _______________________________________

❏ Walk Home

❏ Picked Up

❏ Pearson Center

❏ Boys & Girls Club

Registration Information Form 2021-2022

Student Name: ____________________________________________________________________________

100 Academy SET' goal is to provide the best possible educational experience for your child. We facilitate

this goal by educating children at their own ability levels. To assist us in the process, please complete the

following information.

As a parent/guardian, what are your expectations of 100 AOE:

________________________________________________________________________________________

________________________________________________________________________________________

_________________________________________________________________________________________

_________________________________________________________________________________________

How did you hear about our school?

❑Direct Mail ❑Newspaper ❑Flyer ❑Internet ❑Passing by ❑Magazine

❑Radio❑97.5 ❑105.7 ❑88.1❑103.9 ❑Word of Mouth Referred by: ________________________________

❑Other ___________________________________________________________________________________________

Records Release

The Student listed below has enrolled in our school. Please send the cumulative academic records, including transcripts, special education, report cards, test data, guidance record, immunization and health records

Last Name__________________ First Name _________________MI ____DOB _______________ ENTERING GRADE_________

Previous School

SCHOOL NAME _________________________________________ GRADE (S) AT THIS SCHOOL _______________________________

ADDRESS ______________________________________________CITY/STATE/ZIP_________________________________________

PHONE NUMBER _______________________________________FAX NUMBER __________________________________________

□ If the student left during the school year, please include marks, credits and grade level at time of leaving.

In the event that my student transfers to a school outside of the Clark County School District, I authorize release of all his/her educational records electronically

through facsimile transmission (FAX) or email. I understand and agree that should the records be inadvertently transmitted to an unauthorized recipient,

through no fault of sender, I hereby waive any claim against the sender and agree to hold the sender harmless from any and all responsibility for damages, if

any, arising from the faulty transmission.

□ I do not authorize release of records through facsimile transmission (FAX) or email.

I understand and agree that this authorization, if granted, may be rescinded at any time by submitting a revised authorization form to the student’s current

school of attendance. The District will maintain the privacy of student

Information requested consists of copies of:

❑ Withdrawal Form ❑ Withdrawal Grades and Date of Withdrawal ❑ Legal Guardianship or Custody Papers

❑ Official Transcript ❑ Testing Data and Results ❑ Current IEP and Psych Evaluation

❑ Immunization Records ❑ Behavior Records ❑ Past IEP Evaluations

❑ Birth Certificate ❑ ELL Testing and Results

Your signature below authorizes the Electronic Transfer of Records for your student’s cumulative academic records.

Printed name of parent/guardian (First, Last) __________________________________________________________________________

Signature of parent/guardian _______________________________________________________Date:____________________________

❑Date of 1st Request _______________ ❑Date of 2nd Request _______________ ❑Date of 3rd Request _______________

100 Academy School of Engineering and Technology 2341Comstock Dr.

North Las Vegas, NV 89032 www.100academyset.org

Phone: (702) 636-2551 Fax: (702) 636-9475

Student Absences and Truancy Policies

Student Absences and Truancy NRS 392.130 provides for, among other items, the following:

1. Excused/Approved Absence - If an emergency exists or if the pupil is physically or mentally unable to attend school,

the parent of the pupil shall notify the teacher or principal of the school within three days after the pupil returns to

school in order for the absence to be considered excused.

2. Unexcused/Unapproved Absence - An absence that has not been approved shall be deemed an unapproved absence.

In the case of an unapproved absence a notice of truancy will be delivered to the parent of the child.

3. A pupil shall be deemed a truant who is absent from school one or more class periods or the equivalent of one or more

class periods without the written approval of his teacher or the principal of the school unless the pupil is mentally or

physically unable to attend school.

Below are the steps to be taken by school administration to notify parents/guardians of their child’s attendance.

1. Parent or Guardian will be sent a letter after three unexcused tardies/absences.

2. Parent or Guardian will be called after four unexcused tardies/absences.

3. A required parent conference request will be made for a meeting with parent/guardian, principal and student after

five unexcused tardies/absences.

4. Any additional unexcused tardy/absences may result in a required parent conference regarding proper placement

for the student child attending his/her home school.

Absences that are unapproved or unexcused are considered truancies. 100 Academy of Excellence will work with parents

and students to identify and remediate the causes of poor attendance.

ARRIVAL: Students are expected to be in attendance every day. Regular school attendance teaches responsibility and

establishes a daily routine for students. It is equally important that students report to school on time. There is no

supervision before 8:30 AM for students who are not enrolled in safekey before school care program. All students

dropped off before 8:30 AM will be placed in safekey and charged the daily rate. In addition, if the problem persists, a

mandatory conference will be scheduled between the parents and school administration.

TARDY POLICY: Tardy Passes will be issued after 9:00 AM. A student that enters a classroom with a late pass is

considered tardy. If a student has a scheduled Doctor’s appointment, the parent is required to present a note from the

physician to the main office upon arrival to be considered excused:

Every three unexcused tardies will equal one unexcused absence.

Upon the 3rd unexcused tardy or absence in one grading period, the parent(s) will be notified via letter.

Upon the 4th unexcused tardy or absence in a grading period, the parent will be contacted via telephone and/or Infinite

Campus. Please see absences and truancy policy below.

Upon the 5th unexcused tardy or absence in a grading period, it will result in a Required Parent Conference (RPC).

Student Absences and Truancy Policies

ABSENCES: Anytime a student returns to school after an absence, a note signed by a parent or guardian MUST be brought

from home the same day the student returns, but no later than three days after the students return to school. Acceptable

excuses for student absences are illness, a death in the family, a school-sponsored event or activity that has been previously

approved or religious holiday.

Students who have excused absences will be permitted to make-up any missed assignments. The student will have (2) days

to make up work for each excused absence. It is the students and parent’s responsibility to make all necessary arrangements

for homework. No late make up homework will be accepted. If the absence is unexcused, the issue will be handled on a

case by case basis.

Illness: The importance of regular attendance cannot be over emphasized, but students should not be sent to school when

they are ill. If a student becomes ill during the school day and it appears that they would be best cared for at home, the

parent will be contacted. The school will not permit students who are sick to remain in school. School personnel must be

notified of any student’s chronic illness (i.e. asthma, diabetes, heart conditions or seizures). This heightens awareness in

case of an emergency.

EARLY DISMISSAL: If your child will need to be dismissed prior to the end of the school day, we ask that you come to

the front office and sign him/her out with a school employee. The office will send for your child. The Front Office doors

will be locked Monday through Friday from 2:30 PM until 3:15 PM for pick-up, students will not be released after 2:30

PM, and 1:00 PM respectively, unless it is an emergency or prior approval has been granted.

Only individuals listed on the EMERGENCY CONTACT FORM will be allowed to pick-up students from the school

during the school day. A valid picture ID will be required of all individuals picking-up students. If someone arrives at

the school to seek the release of a student and the person's name is not on the emergency contact card and the person

does not have valid photo identification, the student will not be released. No student will be dismissed early after

2:30 PM. Additionally, early dismissal after a field trip is not permitted.

DISMISSAL: Parents must pick up students promptly at 3:30 PM Parents should review the school calendar, and the

monthly/weekly bulletins to remain current of any changes. All students who walk home or go to the Pearson Center must

leave the school grounds immediately after dismissal. Parents/guardians must pick-up their children in the parent pick-up

area of the school. Teachers will bring the students to the designated area for pick-up. Students who are not picked-up

by their parents at the designated time will be placed in the after school care program and parents will be charged

the daily rate. If this becomes a serious problem Child Protective Services (CPS) will be contacted.

Parent/Guardian

Signature_________________________________________________________Date:_____/_____/____

Media Release

“Achievers with hope & determination”

At the 100 Academy of Excellence, we want to celebrate your child, his/her work, and his/her

participation in certain programs or events. Accordingly, we are requesting permission for your child’s

image and/or name to be published.

During the school year, staff of our school and media representatives may want to interview,

photograph, or videotape your child for use in publications, television reports, public presentations and

Web sites. The pictures may be of groups of students or individuals, and the students’ names may be

used. For student protection online, a student’s photo and last name will not appear together on school

Web Sites.

Please check the choice below that is most appropriate for your family. Then sign the form and

return it to your child’s school with him/her by (date) .

Your permission will remain in effect for the duration of the child’s attendance at our school. However,

you may change this permission at any time by writing to the principal. Your wishes will be honored

immediately upon receipt of your request.

I give permission for my child to be photographed and interviewed and permission

to have my child’s name used, with only first names used on school Web sites.

I give permission for my child to be photographed but do not want my child’sname used.

I do not want my child photographed or interviewed and do not want his or her name used.

Excellence at the 100 Academy is the belief that academic rigor is expected, possible, and attainable

NEVADA DEPARTMENT OF EDUCATION CODE OF HONOR

There is a clear expectation that all students will perform academic tasks with honor and integrity, with the support of parents, staff, faculty, administration, and the community. The learning process requires students to think, process, organize and create their own ideas. Throughout this process, students gain knowledge, self-respect, and ownership in the work that they do. These qualities provide a solid foundation for life skills, impacting people positively throughout their lives. Cheating and plagiarism violate the fundamental learning process and compromise personal integrity and one’s honor. Students demonstrate academic honesty and integrity by not cheating, plagiarizing or using information unethically in any way.

What is cheating? Cheating or academic dishonesty can take many forms, but always involves the improper taking of information from and/or giving of information to another student, individual, or other source. Examples of cheating can include, but are not limited to:

Taking or copying answers on an examination or any other assignment from another student or other source Giving answers on an examination or any other assignment to another student Copying assignments that are turned in as original work Collaborating on exams, assignments, papers, and/or projects without specific teacher permission Allowing others to do the research or writing for an assigned paper Using unauthorized electronic devices Falsifying data or lab results, including changing grades electronically

What is plagiarism? Plagiarism is a common form of cheating or academic dishonesty in the school setting. It is representing another person’s works or ideas as your own without giving credit to the proper source and submitting it for any purpose. Examples of plagiarism can include, but are not limited to:

Submitting someone else’s work, such as published sources in part or whole, as your own without giving credit to the source Turning in purchased papers or papers from the Internet written by someone else Representing another person’s artistic or scholarly works such as musical compositions, computer programs, photographs, drawings, or paintings as your own Helping others plagiarize by giving them your work

All stakeholders have a responsibility in maintaining academic honesty. Educators must provide the tools and teach the concepts that afford students the knowledge to understand the characteristics of cheating and plagiarism. Parents must support their students in making good decisions relative to completing coursework assignments and taking exams. Students must produce work that is theirs alone, recognizing the importance of thinking for themselves and learning independently, when that is the nature of the assignment. Adhering to the Code of Honor for the purposes of academic honesty promotes an essential skill that goes beyond the school environment. Honesty and integrity are useful and valuable traits impacting one’s life.

Student Signature_________________________________________________Student Number:_________________________

Print Student Name_______________________________________________ Date: __________________________________

Parent/Legal Guardian Signature_____________________________________ Date:__________________________________

Questions or concerns regarding the consequences associated with a violation of the Code of Honor may be directed towards your child’s school administration and/or the school district.

Resources: Cheating policies from Clark and Washoe County School Districts’ secondary schools; Foothill Community College

Revised 4/11

NEVADA DEPARTMENT OF EDUCATION EDUCATIONAL INVOLVEMENT ACCORD

PARENT

AND SCHOOL STAFF

Release Agreement

RELEASE AGREEMENT-ACCEPTABLE USE POLICY (AUP)

Student work, artwork, or projects will be identified by first name, grade, and school only.

Students who do not have parent/guardian permission to use the District's computer network

will be given alternative educational activities. http://ccsd.net/aup

□ Yes, I give permission for my child to access, produce, video conference, and communicate information on the Districtcomputer network resources in accordance with the Acceptable Use Policy

□ No, I do not give permission for my child to access, produce, video conference and communicate information on theDistrict computer network resources in accordance with the Acceptable Use Policy

RELEASE AGREEMENT- DIRECTORY INFORMATION

The term "Directory Information" means one or more of the following: student name, date and place of birth, address, school attended, years of attendance, grade level, photographs (only when used in printed school publications as defined in CCSD Regulation 5125.1), participation in officially recognized activities and sports, weight and height of members of athletic teams, and degrees and awards received. FERPA allows the Clark County School District (CCSD) to release Directory Information with the consent of the parent/guardian. However a parent/guardian has the rights to opt-out of the disclosure.

You are required to provide an answer to all questions listed below:

□ Yes, withhold Directory Information from all outside sources.

□ No, do not withhold Directory Information from all outside sources.

□ Yes, withhold Directory Information from all CCSD school publications such as the ANNUAL YEARBOOK,playbills, honor roll or other recognition lists, graduation programs, printed newsletters, and sports activityprograms/sheets.

□ No, do not withhold Directory Information from all CCSD school publications such as the ANNUALYEARBOOK, playbills, honor roll or other recognition lists, graduation programs, printed newsletters, andsports activity programs/sheets.

Release Agreement / Federal Impact Aid

RELEASE AGREEMENT-MEDIA AND PUBLIC RELEASE

MEDIA AND PUBLIC RELEASE (BEYOND DIRECTORY INFORMATION) At times, the CCSD may seek to release additional personally identifiable student information beyond Directory Information in either print or electronic format to be utilized in either internal or external media sources that may be released to the public. This information may include the student’s electronic (digital) photograph, a description of school activities or achievements that contains personally identifiable information, and/or audio/video/film reproduction of your student. This information may be used in media publications, newspaper articles, television coverage, websites (including CCSD.net), school newsletters (including those in electronic formats), video presentations, and/or school district or public presentations.

Examples of CCSD Owned or Produced materials:

May include school newsletter post on CCSD.net that contains student photographs and school district Power Point or video presentations that include personally identifiable information regarding the student.

Examples of NON-CCSD Owned or Produced material:

May include information produced and broadcast by the news media on television and newspaper articles written and published by the local newspaper.

PLEASE CLICK ON AN OPTION BELOW:

□ I give permission to release information described about my child for use in CCSD Owned/Produced materialand NON CCSD Owned/Produced material. (Yes to both)

□ I give permission to release information described about my child for use in CCSD Owned/Produced material;but, do not give permission in NON CCSD Owned/Produced material. (Yes CCSD/No NON CCSD)

□ I do not give permission to release information described about my child for use in CCSD Owned/Producedmaterial and NON CCSD Owned/Produced material. (No to both)

□ I do not give permission to release information described about my child for use in CCSD Owned/Producedmaterial; but give permission in NON CCSD Owned/Produced material. (No CCSD/Yes NON CCSD)

Federal Impact Aid -Military Connections

Is this parent/guardian a member of the military?

□ Yes, this individual is a member of the military.□ No, this individual is not a member of the military.

Does this parent work on a federally owned property?

□ Yes□ No

I hereby certify that all information provided within the enrollment packet is true and correct.

Parent/Guardian Name (Please Print) _______________________________________________________________________

Parent/Guardian Signature_________________________________________________________Date:_____/_____/____