Lumsden Elementary School - Prairie Valley School Division

Administrative Procedure FormAPF-3800.2Student Registration FormPrairie Valley School DivisionPlease complete and leave at the school office.School:Lumsden Elementary SchoolStudent Demographics/InformationLegal Last Name:Birth Date:Legal First Name:Gender:Legal Middle Name:Grade Level:Home Phone #E-Mail:Mailing Address:Physical Address:Previous SchoolLand Location:QS S TR RR M(Quarter Section, Section, Township Road, Range Road, Meridian)Address:Medical InformationDoctor:Phone #Health Care #(Optional)(The HSN can ❑ cannot ❑ be shared with Ministry of Education)Medical Notes:Prairie Valley School DivisionAPF-3800.2 PVSD Student Registration FormPage 1 of 4September 1, 2011

Parent/Guardian InformationParent/Guardian: (Who resides with the student)Mother's Name: Work Phone #Email: Cell Phone #Father's Name: Work Phone #Email: Cell Phone #Parent/Guardian (Who does not reside with the student)Name:Home Phone #Address:Work Phone #Relationship to student: ❑ Father ❑ Mother ❑ GuardianOther Required InformationBillet (in case of emergency): Home Phone #Address: Work Phone #Emergency Contact: Home Phone #Address: Work Phone #Care Giver (if applicable): Home Phone #Address: Work Phone #Bus Route:(Please complete Student Registration Form for School Bus Services if bussing is required and you ore new to the area.)Youngest in this school: ❑ Yes❑ NoSiblings:Prairie Valley School DivisionAPF-3800.2 PVSD Student Registration FormPage 2 of 4September 1, 2011

Ministry of Education InformationBirth Country:Citizenship:Country of Origin:First Language:Second Language:Saskatchewan Resident: ❑ Yes ❑ NoIf you are a person of Aboriginal ancestry and would like this fact to be considered by Prairie Valley School Division,you may voluntarily indicate so by checking the box below.Completion is VOLUNTARY:❑ Person of Aboriginal Ancestry (First Nations, Metis or Inuit).Reserve Residency: ❑ Yes ❑ No (if yes) name of Reserve:Voluntary DeclarationsAboriginal: ❑ Inuit ❑ Antis ❑ Non-Status Indian ❑ Treaty Registered IndianAre there any custody or other legal issues related to this student that the school should be aware of?❑ Yes ❑ No. If yes, please talk to a school administrator.Parent/Guardian Signature:Date:Prairie Valley School DivisionAPF-3800.2 PVSD Student Registration FormPage 3 of 4September 1, 2011

Administrative Procedure FormAPF-3800.3Student Registration for School Bus ServicesPrairie Valley School DivisionPlease fill out the following information if your family will require bussing and you live within the school’sattendance area. If you live outside of the school’s attendance area an Out of Area application (APF-1210.1) willneed to be completed. Please complete and leave at the school office.Legal Student Name:Grade Level:School of Attendance:Parent/Guardian Name________________________________________________________________________________________________________________________________________________________________________Physical Address/Land Location: __________________________________________Mailing Address:__________________________________________Phone Number: (Home)______________ (Cell )______________ (Work)________________Other Information: i.e. allergies, special needs:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Signature of Parent/Guardian __________________________________Date_______________Prairie Valley School Division collects personal information for the purpose of providing education services and is subject to theLocal Authority Freedom of Information and Protection of Privacy Act.Administrative Assistants - Please fax this completed form to 543-1771. (Attention: Transportation)_____________________________________________________________________________________Prairie Valley School DivisionAPF-3800.3 PVSD Student Registration for School Bus ServicesPage 1 of 2September 1, 2011

Central Office Use Only:Start Date of School Bus Service: ____________________________________Bus Driver: _________________________ Route Number: __________Pickup Location: _________________________ Pickup Time: __________(Civic or Legal Land Description)_________________________________Supervisor of Transportation____________________________Date of Approval_____________________________________________________________________________________Prairie Valley School DivisionAPF-3800.3 PVSD Student Registration for School Bus ServicesPage 2 of 2September 1, 2011

Administrative Procedure FormAPF-1400.1Parent/Guardian Permission for Use of Student Work and Personal InformationThe Local Authority Freedom of Information and Protection of Privacy Act (LAFOIP) requires thatschools obtain informed consent for the collection and use of personal information that is notauthorized under The Education Act, 1995. This may include situations within the student’s school,the school division and/or the community.1. Education purposes in the school communityThe school/school division will occasionally wish to share student information or student workspecifically for purposes related to education and the school. The information and purposes forwhich it would be shared may include the following:student’s name, grade level and age, individual photographic or video image, teamphoto, candid or special event photos for the purposes ofo school calendar, newsletter, or other school publicationso honour roll, yearbook, graduation, academic activities and achievement, schoolrelated athletic activities and achievements;student work, such as: art work; writing samples; audio, video or photographicpresentations; individual commentaries or interviews for the purposes ofo educational or promotional useo display student work in the school or division office(s)o display student work at school sponsored events.2. Public media including the InternetThere are times when the school may wish to share information with newspapers, radio andtelevision and other media or publish school-related information in a wider form such as on theschool or school division website accessible via the Internet.** Examples may include the followingtypes of information sharing:images ofo individual student with or without student’s first and last nameo teams or other school groupso school events and activities;announcement of names, grade level and ageo winners of awards, contests, competitionso congratulatory messages for graduation, academic or athletic achievement;student commentaryo media interviews with student upon request to the school/school division.Prairie Valley School DivisionAPF 1400.1 Permission for Use of Student Work and Personal Information and Personal InformationPage 1 of 33/15/10

**Images posted on the web are publicly accessible. Prairie Valley School Division (PVSD) isresponsible for the content of the PVSD website, but is not responsible for what other users maydo with images or content posted on the site.3. Class listsSchools require permission to share student information (including home contact information):with classmates, a home room parent group or School Community Council to assist withorganization of school events;in the event of an emergency situation.**Student lists may be distributed electronically and/or in paper copy to a limited circulation list asnoted.4. Graduate congratulatory messagesSchools may receive requests for graduate lists for congratulatory purposes from:Members of Parliament or Members of the Legislative Assembly.In sharing any information the school and school division will display due diligence with respect toprivacy legislation and parental permissions; being mindful to balance the inherent risks associatedwith posting of information in public or on the Internet, with the interests of students in sharing thepride of their achievements.**Special situations may arise during the school year where a separate form may be utilized forparental consent.Please keep this information page for future reference. For more information contact:Prairie Valley School Division - Privacy Officer/LAFOIP Coordinator - Email: privacy@pvsd.ca;Phone: 306 949-336Prairie Valley School DivisionAPF 1400.1 Permission for Use of Student Work and Personal Information and Personal InformationPage 2 of 33/15/10

Administrative Procedure FormAPF-1400.1Parent/Guardian Permission for Use of Student Work and Personal InformationI agree that the Prairie Valley School Division may use the work produced by my child______________and/or images/commentary of my child with or without my child’s name and forany lawful purpose, including for example such purposes as publicity, illustration, promotion andWeb content without remuneration or payment for the following purposes:(Please check if you agree to provide permission for the following purposes.)□□□□1. For education purposes in the school community2. For the public media including the internet3. Class Lists4. Graduate congratulatory messagesI HAVE READ AND UNDERSTAND THE ABOVE and hereby consent to the collection and useof information as indicated above:_____________________________Parent Name (Print)__________________________Student Name (Print)______________________________Parent Signature____________________DateThis consent shall remain in effect as long as the student is registered with Prairie Valley SchoolDivision and needs to be signed only once.If situations arise that cause you, as a parent, to be concerned about your child’s privacy orsafety, with respect to the potential use(s) of his or her personal information as outlined above,please contact the school principal immediately to make changes to your permissions.Please return this signature page to the school.Prairie Valley School DivisionAPF 1400.1 Permission for Use of Student Work and Personal InformationPage 3 of 33/15/10

taiheSchoolDivisionLeadership in Learning and LifePrairie Valley School Division No. 208P.O. Box 1937 3080 Albert Street North Regina SK S4P-3E1Phone (306) 949-3366 • Fax (306) 543-1771 • Email: Reception@pvsd.caBen Grebinski, Director of EducationJanet Kotylak, Board ChairInformation Technology Acceptable Use Policy (AUP)STUDENT PERMISSION FORMPURPOSEPrairie Valley School Division is committed to the promotion of lifelong learning. As part of thatcommitment, Prairie Valley School Division will provide access to staff and students to thediverse and unique access to the Internet and many different software and hardware options.Disclaimer — The Internet offers access to ideas, information and commentary from around theworld that can be personally, professionally and culturally enriching. However, not all sourceson the Internet are accurate, complete or up-to-date. Prairie Valley School Division does nothave control over, and does not accept responsibility for material in sources on the Internet.Students will remain supervised while using the Internet.GENERAL PRINCIPLESAccess to computer systems and networks owned or operated by Prairie Valley School Divisionimpose certain responsibilities and obligations and is granted subject to Prairie Valley SchoolDivision policies, and provincial and federal laws. Appropriate use always is ethical, reflectsacademic honesty, and shows restraint in the consumption of shared resources. Itdemonstrates respect for intellectual property, ownership of data, system security mechanisms,individual privacy and freedom from intimidation, harassment, and unwarranted annoyance.The intent of the Prairie Valley School Division information systems and the Prairie ValleySchool Division network is to enhance education and research work and to facilitateadministrative processes. All users are to abide by guidelines as set out by Prairie ValleySchool Division.ENFORCEMENTPrairie Valley School Division considers violation of the foregoing principles to be serious, andreserves the right to copy and examine any files or information resident on Prairie Valley SchoolDivision systems allegedly related to this or any other Prairie Valley School Division policy.Offenders will face consequences as set out by the Principals of Prairie Valley Schools up toand including total loss of computer privileges and suspension. Offenders may be prosecutedunder applicable provincial and federal law.IN SUMMARYThe computers at Prairie Valley School Division are to be used for Educational purposes.Students may use computers under the permission, direction, and supervision of a staffmember. Computer and/or Internet privileges may be temporarily or permanently withdrawn forany violation of Prairie Valley School Division's policies and the rules determined by PrairieValley School Division. For more information, visit the Prairie Valley School Division websitewww.pvsd.ca or contact Prairie Valley School Division.Please see reverse.O:\7000 - Business Administration\School Generated Funds\Computer Acceptable Use\STUDENT TECHNOLOGY ACCEPTABLEUSE POLICY PERMISSION FORM.docAdministrator Page 1 15/03/2010

To Be C m gated by Parent or Guardian, have read and understand the aboveInformation Technology Acceptable Use Administrative Procedure given to my child.I agree with the guidelines listed and will ensure that my son/daughter understands theguidelines and the consequences of violating the guidelines.Parent SignatureDate (MR/I/DD/YY)To e Completed by Student, have read and understand the aboveInformation Technology Acceptable Use Administrative Procedure and have gone over it withmy parents.Student SignatureDate (MIVI/DDNY)Please hand in the following sheet to the homeroom teacher.This consent shall remain in effect as long as the student is registered with Prairie Valley SchoolDivision and needs to be signed only once. If situations arise that cause you, as a parent, to beconcerned about your child's privacy or safety, with respect to the potential use(s) of his or herpersonal information as outlined above, please contact the school principal immediately to makechanges to your permissions.If you have any questions or comments, feel free to contact Prairie Valley School Division.Prairie Valley School Division collects personal information for the purpose of providing education services and is subject to theLocal Authority Freedom of Information and Protection of Privacy Act.

Prairie Valley School Division Nov 208P.O. Box 1937 3080 Albert Street North Regina SK S4P 3E1Phone (306) 949-3366 • Fax (306) 543-1771 Email:_Reception@pvsd caSchool DivisionLeadership in Learning and LifeBen Grebinski, Director of EducationJanet Kotylak, Board ChairGUIDELINES FOR STUDENT USE OF TECHNOLOGYEXAMPLES OF UNACCEPTABLE STUDENT USES OF PVSDTECHNOLOGYUnacceptable uses of the computer system include but are not limited to thefollowing:1. Unauthorized release of information:® giving out personal information about another person, including home address andphone number;2. Unauthorized personal use:• personal business or commercial or for-profit purposes;▪ product advertisement or political lobbying including the sending of "junk• mail" or other advertising material;• downloading entertainment software or other files not related to objectives of PVSD ORCLASSROOM TEACHER for transfer to a user's home computer, personal computer, orother media (including freeware, shareware, copyrighted commercial andnoncommercial software, and all other forms of software and files not directly related tothe instructional goals of teachers and PVSD.3. Misuse of Passwords:® revealing a password to any unauthorized person;• attempting to discover another user's password;• allowing use of student's account by an unauthorized party including family and otherhousehold members when work is being done at home;circumventing user authentication or security of any host, network or account;• misrepresenting other users on the network or internet (impersonating others,impersonating others via social networking tools accessed at school or through schooltechnological resources, etc).4. Unauthorized use or modification of equipment or software:• intentionally modifying hardware, software, files, mailbox, web page, other data, orpasswords belonging to other users;• unauthorized installation of any software, including shareware and freeware;• malicious use of the computer system to develop programs that harass other users orinfiltrate a computer or computing system and/or damage the software components of acomputer or computing system;• making unauthorized entry to other computational, information, or communicationsdevices or resources;6 introduction of malicious programs into the network or server (e.g., viruses,worms,Trojan horses, email bombs, etc.);0: \ 7000 - Business Administration\School Generated Funds\Computer Acceptable Use\STUDENT TECHNOLOGY ACCEPTABLEUSE POLICY PERMISSION FORM.docAdministrator Page 3 15/03/2010

© effecting security breaches or disruptions of network communication including but notlimited to accessing data of which the employee is not an intended recipient or logginginto a server or account that the student is not expressly authorized to access, unlessthese duties are within the scope of regular student assignments/duties.5. Orro roper, bjectionable r unethical actlo Sao8 creating or circulating hate mail, chain letters, harassment, discriminatory remarks, andother antisocial behaviours;• any unauthorized access, manipulation or modifications t'. the PVSD website using theservices in a malicious, threatening, or obscene manner;• use of the network to access or process pornographic material, inappropriate text files(as determined by the system administrator or building administrator), or files dangerousto the integrity of the local area network is prohibited;• use of profanity, obscenity, racist terms, or other language that may be offensive toanother user;• sending forged or anonymous email or postings;• any form of harassment, including bullying, via any electronic means or through socialnetworking sites whether through language, frequency, or size of messages;• using PVSD resources for any activities that are offensive or perceived to be offensive toothers.ER transmission of inappropriate jokes or attachments;• °suss of Copyright:• downloading, copying, otherwise duplicating, and/or distributing copyrighted materialswithout the specific written permission of the copyright owner, except when permitted foreducational purposes;ci installation or distribution of products that are not appropriately licensed for use byPVSD.