Scott City Middle School Summer School 2022

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Email *

Student's Last Name *

Student's First Name *

Grade Entering for the 22-23 School Year *

Date of Birth *

YYYY

Gender *

Male

Female

Other

Address *

School Child Attends *

Scott City R-1

Kelso C-7

St. Joseph

St. Augustine

Other

If you chose "other" for the above question, please indicate the school your child attends.

Parent 1 First and Last Name *

Parent 1 cell number and work number *

Parent 1, lives with student *

Yes

Parent 2 First and Last Name

Parent 2 cell number and work number *

Parent 2, lives with student *

Yes

Morning Transportation *

My child will be a car rider most mornings

My child will ride the bus most mornings -- If your child is riding the bus, please provide the address in the next question.

Required

Morning Transportation ONLY IF bus rider. Please provide address that your child will be picked up from.

Afternoon Transportation *

My child will be a car rider most afternoons.

My child will ride the bus most afternoons -- If your child is riding the bus, please provide the address in the next question.

Required

Afternoon Transportation ONLY IF bus rider. Please provide address that your child will be picked up from.

The following people are allowed to pick up my child from school *

Emergency Contact 1 Name and Number (other than parent) Parents are always our first call.

Emergency Contact 2 Name and Number (other than parent) Parents are always our first call.

Does your child have a current IEP

Yes

Clear selection

I give my child permission to receive emergency medical attention. *

Yes

Please list any health concerns. If he/she takes medication that will need to be administered at school, you will need to see the school nurse to fill out appropriate forms.

My child agrees to follow the rules of the SCMS Handbook. Additional Rules as Follows -- 1. There will be no fighting. Students will be dismissed from summer school in the first incident. 2. Students who are taking courses for credit will not receive credit following three absences. 3. Students will be dismissed from summer school on the second disciplinary referral. *

Yes

My child has permission to ride the bus to participate in school field trips.

Yes

Clear selection

Students Entering 5th Grade Check Here

5th Grade

Clear selection

Students Entering 6th Check Here

6th Grade

Students Entering Grades 5th-8th May Choose STUDENT MUST BE 11 YEARS OF AGE

Hunter Safety -May 23-27 only. You may choose other classes for the remaining weeks.

Students Entering 7th/8th Grade Morning Session CHOOSE ONE

AM Session -- History Through Film

AM Session -- Computer Literacy

AM Session -- Physical Education

AM Session -- Bake Shop

Students Entering 7th/8th Grade Afternoon Session CHOOSE ONE

PM Session -- History Through Film

PM Session -- Science

PM Session -- SC Bake Shop

PM Session -- Physical Education

Credit Recovery -- List Classes Needed

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