Belleville Public Schools

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Registration Packet

The questions asked in the following pages will enable us to determine your student’s eligibility to attend school in this district in accordance with New Jersey law. Please be aware that N.J.S.A. 18A:38-1 and N.J.A.C. 6A:22 require that a free public education be provided to students between the ages of 5 and 20, and to certain students under 5 and over 20 as specified in other applicable law, who are:

Note that “guardian” means a person to whom a court of competent jurisdiction has awarded guardianship or custody of a child, provided that a residential custody order shall entitle a child to attend school in the residential custodian’s school district subject to a rebuttable presumption that the child is actually living with such custodian; it also means the Department of Children and Families for purposes of N.J.S.A. 18A:38-1(e). Also note that a student is entitled to attend school in the district of domicile notwithstanding that the student is qualified to attend school in a different district as an “affidavit” student or temporary resident.

Note that the following do not affect a student’s eligibility to enroll in school:

The following forms of documentation may demonstrate a student’s eligibility for enrollment in the district. Particular documentation necessary to demonstrate eligibility under specific provisions in law will be indicated in the appropriate section of the registration form.

The totality of information and documentation you offer will be considered in evaluating an application, and, unless expressly required by law, the student will not be denied enrollment based on your inability to provide certain form(s) of documentation where other acceptable evidence is presented.

You will not be asked for any information or document protected from disclosure by law, or pertaining to criteria which are not legitimate bases for determining eligibility to attend school. You may voluntarily disclose any document or information you believe will help establish that the student meets the requirements of law for entitlement to attend school in the district, but we may not, directly or indirectly, require or request:

Please be aware that any initial determination of the student’s eligibility to attend school in this district is subject to more thorough review and subsequent re-evaluation, and that tuition may be assessed in the event that an initially admitted student is later found ineligible. If your student is found ineligible, now or later, you will be provided the reasons for our decision and instructions on how to appeal.

Optional note if district permits attendance by nonresidents on a tuition basis: State law allows school districts to admit nonresident students, through policies adopted at Board discretion, on a tuition basis. If your student is not eligible to attend school in this district free of charge, he or she may enroll on a tuition basis by... (instructions on how to obtain more information, or register for enrollment as a nonresident student.)

If you experience difficulties with the enrollment process, please call Yolanda Luna at (973) 450-3500 ext. 1019 for assistance.

Mandatory fields marked *

Application Date
School
Student Name
Age
Parent(s)/Guardian Name

Enrollment
Student's Physical Address
Student's Mailing Address (If different)
Parent(s)/Guardian's Physical Address
Parent(s)/Guardian's Mailing Address (If different)
Contact Information
Native Language
Residence

To the Person Enrolling the Student: Please complete the appropriate section A, B, C or D below, according to the situation best matching the student's circumstances:

Section A

Complete SECTION A (DOMICILE) if the student is the child of a parent or guardian, or an adult student, whose permanent home is the address given on page 1 of this application and is located in the district.

Section B

Complete SECTION B (“AFFIDAVIT” STUDENT) if the student is living with a person domiciled in the district, other than the parent or guardian.

Section C

Complete SECTION C (TEMPORARY RESIDENT) if the student is living with a parent or guardian temporarily residing within the district.

Section D

Complete SECTION D (SPECIAL CIRCUMSTANCES) if the student’s situation is not addressed by Section A, B or C or if any of the circumstances in Section D apply.

SECTION A (DOMICILE)

Section A

SECTION A (DOMICILE): Complete this section if the student is the child of a parent or guardian, or an adult student, whose permanent home is the address given on page 1 of this application and is located in the district. If you are the student’s guardian, or will be the guardian of a student from out of state following expiration of the required 6-month waiting period, you will be asked to provide official papers proving guardianship. You will not be asked to produce "affidavit student" proofs of the type requested in Section B below.

Please list four forms of proof (see attached list) you will provide to demonstrate that the address given on page 1 of this application is your permanent home.




If the student’s parents are domiciled in different districts, regardless of which parent has custody, please answer the following questions:
  1. Is there a court order or written agreement between the parents designating the district for school attendance, and if so, where does it require the student to attend school? (You will be asked to provide a copy of this document.)

  1. Does the student reside with one parent for the entire year?


SECTION B ("AFFIDAVIT" STUDENT)

Section B

SECTION B ("AFFIDAVIT" STUDENT): Complete this section if the student is living with a person domiciled in the district, other than the parent or guardian

Is the person domiciled in the district, supporting the student without remuneration as if the student were his or her own child, keeping the student for a longer time than the school term and assuming all personal obligations for the student relative to school requirements? Please explain. (You will be asked to file a sworn statement, along with a copy of the person's lease if a tenant, or a sworn landlord’s statement if a tenant without written lease.)
Students are not eligible to attend school as "affidavit" students unless the student’s parent or guardian is not capable of supporting or providing care for the student due to family or economic hardship, and unless it is clear that the student is not living in the district solely for purposes of receiving a public education there. Please explain the circumstances applicable in this case, with special attention to the parent/guardian’s family and/or economic hardship. (The parent/guardian will be required to file a sworn statement with documentation to support the claims made.)

Please note: A student will not be considered ineligible because required sworn statements(s) cannot be obtained, so long as evidence is presented that the underlying requirements of the law are being met.

A student will not be considered ineligible when evidence is presented that the student has no home or possibility of school attendance other than with a non-parent district resident who is acting as the sole caretaker and supporter of the student.

A student will not be considered ineligible solely because a parent or guardian provides gifts or limited contributions, financial or otherwise, toward the welfare of the student, provided that the resident keeping the student receives no payment or other remuneration from the parent or guardian for the student’s actual housing and support. Receipt by the resident of social security or other similar benefits on behalf of the student do not render a student ineligible.

It is not necessary that guardianship or custody be obtained before a student will be considered for enrollment on an "affidavit" basis.

SECTION C (TEMPORARY RESIDENT):

Section C

SECTION C (TEMPORARY RESIDENT): Complete this section if the student is living with a parent or guardian temporarily residing within the district, even if the parent has a domicile elsewhere.

Please list four forms of proof (see attached list) you will provide to demonstrate that you are residing at the address given on page 1 of this application, and that such residence is not solely for the purpose of the student attending school in the district.




Please note: Under New Jersey law, where a dwelling is located within two or more local school districts, or bears a mailing address that does not reflect the dwelling’s physical location within a municipality, the district of domicile for school attendance purposes is that of the municipality to which the resident pays the majority of his or her property tax, or to which the majority of property tax for the dwelling in question is paid by the owner of a multi-unit dwelling.
If the student’s parents are domiciled in different districts, regardless of which parent has custody, please answer the following questions:
Please note: No district is required, as a result of being the district of temporary residence for school attendance purposes where a student lives with more than one parent, to provide transportation for a student residing outside the district for part of the school year, other than transportation based upon the home of the parent residing within the district to the extent required by law.
SECTION D (TEMPORARY RESIDENT):

Section D

SECTION D (SPECIAL CIRCUMSTANCES): Please indicate if any of the following apply.

BELLEVILLE TOWNSHIP PUBLIC SCHOOLS STUDENT INFORMATION RELEASE OPT OUT FORM NAME / PHOTO / VIDEO

Dear Parent/Guardian:

Your school principal, teacher, or district supervisor will be using the name, photo or video images of students in your school to highlight the many wonderful events that occur at school.

I agree that you may photograph or video my child/ward and that you may use my child’s name, photo or video image in the Belleville Public Schools Website or any school newsletter published and produced by the Belleville Public Schools.

Belleville Public School district and school newsletters are published periodically throughout the school year and may appear on the school district web site, in print for local distribution, or on the Belleville High School television station, WBHS. I understand that I will not be paid and I may not revoke my permission. To the extent permitted by law, parent/guardians and pupils shall defend, indemnify and hold the Belleville Board of Education harmless from and against any claims, losses, liabilities, damages, demands, penalties, and expenses arising out of or in connection with photographing or videotaping/filming of the pupil.

Please read and sign this letter if you wish to DENY permission for your child’s name, photo or video image to be published in the Belleville Public Schools Website or school newsletter. Please return this form to your child’s teacher.

  1. NO, I do not give permission for my child’s name, photo or video image to be published.
Technology Acceptable Use Agreement

Belleville Public Schools is pleased to offer access to the district computers, networks, e-mail and to the Internet. There are specific rules that all users must follow. Users agree to the following:

1. The computers, networks, and Internet connectivity are provided for the educational use of students, staff, faculty and other authorized users. Work of a commercial nature is not permitted. Supplies and equipment are to be used only for academic purposes.

2. The use of the computers, networks, and Internet connectivity is a privilege that will be revoked for inappropriate use. The system administrator has the authority to enforce this agreement.

3. Your computer account and password should be protected as you would protect your locker and combination. Therefore, you should not consider anything that you say or store as private. The system administrators may spot check to insure adherence to these rules.

4. If you notice any security problem on the Internet or on our network, it must be reported to the system administrator immediately. Do not demonstrate the problem for anyone else. Any user identified as a security risk or having a history of problems with other computer systems may be denied access.

5. Vandalism will not be tolerated. Vandalism is defined as any malicious attempt to harm or destroy data or the physical hardware. Violators will be subject to the board discipline code.

6. Network etiquette is expected. Students should:

    a) Be polite. Do not be abusive in your messages to others.

    b) Use appropriate language. Do not swear, use vulgarities or any other inappropriate language. Illegal activities are strictly forbidden.

    c) Do not reveal the address, phone number, or other personal information of yourself, other students, or colleagues.

    d) Note that electronic mail (e-mail) and the World Wide Web are not guaranteed to be private. People who operate the system do have access to all e-mail. Messages relating to or in support of illegal activities will be reported to the authorities.

    e) Do not use the network in such a way that you would disrupt the use of the network by other users.

    f) All communications and information accessible via the network should be assumed to be private property and will be subject to copyright laws.

7. The viewing, downloading, and distribution of pornographic and/or obscene materials are prohibited.

8. The unlicensed copying and distribution of copyrighted software is prohibited. The installation of unauthorized software is prohibited.

9. Belleville Public Schools makes no warranties of any kind, whether expressed or implied, for the service it is providing. Belleville Public Schools will not be responsible for any damages you suffer. This includes loss of data resulting from delays, non-deliveries, mis-deliveries, or service interruptions caused by its own negligence or your errors or omissions. Use of any information obtained via the Internet is at your own risk. Belleville Public Schools specifically denies any responsibility for the accuracy or quality of information obtained through its services.

10. Permission is granted for the Belleville Public Schools to post photographs, images, and works of art or other material created by students or staff on the district website without specific written authorization.

Student

I understand and will abide by the above Acceptable Use Agreement. I further understand that any violation of the regulations above is unethical and may constitute a criminal offense. Should I commit any violation, my access privileges will be revoked, school disciplinary action may be taken, and/or appropriate legal action.

Parent or Guardian (If student is under 18)

As the parent or guardian of this student, I have read the Acceptable Use Agreement. I understand that this access is designed for educational purposes. Belleville Public Schools has taken precautions to limit controversial material. However, I also recognize it is impossible for Belleville Public Schools to restrict access to all controversial materials and I will not hold them responsible for materials acquired on the network. Further, I accept full responsibility for supervision if and when my child's use is not in a school setting. I hereby give permission to issue an account for my child and certify that the information contained on this form is correct.

Request for Transfer of Records
  1. * As the Parent/Guardian of I am authorizing the release of all academic and health records for my child to the school listed below.

Please send the following information to the attention of the secretary at the school checked below:*

  1. Cumulative Academic Records
  2. Educational Test Results
  3. Health Records
  4. Transfer Card
  5. Confidential Files (example - IEP, behavior plan)
  6. Other Pertinent Data

Belleville High School
100 Passaic Avenue
Belleville, NJ 07109
Attn: Liz DiNapoli

Belleville Middle School
279 Washington Avenue
Belleville, NJ 07109
Attn: Carmel Romano

School #3
230 Joralemon Street
Belleville, NJ 07109
Attn: Jean Percario

School #4
30 Magnolia Street
Belleville, NJ 07109
Attn: Janice McManus

School #5
149 Adelaide Street
Belleville, NJ 07109
Attn: Donna Giuliano

School #7
20 Passaic Avenue
Belleville, NJ 07109
Attn: Susan Svehla

School #8
183 Union Avenue
Belleville, NJ 07109
Attn: Lisa Kistner

School #9
301 Ralph Street
Belleville, NJ 07109
Attn: Maria Zarro

School #10
527 Belleville Avenue
Belleville, NJ 07109
Attn: Elaine Perinotti