Family Handbook John Adams Elementary School
Transcription
Family Handbook John Adams Elementary School
John Adams Elementary School 1450 Redmond St. North Brunswick, NJ 08902 Telephone (732)-289-3100 Fax (732)-249-4521 Family Handbook Frederick D. Johnson, Ed. D Principal Susan Stern Director of Elementary Instruction 2013-2014 Welcome to the 2013-2014 school year! September 2013 Dear John Adams’ Families, Welcome to John Adams. This handbook was prepared for you and your child to provide information regarding activities, school policies and procedures. A yearly calendar of school holidays and scheduled events can be found in the 2013-2014 District calendar. Also, please check the district and John Adams’ web site for updated information throughout the school year (www.nbtschools.org). Please read and discuss the contents of this handbook with your child. All students are expected to know and follow the rules and regulations described within the handbook. Your child’s teacher will send home a separate sign-off sheet documenting your review of this handbook. Please sign and return by Friday, September 20th. We look forward to building a home-school partnership to create a nurturing environment for the children. Please do not hesitate to call the office if you require any additional information. John Adams Bell Schedule K-5 Regular Day K-5 1:30 Closing K-5 Delayed Opening K-5 Doors Open 8:35 8:35 10:05 Late Bell 8:55 8:55 10:25 Dismissal 3:30 1:30 3:30 Pre-K Pre-K AM 1:30 Closing Delayed Opening Arrival 8:55 8:55 No AM Pre-K classes Dismissal 11:25 10:50 Pre-K PM 1:30 Closing Delayed Opening 12:30 11:35 12:30 3:00 1:30 3:00 John Adams School Family Handbook Topics ACADEMIC SUPPORT Academic Support teachers provide support in Language Arts and Mathematics to students on an as needed basis. ANIMALS/PETS Animals are not to be kept in the classroom without permission from the principal. Consideration must be given to health and safety issues. Parents may bring in animals to show the class providing that the parent obtains permission at least one day in advance and the parent remains with the animal at all times. ARRIVAL PROCEDURES Students should not arrive at school prior to 8:35 a.m. There is no adult supervision before that time and students will not be allowed in the building (unless they are enrolled in the morning LEAL program or part of a before-school activity). Students arriving by car should be dropped off at the Student Drop Off Zone. No student should be dropped off in the parking lot. Students will report directly to their classrooms. Buses: Buses will transport students to and from the school. Students will exit the bus and walk to their classroom. ● Please insure that your child knows his/her bus route number. ● All students must behave appropriately while waiting for the bus at their designated bus stop, while riding the bus, and while leaving the bus. Infractions of accepted behavior will be reported to parents and may result in suspension of bus privileges. ● Any difficulty involving buses should be referred to the district transportation director, Mr. Ray Kuehner, at the Board of Education office (732-289-3000 ext. 3034). ● No one should walk between the buses. Tardiness: ● A student is considered tardy if arrival to the classroom is after 8:55 a.m. ● A student who arrives late to school must report to the security aide in the front lobby where his/her time of arrival will be recorded and a late pass will be issued. It is the parent’s responsibility to accompany a tardy student into the school and sign the student in. Continued tardiness on the part of any student will be viewed as a serious matter. Frequent tardiness may result in reporting to the district attendance officer. Legal action will be instituted in cases of excessive tardiness. ART Formal art classes are scheduled once per week for all students, K-5. Other art activities are integrated within the core curriculum content areas. You may receive a request for a smock or an old shirt for your child to protect clothing during art class. ASSEMBLY AND SCHOOL PROGRAMS Our PTO and community organizations provide a number of assembly programs throughout the year. Classes will be invited to those programs that are appropriate to each grade level. Information on other whole school programs will be sent home with students or found in the district calendar. ASSIST PROGRAM A before school program is offered for students who are identified by the teachers as needing remediation. ATTENDANCE School hours: 8:55 a.m.-3:30 p.m. Each student is required to attend school regularly and to arrive on time. Excessive absences and tardiness will be noted and sent to the Superintendent of Schools. Regular, on-time attendance is an essential part of academic success. State school attendance laws require that students attend whenever school is in session, unless the child is personally ill. Excessive absences will be dealt with through the office. Other excused absences are for religious holidays or for a death of a child’s family member. Family vacations are not considered excused absences. Parents are requested to schedule vacations in accordance with our school calendar. If a trip is planned during school totaling more than 10 school days the parent must complete a withdrawal form, found in the school office. After 10 days, the student will be taken off the school register. Upon returning, the parent must make an appointment to register the child again as a new student in North Brunswick. A place in the class or the school is not guaranteed. No homework will be assigned or given during the unexcused absence. (see: Vacations) Absence: ● The school operates a Student Absence Calling system. Parents are responsible for calling the school at 732-289-3100, option 1 to leave a message. ● If we do not hear from the parent or guardian, we will contact you. The school nurse may also make a family contact when a child has been absent for three consecutive days and the school has not been notified. Delayed Openings/Emergency Closings: ● Emergency closings due to inclement weather will be announced between 6:30 and 8:30 a.m. on local radio stations (WCTC 1450 AM and WMGQ 98.3 FM) as well as via the District’s phone/email notification system. Information will also be available on the School and District websites: (www.nbtschools.org). ● In the event of an emergency early dismissal these same sites will also make announcements. It is extremely important that you keep us informed of current home or emergency phone numbers for all children. In addition, children should know what contingency plan is in place in the event that their parent cannot be reached. Transfers: ● If you transfer your child to another school district, please notify the office at least one week in advance. You will need to provide your new home address and the name of the new school and school address, so the appropriate papers can be prepared for you in a timely manner. Truancy: ● Any unauthorized absence from school shall be considered truancy. All truancies will be reported to the district attendance officer for review and possible legal action. BICYCLES Students in grades 3-5 are permitted to ride their bicycles to school, only if the parent/guardian has signed the appropriate permission form, which will be kept on file in school. Bike riders must walk their bicycles on school grounds and must secure them in the bike rack with a bicycle lock. The school cannot accept liability for damaged or stolen bikes. Also, please note that New Jersey state law requires helmets for our students. BIRTHDAYS We acknowledge each child’s birthday with a birthday pencil. Before sending treats in for the class, please check with the teacher. Treats will be limited to ONE per student. Because there are so many students at John Adams with allergies and special dietary needs, edible treats must be commercially packaged with clear and visible ingredient labels. Items with peanuts or nut products will not be allowed. Likewise, Dunkin’ Donuts products are not permitted because they are processed in an environment that has the potential for cross contamination with nuts. Do not send drinks, favors, cake, ice cream, party hats, etc. Invitations to home birthday celebrations may not be distributed during the school day except when every child in the class is invited. Do not bring in candles since we CAN NOT light them in school. BOOK BAGS Please provide a book bag for your child to carry his school materials. Rolling book bags are not permitted. These have caused a safety problem in our hallways and on buses. BREAKFAST A simple breakfast is available to all students through our food service. It is delivered to homerooms in the morning and is eaten in the homeroom at the beginning of the school day. Breakfast must be preordered a week in advance and is available for purchase on a weekly basis. Homeroom teachers will distribute order forms for preordering breakfast. BUS TRANSPORTATION Students receive their bus assignment, bus stop and boarding time from our Transportation Department. It is the bus driver’s responsibility to insure the safety of the passengers. Students are required to obey all bus safety rules. School law, Title 18, 18A: 25-2 states “A pupil may be excluded from the bus for disciplinary reasons by an administrator, and his parents shall provide for his transportation to and from school during the period of such exclusion.” There is no eating or drinking on the bus. The bus driver will report all incidents to the school. Only students assigned to a bus by our transportation department may ride a school bus. Parents must send a note if they do not want their child to take the bus home on a particular day. Without written instructions, the child will be put on their regular bus at dismissal. No changes will be made after 3:00, unless an emergency occurs. CAFETERIA/ RECESS Children may buy standard lunch each day or bring lunch from home. Lunches may be prepaid. Student lunches are $2.40 for an entire meal and $.40 for reduced cost lunches. Beverages are sold separately. Please do not send glass containers, carbonated beverages or energy drinks to school. More information is available on the lunch menu your child will bring home or the district website. (www.nbtschools.org) Information about applying for Free or Reduced Lunch or Breakfast will be sent home in the beginning of the year. While in the cafeteria, children are assigned to tables and are expected to behave appropriately. The following guidelines have been established in order to provide a safe and pleasant atmosphere. An adult in charge will send students to the lunch lines. Cutting in line is not acceptable behavior. Tables must be kept clean. Trash must be picked up around the table and discarded properly. School rules such as walking, using proper language and manners, and respecting others are consistently enforced in the cafeteria. If a child does not behave appropriately in the cafeteria, recess may be forfeited. Recess: When weather and time permit, students will go outside for recess. Students will bring necessary clothing outside and will not be permitted to return to classrooms once lunch/recess has begun. Food and drink are not permitted outside. Candy/gum-chewing is never permitted anywhere in the school or on the campus. Games involving bodily contact, such as football, wrestling, etc., are not permitted. Students must keep within the boundaries of the playgrounds. Students will follow the directions of the adults supervising the playground. CHANGE OF ADDRESS/TELEPHONE It is extremely important that the school office has a current address and telephone number for every student. Please notify the school immediately of any changes made during the school year. (See EMERGENCY FORM.) CHILD STUDY TEAM Members of the Child Study Team consist of a Social Worker, Psychologist, and Learning Disabilities Teacher-Consultant (LDTC). Classroom teachers who request assistance in dealing with individual students or parents who seek assistance for their children make referral to this group through the I&RS team. CLASS PARTIES Money is collected through PTO room parents for class parties. The teacher and class parents will decide on the activities. CLASS TRIPS Trips for off campus programs and enrichment activities for each grade level vary from year to year. Such excursions are viewed as a privilege and good school behavior is required for a child to be eligible to attend. As representatives of John Adams, students are expected to dress appropriately and conduct themselves properly on field trips. Teachers will arrange for chaperones from among the class parents. Every trip, no matter how short, in which students leave the school grounds during a school day, requires a signed permission slip from parents. No student will leave without a signed permission slip, a phone call is unacceptable. When a child goes on a class trip, the child must leave with the class on the bus and return with the class on the bus. NO EXCEPTIONS. CONFERENCES Parent-Teacher conferences are scheduled throughout the school year. Teachers and parents who prepare thoroughly for these conferences leave the meetings with feelings of satisfaction. Parent/Teacher communication should not be limited to these formally scheduled activities. Teachers are obligated to suggest a conference at any time when there are concerns regarding a child’s academic progress or behavior. CONTACTING TEACHERS Teachers cannot be called to the telephone from their classrooms except in emergency situations. You may leave a message on the teacher’s phone mailbox. Parents may be assured a return call will be forthcoming from the teacher within 24 hours. Teachers must not be disturbed while carrying out supervision duties or when children are in the classroom. Please do not contact teachers at home. DISCIPLINE A safe and respectful environment is critical if quality teaching and learning are to take place in our school. A key element in achieving such an environment is to ensure that parents and students understand the rights and responsibilities that students have at school, what conduct is expected of them, and the consequences for inappropriate or dangerous behaviors. There will be a zero tolerance for fighting. DISMISSAL PROCEDURES Students are dismissed and will exit the building at 3:30 p.m. each day, except for early closings. Walkers must immediately make their way home. Parents should wait for their children outside of their assigned dismissal door. Kindergarten, First and Second grade students will have a hand-off from the classroom teacher to a parent. When parents are late, they must come into the building to get children so that we are certain children are leaving with parents/guardians. Any students remaining after 3:50 p.m. will be safely placed with LEAL. LEAL will charge parents a fee for this service. If an early dismissal is absolutely necessary, we ask that you do not call for your child during the last 30 minutes of the day. Such requests are disruptive to closure in the classroom. A written request is required and must be submitted to the student’s teacher for early dismissal. Parents or the person named in the note must sign the child out in the lobby. Students will be called from the class once you arrive at school. For student security no telephone messages will be accepted. In case of emergency call our security desk at 732-289-3100 extension 13131 and state your emergency and we will try to make the necessary emergency arrangements. Proper identification will be required when you pickup your child. Parents/ Guardians are asked to promptly exit the school grounds with their children. The school playgrounds will reopen for play after 3:45 p.m. DRESS AND GROOMING Student dress and grooming must be neat and in good taste so that each student shares in a positive, healthy, and safe school environment. Student dress will be the responsibility of each individual with the following guidelines: ● Dress or grooming may not interfere with the teaching/learning process or cause undue attention to an individual student; or create an unsafe situation (Policy # 5511). ● Sneakers are required of all students participating in physical education classes. ● Students must wear sneakers, shoes, sandals with back straps in order to participate in playground activities. Flip flops are not acceptable footwear for school. ● Clothing must be modest and appropriate for the school setting. ● Clothing with profanity, inappropriate images, or suggestive wording is inappropriate as is beachwear, beach shoes, sunglasses and hats. ● Hats, head covers (including visors, scarves, caps, etc.) coats, jackets, and gloves are not to be worn in the building. Additional dress requirements may be made of students as needed. Any child, who comes to school wearing clothing that is inappropriate or contains unacceptable graphics, may be asked to change into something available at school or call home for a change of clothing. EMERGENCY FORMS Emergency cards are distributed the first day of school and should be filled out and returned to school immediately. It is essential that we have these on file. Please be sure that all information on the card is accurate and alternate contacts are available to act on your behalf in case of an emergency. It is also essential that the school be provided with up-to-date addresses, home and cell numbers at which responsible persons can always be reached in case of sickness, accident, or early dismissal. Throughout the year, please keep the office informed of any changes in emergency information. In the event of an emergency at school when the parent or guardian cannot be contacted, an adult designated on the emergency form will be called to take the child home. Pupils will not be sent home alone. ENGLISH AS A SECOND LANGUAGE The district offers assistance to students whose native language is other than English and who have limited English speaking proficiency. An ESL specialist serves our ESL population with a pullout program. FIRE DRILLS/LOCK-DOWN, ETC. A state law requires safety and security drills each month. The bill defines a school security drill as an exercise, other than a fire drill, to practice procedures that respond to an emergency situation including, but not limited to, a non-fire evacuation, lockdown, or active shooter situation that is similar in duration to a fire drill. Detailed routes are posted inside the door of each classroom. Students are reminded to follow the safety rules established in the building. There is no talking or running during a fire drill or emergency drill. FREE/REDUCED PRICE MEALS Families may confidentially qualify for free or reduced price lunches through an annual application process. This year, registration will take place online. Applications are also available through the main office. GUIDANCE COUNSELOR A full time guidance counselor is available for students. Referral may be made by a child’s parent or by a teacher using a referral form. Note that written parental approval must be obtained prior to the initiation of regular counseling contact. HARRASSMENT, INTIMIDATION, AND BULLYING Bullying among children is commonly defined as intentional, repeated, hurtful acts, words, or other behavior. The Board of Education Policy #5512.01 spells out the definitions and rule of the District regarding pupil conduct, pupil due process, consequences, and other responsibilities and rights related to behavior. Visit the District website at www.nbtschools.org to read the policy in it’s entirely. HOMEWORK Children will often be assigned lessons to practice or complete at home. Projects in connection with school studies are also frequently assigned for home completion. Parents should assist children in organizing their leisure and work periods in order that home assignments are well done and returned to school. This is vital for development of positive learning and work habits. A general guideline for homework assignments is as follows: ● Grades K-3 - 15-30 minutes per night ● Grades 4-5 - 30-60 minutes per night Both the quality and the regularity of homework completion are factors in assessing a child’s progress. Homework must be submitted on time. Credit may not be given for daily homework that is late. Partial credit for any homework assignment may be given at a teacher’s discretion. Students who have been absent from school due to illness or religious observance will be given the opportunity to make up homework upon their return. If parents wish to pick up homework while the student is absent, leave a message at 732-289-3100, option 1, on the second day of absence. Students and/or parents will NOT be allowed back into the building after school to get materials and homework that was forgotten. The custodians will not be asked to unlock a classroom for parents. Homework will not be given to students on vacation while school is in session. LEAL/ EXTENDED DAY PROGRAM In an attempt to meet the needs of working parents, The Board of Education in cooperation with the Department of Human Services provides child care services. Project LEAL is an extended school day program for the children of working parents. The morning program begins as early as 7:00 a.m., while the after school program begins immediately following the end of the school day and continues to 6:00 p.m. Please call DHS @ 732-247-0922 for additional information on the LEAL program. LIBRARY/MEDIA CENTER Students are scheduled for media center class once each week. Responsibility for care of borrowed materials rests with the child and parent. Students are held financially responsible for lost or damaged books. LOST AND FOUND A Lost and Found area is located in the cafeteria. Eyeglasses, money, or valuables that have been lost or found will be in the main office. MONEY AND VALUABLES The school cannot assume responsibility for lost or damaged items. Children should not bring valuable items to school. Money brought to school should be put in an envelope with the child’s name on it. MUSIC A general music class is scheduled once per week for all students, grades K-5. In addition, participation in a chorus is available for all interested students in grades 4 and 5. Instrumental music lessons, which are scheduled as a weekly pull-out program, are available for children in grades 3, 4 and 5 for strings and grades 4 and 5 for band. NURSE/HEALTH SERVICES Students becoming ill or injured during the school day or on the way to the school must notify the teacher/supervisor in charge to obtain a pass to the nurse’s office. Injuries incurred outside the school day must be cared for at home. Similarly, children who feel ill in the morning should be kept at home for the day. Whenever it is determined that a student’s condition warrants leaving school, a parent/guardian/designated adult will be notified. In such cases, arrangements must be made to pick up the student; students may not be sent home unescorted. In medical emergencies, the North Brunswick Rescue Squad will be called. Medical Guidelines: If your child is sent home from school due to vomiting, diarrhea, temperature 100 or greater, etc. they must remain at home the following school day. They may return the day after that providing they have been symptom free for the previous 24 hours without the assistance of medication. Keep your child home if she/he is too sick to eat breakfast. Keep your child home if she/he has a bad cough or cold. A child who is kept home for diarrhea, vomiting or fever must be symptom free 24 hours without the assistance of medication (Tylenol, Advil, Motrin, etc.) If your child is put on antibiotics, they must be on the medication 24 hours before they may return to school. It is essential that children with communicable diseases be kept home until the danger of contamination and relapse has passed. Report all contagious diseases (Strep Throat, Pink Eye, Scarlet Fever, Chicken Pox, etc.) or contagious conditions (lice or ringworm) to the nurse promptly. Medications: All medications given during school hours must be administered by the school nurse or parent. Before any medication (prescription and nonprescription) may be administered to a student during school hours, the Board of Education requires the written request of the parent/guardian and the written order of the prescribing physician. These requests and orders must include the medication name, dose, time to be given and the reason for giving it. Prescription medication must be in its original packaging with the label intact, showing the name of the child, dose, and name of the physician. Patent medicines, such as acetaminophen and antihistamines, must also be in the original packaging. All medications must be delivered to and picked up from school nurse by the child’s parent or guardian. Any unused medication that remains in the school at the end of the school year or four weeks after the student stops taking the medication, whichever first occurs, will be destroyed or discarded in accordance with Board Policy. Immunizations: New Jersey law governs the school immunization requirements and provides that children may be excluded by the school administration for non-compliance. Copies of the immunization requirements are available in the school office or from the school nurse. Nut Free Classrooms: Classrooms with students with nut allergies will be Nut Free classrooms. A classroom allergy letter will be sent home with all students in the class advising parents of this. Parents may not send in any food products that contain nuts or are processed in a plant that processes nuts. Students will not be permitted to eat any of these foods in the classroom. PARENT TEACHER ORGANIZATION (PTO) PTO meetings are held monthly at the school throughout the year and are listed on the district calendar. Program topics, dates, and membership information, along with other requests for information will be sent home early in the school year. The PTO has a mailbox in the school for any correspondence. All parents are invited to take an active role in the PTO sponsored activities. PERSONAL PROPERTY Students may not bring valuable personal possessions to school. The school cannot assume responsibility for lost or damaged personal items. Common sense and consideration are the best guides for determining what is appropriate for school. Generally speaking, any item that may disrupt the educational process is prohibited. The following guidelines will also be maintained: CELL PHONES: For safety purposes, students may carry cell phones to school with parent permission. They must, however, be kept in the child’s book bag and they must be turned off and kept PHYSICAL EDUCATION Students participate in a regularly scheduled physical education program. Students are required to wear sneakers in order to participate. Roller-skate/sneaker combination shoes are not permitted. PLAYGROUND PROCEDURES While on the playground, children will adhere to the following basic rules: No children are to be in the school area before 8:35 a.m. No food is allowed on the playground. No bats, hard balls, footballs, or other dangerous equipment are to be brought to or used on the playground. No rough games such as football, etc. which involves potentially dangerous physical contact will be allowed. No “play fighting” will be allowed. Prompt responses to adult requests and to the line up signal are expected. Students arriving to school in the morning and when dismissed at the end of the day, may not use the playground equipment. SCHOOL INSURANCE Envelopes and forms explaining the optional school insurance will be sent home early in the school year. If you decide to purchase this insurance, please return your remittance to the classroom teacher. SCHOOL PICTURES Individual pupil and class pictures will be taken early in the year and individual pictures again in the spring. Check the district calendar for the date. Notices will also be sent home to remind parents of the event and to provide ordering information. Parents are under no obligation to purchase pictures, however, unpaid pictures must be returned to the school. SPEECH Children who have been assessed and need assistance in correcting speech or language patterns will receive instruction from a speech and language specialist outside the classroom. SUPPLIES While the school provides most materials, requests may be made at times for special kinds of notebooks, covers for books, extra pencils, etc. Suggested supply lists can be found on our website. Your cooperation in this matter is appreciated. SUSPENSION As indicated by board policy, suspension from school or the school bus is to be considered as a severe sanction that can be imposed by an administrator. All other avenues will be tried first before suspension will be enacted or the offense has to be such that the student has materially or substantially interfered with the maintenance of good order in the school or it is necessary to protect the students’ physical or emotional safety and well being. TECHNOLOGY Our district policy on technology states in part: “While in school, student access to technological resources will be under the supervision of teaching staff and will be monitored by the staff member in the same manner as any other classroom activity. “ The guidelines specifically prohibit a student’s use of our technological resources for non-educational purposes. Of course, disrupting or damaging equipment, software, or the operation of the system is also prohibited. Any student who violates district technology guidelines is subject to disciplinary action. The entire district policy and district guidelines are available upon request at the school office. TELEPHONES Students are to make only extremely necessary or emergency calls. Only in the case of an emergency will a child be called from a classroom to speak to a parent. The school nurse will make calls to parents regarding illness. TEXTBOOKS Textbooks are costly. We ask all families to help care for and preserve these books. Students are to cover all hard cover books; please do not use contact paper. It is the responsibility of the family to replace a textbook that is lost. VACATIONS We respect your decision to make plans in the best interest of your family, but we believe strongly that a child’s presence in the classroom each and every day is very important for his/her learning. Board of Education Policy #5200 states, “the educational program offered by this district is predicated upon the presence of the pupil and requires continuity of instruction and classroom participation.” The policy goes on to declare that attendance is required of all children unless excused due to sickness, death in the family or religious observance. Family trips do not qualify as excused absences from school. If you choose to take your child out of school, homework will not be provided in advance. (See: Attendance) VISITORS John Adams welcomes parents, community members, professional guests and other visitors. To insure a safe environment, anyone entering the building for any reason must report to the security desk and sign in. They are to obtain a visitor’s badge before going to any part of the building. For a parent visitation to a classroom, the District policy calls for ● a one day notice to teacher ● a one period time limit ● a visit is to the classroom of the parents’ child only WEBSITE Additional information may be found on the school’s website http://wwww.nbtschools.org/ja. Please check the website for school activities and closings. WISE (Gifted and Talented program) Weekly Integrated Student Enrichment is open to all qualified students from grades 3 through 5. Classes meet on a regular basis with a full time teacher after school. Buses are provided. The curriculum is differentiated and students are involved in units of study separate from classroom curricula. Criteria for selection: Teacher Recommendation, Surveys, Standardized Tests (NJASK/NJPASS), and a test for Creative and Cognitive Thinking. YOUTH HELPLINE The New Jersey Youth Helpline, 2ND FLOOR, is a toll-free, anonymous and confidential helpline available 24 hours a day, 7 days a week, 365 days a year to all New Jersey young people, ages 10 to 24. Youth can call 2NDFLOOR at 1-888-222-2228 to speak with professionals and trained volunteers who listen attentively, non-judgmentally and compassionately to issues and problems they are facing. Visit www.2NDFLOOR.org for more information and try the message board. John Adams Elementary School Family Handbook Dear Parent/Guardians, For a successful partnership, the school and family must have open communication. Please take the time to carefully review the contents of this handbook with your child. Upon review, complete and return this page to your child’s teacher by Monday, September 16, 2013, acknowledging receipt and review of the handbook. Thank you. Parent Signature: _____________________________________________ Student Signature: _____________________________________________ Date: _____________________________________________ I do not have access to the internet. Please send me a hard copy.
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