Our Mission: Our Montessori school challenges each child to achieve excellence through an
individualized program, which includes a schoolwide musical strings program. We inspire a passion for
learning, instill a sense of personal responsibility, and cultivate a respect for the environment and
involvement in the community.
January 25, 2017
Dear Prospective Parent,
WELCOME TO SEDONA CHARTER SCHOOL!
Thank you for considering Sedona Charter School for your child. We at Sedona
Charter School are proud of the academic achievements of our students, of their
involvement in the local and global community, and of the commitment our parents
show in supporting the school.
Montessori education is very different from traditional education, and each
Montessori school offers its own interpretation and application of this teaching philosophy
and methodology. For this reason, we encourage you to observe the classroom in which
you are considering enrolling your child. Please call our office at (928) 204-6464 to
schedule an observation—we welcome your visit!
To enroll your child, simply fill out the enclosed forms and return them to our office at
165 Kachina Drive, Sedona, Arizona, 86336. Enrollment is on a first-come, first-served
basis, and the enrollment for each classroom is capped — so act quickly!
We cannot accept incomplete enrollment packets. Please review the enclosed
checklist and ensure that you have filled out all the forms. Then, bring an original birth
certificate, proof of Arizona residency, your $50 non-refundable supply fee deposit, and
copies of immunization records and custody papers with you. If your student will be
enrolling in grades 4 through 8, it very important that you bring copies of your child’s
school records with you. (See the enrollment checklist on the next page for details.)
We look forward to having your family join all of ours at Sedona Charter School.
Sincerely,
Alice Madar
Director of Finance and Administration
165 Kachina Drive, Sedona AZ 86336
tel. 928-204-6464
fax 204-6486
www.sedonacharterschool.com
ENROLLMENT CHECKLIST
2017-2018
Include this page with your enrollment papers
Student Name: ___________________________________ Date: ___________
□ Student Enrollment Form
•
Grade Entering: _______
Fill out this form completely, including prior school information, sign and date it.
□ Parent Information Form
•
•
Fill out this form completely, including prior school information, sign and date it.
If there is a divorce or separation, please provide custody papers.
□ Home Language Survey Form
□
Fill out this form, sign, and date.
□ Health Form
•
Fill out, sign, and date this form. You must list at least one emergency contact person.
□ One Call Now Information and Participation Form
•
Please read the Information sheet. Fill out, sign, and date the participation form. Check all appropriate boxes.
□ Immunization Records
•
Proof of all immunizations must be provided from documentation from your health care provider. Bring photocopied
documentation or bring your originals into the office and we will make copies for you. Request for Immunization Exemption
Forms may be requested from office and must be completed IN FULL with all proper initials, dates and signatures to ensure
enrollment.
□ Arizona Proof of Residency Form and Documentation
•
Fill out this form and bring your proof of residency document with you so that we may photocopy it.
□ Original Birth Certificate or Passport
•
Bring the ORIGINAL certified birth certificate to the office and we will make a copy. Arizona state law 15-828 mandates that we
see and photocopy the original. This must be done within 30 days of the first day of attendance.
□ Title 1 Allocation Form
•
Regardless of your qualifications, check one of the boxes, and sign and date this form.
□ Media Release Form
•
Fill out, sign, and date this form. Check all appropriate boxes.
□ Parent Partnership Agreement
•
Read and sign the Parent Partnership Agreement. Make sure you understand the Agreement and the policies and philosophies of
the school. Keep a second copy for your records.
□ Recent Report Card (grades 4-8), recent Standardized Test Results (grades 4-8),
and Special Education records (if applicable)
•
We use these records to help design your child’s curriculum. These records do not affect enrollment.
□ Fee Schedule Form
□
Read, sign and date the Fee Agreement. Be sure you understand all of the fees outlined.
New students are required to include a payment of at least $50 of their supply fee with their enrollment paperwork.
Keep a second copy of the fee schedule for your records.
□
Records Request Form
□
Musical Strings Program Form (for all students grades 4-8)
□
□
□
Fill out this form, sign, date, and return to us. We will send it to your previous school.
All grades 1-3 students are in the strings program. If your child is in grades 4-8, please complete and return the form.
McKinney-Vento Form
Please complete and return this federally-required form. All information is confidential and not shared with outside organizations.
rev 1.25.2017
2017-2018 STUDENT ENROLLMENT FORM
rev 8/22/2016
Student Name ____________________________________________________________________________ Gender (M/F)_____ GRADE ENTERING____
Last
Birthdate _____________________
First
Middle
Home Phone ____________________________________ Student’s Cell (if applicable)_______________________
Street Address _______________________________________________________________________________________________________________________________
Street
City
State, Zip
Mailing Address (if different than street address) ________________________________________________________________________________________________
Street
City
List all brothers and sisters school age or younger:
Name
Age
State, Zip
Grade
School (if attending)
(For parent) How did you learn about Sedona Charter School? ____________________________________________________________________
Has student ever attended Sedona Charter School?  No
 Yes
Last school attended ____________________________________________
If yes, what years? __________________________
Dates Attended _____________________________
School address/phone_____________________________________________________________________________________________________________________
Street
City
State/Zip
Phone
Has this student been suspended or expelled from any school in the last 2 years? If yes, circle which one, or both.
Please note: we cannot accept students who have been expelled from another school
 No
If yes, explain: __________________________________________________________________________________________________________________________
Has this student ever been identified as needing special education services?  No  Yes If yes, what type? _________________
Has this student ever received any of the following services?
Tutoring outside school
Speech/Language Services
Occupational Therapy
Dates of Service
Remedial Reading
Remedial Math
Special Education
(If yes, please bring special education records with you)
Dates of Service
Counseling or Psychotherapy
Gifted Education
Dates of Service
LANGUAGE SURVEY
1.
2.
3.
What is the primary language used in the home, regardless of the language spoken by the student? _______________________________
What is the language spoken most often by the student? _____________________________________________
What is the language that the student first acquired? ________________________________________
F E D E R A L E T H N I C I T Y /R A C E S U R V E Y
Part A. Is this student of Hispanic/Latino ethnicity? (A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture
or origin, regardless of race.) Choose only one.
 No, not Hispanic/Latino
 Yes, Hispanic/Latino
In accordance with Federal guidelines, the above part of the question is about ethnicity, not race. No matter what you selected above, please continue to
answer the following by marking one or more boxes to indicate your child’s race.
Part B. What is this student’s race? Choose one or more.
 American Indian or Alaska Native (A person having origins in the original peoples of North and South America, including Central America, and
who maintains tribal affiliation or community attachment.)
 Asian (A person having origins in the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia,
China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.)
 Black or African American (A person having origins in the black racial groups of Africa.)
 Native Hawaiian or Other Pacific Islander (A person having origins in the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.)
 White (A person having origins in the original peoples of Europe, the Middle East, or North Africa.)
Parent/Guardian Signature ______________________________________________________________________ Date ________________________
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------FOR OFFICE USE ONLY:
 Parent Information Form
 Custody Papers
 Home Language Form
 Emergency/Health
 One Call Now Form






Immunization Records/Exemption
AZ Residency Documentation
Original Birth Certificate
Title I
Media Release Form
Local Field Trip Permission
 Parent Partnership
 Fee Schedule Agreement
 Records Request Form
 Records Received

STAFF INITIALS:
Entry & Withdrawal Record
Grade
Code
Entry: _____________________________________________
Exit:
Date
P ARENT I NFORMATION F ORM 2017-2018
Note: If there is a divorce or separation, you must provide custody papers.
PRIMARY PHONE = the best phone number school personnel may use to contact you
Mother Father Stepmother Stepfather Other – specify ___________________
Parent or Guardian 1:
Full Name_________________________________________ Does this parent have legal custody? Yes No
Joint
If step-parent, does he or she have permission to see educational records and discuss the student with staff? Yes No
Does student live with this parent full-time
part-time
Primary phone:
not during the school year
E-mail Address:
Home phone:
Occupation/Employer:
Cell phone:
Work phone:
For volunteering, list special skills: ________________________________________________________________________
Same residence/mailing address as student? Yes
If different:
No
Residence address____________________________________________________________________________________
Mailing address
____________________________________________________________________________________
Parent or Guardian 2:
Mother Father Stepmother Stepfather Other – specify ___________________
Full Name_________________________________________ Does this parent have legal custody? Yes No Joint
If step-parent, does he or she have permission to see educational records and discuss the student with staff? Yes No
Does student live with this parent full-time
part-time
Primary phone:
not during the school year
E-mail Address:
Home phone:
Occupation/Employer:
Cell phone:
Work phone:
For volunteering, list special skills: ________________________________________________________________________
Same residence/mailing address as student? Yes
If different:
No
Residence address____________________________________________________________________________________
Mailing address
____________________________________________________________________________________
Parent or Guardian 3:
Mother Father
Stepmother
Stepfather Other – specify ___________________
Full Name_________________________________________ Does this parent have legal custody? Yes No
Joint
If step-parent, does he or she have permission to see educational records and discuss the student with staff? Yes No
Does student live with this parent full-time
part-time
Primary phone:
not during the school year
E-mail Address:
Home phone:
Occupation/Employer:
Cell phone:
Work phone:
For volunteering, list special skills: ________________________________________________________________________
Same residence/mailing address as student? Yes
No
If different:
Residence address____________________________________________________________________________________
Mailing address
____________________________________________________________________________________
I certify that I have the legal authority to enroll my child at Sedona Charter School, and that the above information is correct:
Enrolling parent’s name: _________________________________________
Signature: _____________________________________________________
Rev 6-3-15
State of Arizona
Department of Education
Office of English Language Acquisition Services
Primary Home Language Other Than English (PHLOTE)
Home Language Survey
(Effective April 4, 2011)
These questions are in compliance with Arizona Administrative Code, R7-2-306(B)(1), (2)(a-c).
Responses to these statements will be used to determine whether the student will be assessed for
English Language Proficiency.
1. What is the primary language used in the home regardless of the language spoken
by the student? __________________________________________________________
2. What is the language most often spoken by the student? _______________________
3. What is the language that the student first acquired? __________________________
Student Name ______________________________________ Student ID __________________
Date of Birth _____________________________________ SAIS ID ______________________
Parent/Guardian Signature __________________________________ Date _________________
District or Charter :_________Sedona Charter School__________________________________
School: ____Sedona Charter School_________________________________________________
-------------------------------------------------------------------------------------------------------------------------------------------Please provide a copy of the Home Language Survey to the ELL Coordinator/Main Contact on site.
In SAIS, please indicate the student’s home or primary language.
1535 West Jefferson Street, Phoenix, Arizona 85007 • 602-542-0753 • www.azed.gov/oelas
Our Mission: Our Montessori school challenges each child to achieve excellence through an
individualized program, which includes a schoolwide musical strings program. We inspire a passion for
learning, instill a sense of personal responsibility, and cultivate a respect for the environment and
involvement in the community.
HEALTH FORM
Student’s Last Name: __________________________________________________ First Name: _______________________________________
AUTHORIZATION FOR PICK UP/TEMPORARY CARE
List at least two neighbors or relatives who have consented to, and who can pick up and/or assume temporary care of your
child either for your convenience, or in case of accident or illness when you cannot be reached.
Name:______________________________________________________________________________ Relation to Child: __________________________________________
Address: ________________________________________________________________ City:______________________________ State:_______ Zip:__________________
Cell Phone: __________________________________ Home Phone: _________________________________ Work Phone: ___________________________________
Name:______________________________________________________________________________ Relation to Child: __________________________________________
Address: ________________________________________________________________ City:______________________________ State:_______ Zip:__________________
Cell Phone: __________________________________ Home Phone: _________________________________ Work Phone: ___________________________________
Name:______________________________________________________________________________ Relation to Child: __________________________________________
Address: ________________________________________________________________ City:______________________________ State:_______ Zip:__________________
Cell Phone: __________________________________ Home Phone: _________________________________ Work Phone: ___________________________________
HEALTH CONDITIONS/RESTRICTIONS/MEDICATIONS
DESCRIBE any current health conditions, restrictions or medication needs of the above child that Sedona Charter School
should be aware of. This includes any medication allergies. If your child needs any medication for an extended time, or
for a chronic condition, you must supply the medication to the school office directly, where the student will come to
take the medication. Students may not carry medication at any time. EXCEPTION: Children with an asthma inhaler
may keep it with them. Please indicate below if your child is using an inhaler.
_______________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________________
EYEGLASSES: Does your child wear eyeglasses? Please mark at least one:
____NO
______Reading Only
_______Distance Only
_____All the time
Acetaminophen: Occasionally your child may unexpectedly have a need for acetaminophen (such as Tylenol) during a school day.
Please indicate by checking below as to whether or not you will allow the office staff to dispense acetaminophen to your student:
I authorize the school designee to be my agent to give acetaminophen to my child: _____Yes _____No
PHYSICIAN CONTACT INFORMATION
Family Physician: _______________________________________________________ Phone: _______________________________
BE IT KNOWN that I, the undersigned parent or guardian of the student named above, do hereby give and grant unto any medical
doctor or hospital my consent and authorization to render such aid, treatment or care to said student as, in the judgment of said
doctor or hospital may be required, on an EMERGENCY BASIS, when the need for such treatment is clear, and when all efforts to
contact me are unsuccessful. IT IS FURTHER understood that any expense incurred for transportation and/or treatment will be the
responsibility of the parent or guardian of the student. I agree that payment of the expense is not a school responsibility.
________________________________________________________________________________
Signature of Parent/Guardian
165 Kachina Drive, Sedona AZ 86336
tel. 928-204-6464
___________________________________
Date
fax 928-204-6486
www.sedonacharterschool.com
rev 3-7-2016
PARTICIPATION FORM
Sedona Charter School is pleased to announce the arrival One Call Now, an automated parent notification service that will allow
us to improve communication between our school and parents by giving us the ability to contact all parents within minutes in a
variety of ways. One Call Now allows school personnel to keep you updated quickly and efficiently with personalized messages
enabling you to stay actively involved in your child’s education. As a parent, if you choose to participate in One Call Now, you
may select two ways to be contacted. They are:
 Routine notification – these are calls that do not directly deal with the safety of students or staff. These calls may include,
but are not limited to: information on upcoming events, the cancellation of a school activity that your child is involved in,
school closings or delays, absenteeism, etc. Should we have inclement weather and have to close or delay school,
notifications will begin at approximately 6:30 am in the morning. Please note: the primary* number will receive all of the
same calls that the emergency number receives. One Call Now also offers a texting service that we hope to merge into our
system as we gather phone numbers and incorporate them into our database.
 Emergency notification – these are calls made only during critical incidents where the safety of students and staff is in
immediate jeopardy. These calls may include, but not be limited to, lockdowns, evacuations and relocations. If you designate
a number as emergency it will not receive routine notifications.
*At least one phone number given to the school has to fall into the category of Primary Notification.

YES, I want to participate in One Call Now Routine Notifications. Please contact me
by the method(s) listed below (check all that apply).
 Phone _____________________________________________
The Primary number where I want to receive One Call Now voice messages

 Texts
_____________________________________________
The cell number where I want to receive One Call Now text messages

 E-mail ______________________________________________
The e-mail where I want to receive One Call Now e-mail messages


YES, I want to participate in One Call Now Emergency Notifications. Please contact
me by the method(s) listed below (check all that apply).
 Phone _______________________________________________
The Emergency number where I want to receive One Call Now voice messages

 Texts
_______________________________________________
The cell number where I want to receive One Call Now text messages

NO, I would rather not participate in the One Call Now notification system.
__________________________________________
Student’s Name (PLEASE PRINT)
__________________________________________
Parent’s Signature
_____________________
Date
Thank you!
165 Kachina Drive, Sedona AZ 86336
tel. 928-204-6464
fax 928-204-6486
www.sedonacharterschool.com
Arizona Department of Education
Arizona Residency Documentation Form
Student
School
Sedona Charter School
Sedona Charter School
School District or Charter Holder _____________________________________________
Parent/Legal Guardian
As the Parent/Legal Guardian of the Student, I attest* that I am a resident of the State of Arizona and
submit in support of this attestation a copy of the following document that displays my name and
residential address or physical description of the property where the student resides:
___
___
___
___
___
___
___
___
___
___
___
Valid Arizona driver’s license, Arizona identification card or motor vehicle registration
Real estate deed or mortgage documents
Property tax bill
Residential lease or rental agreement
Water, electric, gas, cable, or phone bill
Bank or credit card statement
W-2 wage statement
Payroll stub
Certificate of tribal enrollment or other identification issued by a recognized Indian tribe that
contains an Arizona address.
Documentation from a state, tribal or federal government agency (Social Security Administration,
Veteran’s Administration, Arizona Department of Economic Security)
I am currently unable to provide any of the foregoing documents. Therefore, I have provided an
original affidavit signed and notarized by an Arizona resident who attests that I have established
residence in Arizona with the person signing the affidavit.
__________________________________
________________
Signature of Parent/Legal Guardian
Date
*For members of the armed services, the provision of verifiable documentation does not serve as a declaration of
official residency for income tax or other legal purposes.
#2803440
PARENT SURVEY TO DETERMINE SCHOOL FUNDING
FOR
TITLE I ALLOCATIONS 2017-2018
The Arizona Department of Education is responsible for determining the allocation of Title I funds to the State of Arizona. Title I
allocations provide additional funds to schools to help meet the needs of children who require extra educational assistance. In
order for Sedona Charter School to be eligible for these extra funds, we must have documentation that some of our families fall
within the Title I eligibility income guidelines.
Instructions—Please Read Carefully
Please review the Title I eligibility income guidelines below. If your total family income equals or is less
than the income listed in Column 1F for your family size, check the first box. If your total family income equals
or is less than the income listed in Column 2R for your family size, check the second box. If your total family
income is more than the income listed in Column 2R for your family size, check the third box. Then sign and
date the form and return it to the school office with your enrollment forms.
Thank you so very much for your cooperation and assistance with this survey.
Note: This form will be kept CONFIDENTIALLY on file in the Sedona Charter School office. It will NOT be forwarded to
the Arizona Department of Education or any other agency or organization.
Title I Eligibility Income Guidelines
As of March 31, 2016
Family Size:
2
3
4
5
6
7
Column 1F
Annual
Income
Column 2R
Annual
Income
+5,408
+7,696
20,826
26,208
31,590
36,972
42,354
47,749
Each Additional Member Add:
29,637
37,296
44,955
52,614
60,273
67,951
Income includes income for all people living in your household. It includes virtually all items including wages and salaries before any
deductions and other income, such as: self employment, welfare, social security, retirement benefits, unemployment compensation, workers
compensation, aid for dependent children, alimony, child support, pensions, insurance or annuity payments.
Please check one box below:
 Our family income is equal to or less than the income guidelines in COLUMN 1F above.
 Our family income is equal to or less than the income guidelines in COLUMN 2R above.
 Our family income is more than the income guidelines in COLUMN 2R table above.
Student name: _____________________________________________
I hereby certify that the above information is true and correct.
Parent/Guardian Signature ______________________________________________
Date ____________
Rev 1-5-2017
165 Kachina Drive, Sedona AZ 86336
tel. 928-204-6464
fax 928-204-6486
www.sedonacharterschool.com
Our Mission: Our Montessori school challenges each child to achieve excellence through an
individualized program, which includes a schoolwide musical strings program. We inspire a passion for
learning, instill a sense of personal responsibility, and cultivate a respect for the environment and
involvement in the community.
MEDIA / DIRECTORY RELEASE FORM
In order to respect the privacy of our students while still celebrating individual and classroom accomplishments,
Sedona Charter School uses photographs and videos of students, as well as artwork and/or writings created by
students in a variety of venues which may include print and/or digital media. Please carefully review this media
release to ensure you are aware of the school’s policy in regard to directory and media information.
Photographs/Artwork
I, _____________________________, as parent/guardian of ____________________________ do hereby grant
unrestricted permission for images of my child as well as artwork and writings created by my child, to be used in
materials that include, but are not limited to, school publications, newsletters, school publicity, newspaper articles
and digital media including the school’s website and Facebook page. I understand that Sedona Charter School
takes special care to protect the safety and identity of all students and that Sedona Charter School will NOT use my
child’s last name in conjunction with any print, video or digital images, except the school yearbook.*
Directory Information
I, _____________________________, as parent/guardian of ____________________________ am aware that
Sedona Charter School publishes a student/parent directory at least once a year that is exclusively for the use of
Sedona Charter School families and is not distributed to anyone outside Sedona Charter School. I hereby grant
permission for my student’s name, mailing address, parent/guardian names, and phone number to be published in
that directory.
The best phone number to list in the directory is: ____________________________________
Note: If there is something you do NOT want listed in the directory (for example, phone number or mailing
address) please write it here: ____________________________________________________________
Student's Name: (please print)
Parent's Signature
Thank you!
Date
I understand that my approval can be withdrawn at any time upon written notice delivered to Sedona Charter
School, 165 Kachina Drive, Sedona, AZ 86336.
*In the absence of a signed media release form, the school will use its best judgment (following school guidelines) in the release of a student’s
name, photograph, artwork or writing.
165 Kachina Drive, Sedona AZ 86336
Rev 1.7.2016
tel. 928-204-6464
fax 928-204-6486
www.sedonacharterschool.com
Our Mis sion: Our Mon tessori school challenges each child to a chieve e xcellence through an individua lized program , which includes a
schoolwide musical s trings program . We inspire a passion for learning , instill a sense of personal responsibility, and cultiva te a respect fo
the environment and involvemen t in the commun ity.
PARENT PARTNERSHIP AGREEMENT
Enrolling a child at Sedona Charter School requires parents to make a strong commitment to the education of their child. Sedona Charter School
believes that education takes place both at home and in the school. Therefore, parents and the school must be active partners in the education of
the child. The partnership is intended to be a friendly, supportive, common effort designed to enhance the development of the whole child.
Sedona Charter School Responsibilities
• Provide and develop an academic program that fulfills the goals expressed in Sedona Charter School’s mission and goals statements, thereby
exceeding State academic standards.
• Together with parents, provide high-quality K-8 Montessori instruction in a supportive and effective learning environment that enables students
to meet the State’s academic achievement standards through individualized educational plans.
• Provide programs for parents on the school’s philosophy and teaching methods, including 3 required parent-teacher conferences during which
this partnership will be discussed as it relates to the individual child’s achievement.
• Ensure the health, safety, and welfare of the children at school. We will meet or exceed all federal and state requirements.
• Provide advice and encouragement toward developing a home atmosphere conducive to nurturing a love of learning.
• Provide parents with frequent reports on their child’s progress by utilizing the ParentVUE portal to give parents up-to-date grade, assignment and
absence information. Notify families of any perceived failure to fulfill their obligations of the agreement.
• Provide parents reasonable access to staff. PEs are usually available to meet with parents before or after school or by appointment. Parents are
asked to write a note, send an e-mail or leave a phone message for staff. Staff will respond within 24 hours during the school week.
• Provide parents opportunities to volunteer and participate in their child’s class and to observe classroom activities. Parents are welcome to
observe or volunteer at any time in our classrooms. Appointments should be made with the PE in advance. Weekly take home packets and/or emails provide information to parents about school events for which they can volunteer.
• Notify families of any disciplinary action regarding their child.
Parent Responsibilities
• Participate in the Sedona Charter School’s orientation program to thoroughly understand the school’s philosophy and policies. The school believes
children develop best when their family and school share a strong and consistent set of values. Our shared values include: honesty, integrity,
responsibility, self-discipline, compassion, courage, perseverance, loyalty, faith, work, and friendship.
• Provide a nurturing home support system: provide healthy meals, dress your child appropriately, get your child to school on time, and ensure
that your child is well rested and ready to learn. Also, make sure that your child has a daily lunch at school. Note: Sedona Charter School provides
educational services only and should not be expected to provide food, health, or other services that are normally the responsibility of parents.
• Provide a home setting that stimulates a love of learning.
• Support your child in ensuring that he or she completes all homework and long-term projects on schedule.
•
•
•
•
Spend at least one hour per year observing your child’s classroom.
Complete and return the annual spring Parent Satisfaction Survey.
Participate in funding extracurricular and enhancement activities through the Kids Tax Credit program.
Volunteer 50 hours per year for the school. If you do not volunteer in some way, serve to the extent possible by being a parent representative on
the school’s Parent Partnership Team, the Governing Council or other school advisory or policy groups. Volunteer options include:
 Volunteer on a committee
 Volunteer your time in the classroom or school office
 Help organize and chaperone field trips
 Volunteer your expertise in the classroom
 Donate or make materials or art supplies
 Look for other school needs and work to fill them
Note: If you cannot volunteer, we ask that you contribute $10 per hour for every hour you cannot volunteer.
• Conduct activities with your child to develop personal skills and values using methods that are compatible with those of the school. In partnership
with your child’s Principal Educator, develop, update, and implement an educational plan that defines the activities you will conduct in the home
during the school year. Promote positive use of your child’s extracurricular time.
 Read with your child daily
 Share current events
 Take trips to the library, museums, art galleries, exhibits
 Manage time, include TV/video screen time — develop a schedule
 Develop skills on a musical instrument
 Spend at least 15 minutes daily talking about the day's events
 Engage your child in practical life exercises such as cooking,
preparing shopping lists, and banking
 Participate in community sports or theater programs
 Recycle
• Involve your family in activities that contribute to your child's development as an active citizen of the local community.
• Stay informed about your child’s education by promptly reading all school communications and responding as appropriate.
As Sedona Charter School staff, Governing Council, and families work together to fulfill the above responsibilities, we will create an extraordinary
educational environment for our children.
We, the family of ________________________________________, enter into this partnership agreement with Sedona Charter School. This
agreement becomes effective when we enroll our child in the school.
Parent/Guardian Signature
Date
Parent/Guardian Signature
Please keep a copy for your records
Date
rev1/25/2017
FEE SCHEDULE 2017-2018
At Sedona Charter School, we do our best to keep fees to a minimum. While other schools charge
enrollment fees, activity fees, scheduling fees, book fees, lab fees, etc., we prefer to keep things simple. Our
supply fee for each classroom covers all student costs for the entire school year, except field trips or extracurricular programs. If your budget does not allow for a one-time payment, you may set up a monthly
automatic payment plan on our website (see information below).
Strings Fee - $200 (For all students grades 1-3, and students in grades 4-8 who participate in the
Strings Program. May be paid as AZ Kids Tax Credit contribution)
Supply Fee - $150 (for grades 1-8)
New students must include at least $50 of their supply fee payment with their enrollment paperwork.
Every Lower Elementary student participates in our strings program, learning to play the violin. Families
should plan on paying the strings fee once per year for each student enrolled in the program. Arizona Kids
Tax Credit payments can be used to offset the annual strings fee. Upper Elementary and Middle School
students may also enroll in the strings program; however, it is optional for those age groups.
PAYMENT OPTIONS: All fees should be paid by the first day of school. However, for those families for
which this is financially difficult, we do provide the opportunity to set up a payment schedule on our
website www.sedonacharterschool.com. Click on the Donate or Pay Fees button and set up a customized
payment plan to fit your budget. Automatic payments can be made via credit card or e-check. If you have
any questions about a custom payment plan, please contact the school office.
PLEASE NOTE: All fees are non-refundable and cannot be transferred. In addition, there are other costs
throughout the year for individual field trips, after school care or classes, and extra-curricular activities.
Because many of these are voluntary events, they are not included on this fee schedule. Please speak with
the Principal Educator in your child’s classroom for a list of events, activities and costs for the year.
PLEASE SIGN AND RETURN TO THE SCHOOL OFFICE WITH YOUR OTHER ENROLLMENT DOCUMENTS
I acknowledge that I have reviewed the 2017-2018 Fee Schedule and I agree to pay the required fee(s)
for each student I enroll at Sedona Charter School. If these fees present a financial hardship, I will contact
the school office.
Student Name(s) and Grade(s) ____________________________________________________________________________________
Parent/Guardian Name(s) _________________________________________________________________________________________
Parent/Guardian Signature ________________________________________________________________________________________
Date Signed
Please keep a copy of this form for your records
Rev 1.5.2017
Our Mission: Our Montessori school challenges each child to achieve excellence through an
individualized program, which includes a schoolwide musical strings program. We inspire a passion for
learning, instill a sense of personal responsibility, and cultivate a respect for the environment and
involvement in the community.
R ECORDS R EQUEST
I/We are withdrawing our child____________________________________________
(Student)
from ___________________________________________________________________
(School)
____________________________________________________________________________________________________
(Address)
____________________________________________________________________________________________________
(City, State, Zip)
________________________________________
(Phone #)
___________________________________________
(Fax #)
Anticipated start date at Sedona Charter School ________________________________________
(Date)
I/we request that you release any medical information, educational records, special
education records, psychological reports, or other pertinent data you may have, or
may receive, to Sedona Charter School. Please mail to:
Sedona Charter School
165 Kachina Drive
Sedona, AZ 86336
Attention: Admissions
Thank you
______________________________________________________________________________________________
(Parent/Guardian Signature)
(Relationship)
________________________________________________________________________
(Requested by)
165 Kachina Drive, Sedona AZ 86336
(Date)
(Official Title)
tel. 928-204-6464
fax 204-6486
www.sedonacharterschool.com
MUSICAL STRINGS PROGRAM FORM—GRADES 4-8
This Form Must Be Completed for ALL students entering grades 4-8!
Sedona Charter School believes that the enjoyment, respect and knowledge of music and the development of the
skills necessary to create and perform music enhance learning, enrich quality of life and nourish the human spirit.
Therefore, our mission is to provide a foundation, at an early age, for lifelong engagement with music.
We offer a unique music program for an elementary school. It is not an introduction to music — it is an in-depth,
multi-year study of musical strings performance, beginning with Suzuki instruction for our youngest musicians. We
believe that by giving children the experience of working over time to develop a challenging skill, they learn
lessons about the value of perseverance and hard work that will serve them well throughout their lives.
Why did we choose to focus on strings for music education? Here are a few reasons:
 Strings are the only family of instruments that come in sizes. Playing any instrument requires physicality,
and stringed instruments can be adapted without placing any physical burden on a growing child.
 There is a wealth of available strings performance repertoire that includes a variety of skill levels and a
broad variety of ensemble combinations. Almost every conceivable opportunity for string players to
assemble and play is available.
 Opportunities to produce a variety of expressive sounds and emotions on stringed instruments exceed that
of other instrumental families.
 The music skills acquired through string playing contribute greatly toward students’ overall development.
No family of instruments is more demanding for mastering pitch discrimination and auditory perception at
the same time students are coordinating large and fine motor skills with the independent movement of
limbs.
 Teamwork is of utmost importance. Few disciplines require so much dependency on the accuracy of
individual participants to produce a joyful, satisfying result.
Every student in grades 1 to 3 participates in the program. All of our strings students are given one of the school’s
own instruments to use for the year — to take home and practice with, to take care of, and to play during concert
performances. These young musicians have small-group lessons twice per week during the school day, with
orchestra practices before and after school. The fee for the entire year is $200, which can be divided into
installments.
In grades 4 to 8, participation is by choice.
the program and join one of our two orchestras.
A majority of our students in these upper grades stay in
If you would like your child to participate in the program, please let us know so that we can develop schedules
accordingly, right from the beginning.
Child’s Name: ____________________________________________
Will_____
participate in the strings program for the upcoming school year.
Will Not ______
If your child is participating, please answer the following:
My child is entering grade:____________
My child has had prior music instruction: Yes_______
No_______
Please describe any prior instruction below so that we can place your child in the appropriate group.
_________________________________________________________________________________________________________________
Our Mission: Our Montessori school challenges each child to achieve excellence through an
individualized program, which includes a schoolwide musical strings program. We inspire a passion for
learning, instill a sense of personal responsibility, and cultivate a respect for the environment and
involvement in the community.
Student Name: __________________________________________________ Grade :_______ Date ___________________
Confidential McKinney-Vento Homeless Education Assistance Program Eligibility Questionnaire
Your child may be eligible for additional services through the McKinney-Vento Homeless Assistance Act
42 U.S.C. 11435. To determine eligibility, please complete this form. All information is confidential.
1. Is the student’s home address a temporary living arrangement? Yes ____ No ____
2. Is this temporary living arrangement due to loss of housing or economic hardship? Yes ____ No ____
The undersigned Parent/Guardian certifies that the information provided on this form is correct. False
claims about living situations may affect enrollment.
Name of Parent(s)/Guardian(s): _____________________________________________
Signature: __________________________________________________ Date _______________
If you answered YES to EITHER of the above questions please complete the
remainder of the form. If you answered NO to BOTH of the above questions, you may
STOP here. Thank you.
Where is the student currently living? _____ In a motel _____ In a shelter _____
Temporarily staying with one or more families in a residence _____
Moving from place to place _____
In a place not designed for ordinary sleeping accommodations such as a car, park, or campsite _____
In a place without electricity, heat, or water _________
Other children in the family:
Name: _______________________________________ School: _____________________Grade: _____
Name: _______________________________________ School: _____________________Grade: _____
Name: _______________________________________ School: _____________________Grade: _____
Name: _______________________________________ School: _____________________Grade: _____
Physical Address: ___________________________________________________________________
If you have any questions or believe you qualify for the McKinney-Vento Homeless Education Assistance
Program, please contact our school office, attention Alice Madar, to access services.
The following is a list of possible services available for eligible McKinney-Vento students:
Immediate school enrollment ~ Assistance in obtaining immunization records and birth certificates
Tutoring ~ Free Lunch ~ School Supplies ~ Extracurricular Programs/ /School Fees Assistance ~
Information and Referrals to Community Services
165 Kachina Drive, Sedona AZ 86336
tel. 928-204-6464
fax 204-6486
www.sedonacharterschool.com