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REGISTRATION INFORMATION & FORMS

Registration 2020-21*** 

 

 

 

Please Click on READ MORE For the Complete FEE SCHEDULE.

ALL FEES MUST BE PAID AT REGISTRATION TIME, UNLESS FAMILIES HAVE SUBMITTED AND COMPLETED A FREE/REDUCED APPLICATION.

Elementary Grades KG-6

Junior High Grades 7-8

High School Grades 9-12

Instructional Fees                   $35

Instructional Fees                 $70

Instructional Fees               $70

 Reduced Fee     $17.50

Must submit all required forms before determining fees owed

Reduced Fee   $35

Must submit all required forms before determining fees owed

Reduced Fee   $35

Must submit all required forms before determining fees owed

 

Instrument Rental                $50*

Percussion Rental                $25

*If more than one student in the family is renting an instrument  $20 per student

Instrument Rental               $50*

Percussion Rental               $25

*If more than one student in the family is renting an instrument  $20 per student

Activity Pass Fees**

These prices are for a yearly pass; no price adjustment for passes bought late in the year

Student Activity Pass            $25.00

Student Activity Pass     $30.00

Student Activity Pass        $30.00

Adult Activity Pass                                              $70.00 Yearly Pass

Senior Citizen Pass (60+)                                     $30.00  Yearly Pass

 

Southeast Iowa Super Conference Admission Fees:

 

JV/Varsity:       $4.00 Student          $5.00 Adult

 

Junior High:      $2.00 Student         $3.00 Adult

******MEAL PRICES******

PreK-6th Grade Meal Prices

Grades 7-8 Meal Prices

Grades 9-12 Meal Prices

Student Lunch      $1.75 

Student Lunch   $2.20   

Student Lunch $2.20 

Student Breakfast $1.45  

Student Breakfast $1.55 

Student Breakfast $1.55

Extra Milk/Juice                    $0.40 

Extra milk/juice                  $ 0.40 

Extra milk/juice                  $ 0.40 

Seconds on Main Entree 1.00 Breakfast 

Seconds on Main Entrée $1.50 Lunch 

Reduced Lunch  $0.40

Reduced Breakfast $0.30

Seconds on Main Entree 1.00 Breakfast 

Seconds on Main Entrée $1.50 Lunch 

Reduced Lunch  $0.40

Reduced Breakfast $0.30

Seconds on Main Entree 1.00 Breakfast 

Seconds on Main Entrée $1.50 Lunch 

Reduced Lunch  $0.40

Reduced Breakfast $0.30

ADULT LUNCH FEE  $3.85   ADULT BREAKFAST FEE   $2.40

Book Rental fees will be assigned to all students at the beginning of the year.    Families may qualify for partial or full waiver of book if they complete Iowa Eligibility Application and waiver.  Adjustments will be made to these assigned fees after approved signed wavier has been received. Optional fees are not subject to fee waivers.  

Book Rental fees will be assigned to all students at the beginning of the year.  Families may qualify for partial or full waiver of book and towel fees if they complete Iowa Eligibility Application and waiver.  Adjustments will be made to these assigned fees after approved signed wavier has been received. Optional fees are not subject to fee waivers.  

 

2020-2021 Supply Lists

 

 

 

PEKIN HOT LUNCH FORMS FOR FREE/REDUCED MEALS

Click on links below:

 

USDA Nondiscrimination Statement

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.

Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

(1)        Mail: U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights

1400 Independence Avenue, SW

Washington, D.C. 20250-9410;

(2)        Fax: (202) 690-7442; or

(3)        Email: program.intake@usda.gov.

This institution is an equal opportunity provider.

Iowa Non-Discrimination Statement: 

“It is the policy of this CNP provider not to discriminate on the basis of race, creed, color, sex, sexual orientation, gender identity, national origin, disability, age, or religion in its programs, activities, or employment practices as required by the Iowa Code section 216.6, 216.7, and 216.9.  If you have questions or grievances related to compliance with this policy by this CNP Provider, please contact the Iowa Civil Rights Commission, Grimes State Office building, 400 E. 14th St. Des Moines, IA 50319-1004; phone number 515-281-4121, 800-457-4416; website: https://icrc.iowa.gov/.”

Medical Forms/ Student Health Requirements

 

  • ALL 6-12 STUDENTS Physical Activity Contract this form is pertinent to Healthy Kids Act.
  • 2020-2021  Sports Physical Form All 7 – 12 grade students engaged in Athletics, Cheerleading and/or Dance must obtain a certificate signed by a licensed physician and surgeon, osteopathic physician and surgeon, osteopath advanced registered nurse practitioner (ARNP), physician’s assistant or qualified doctor of chiropractic, to the effect that the student has been examined and may safely engage in athletic competition.  This certificate is valid for 1 year. A grace period, not to exceed 30 days is allowed for expired physicals.
  • Kindergarten & 9th Grade Dental Screening form
  • MS-HS 2019-2020 Concussion Fact Sheet  (MUST BE SIGNED ANNUALLY BY PARENTS/GUARDIANS AND THEIR STUDENT(S) IN GRADE 7-12 BEFORE THE STUDENT(S) CAN PARTICIPATE IN INTERSCHOLASTIC ATHLETICS, CHEERLEADING, AND DANCE.)
  • Asthma/Airway Constricting Contract 2019(*Required for Students that are using inhalers at school or activities.)
  • Physician's Form to Administer Prescription Medicine
  • Permission form to administer Over-the-counter medicine

Internet usage policy

Approved January 2013 – 6-12th grade parents/guardians please read.

 

NEW STUDENTS TO THE DISTRICT

 

 

Kindergarten Student Information

Elementary Climbing Wall Permission - FOR ALL KINDERGARTEN AND NEW ELEMENTARY STUDENTS

Student Profile Form

Home Language Survey, Race and Ethnicity forms 

Physical for Kindergartners

Immunization Certificate and Schedule

Immunization Exemption

Dental Screening

♦Dental Screening Exemption

Blood Lead Testing is Required Before Starting Kindergarten

♦Physician’s Form to administer prescription medicine

Medication/Treatment form Over-the-counter medication

Free & Reduced Application

Annual Notices

Please click here for all Notices

AEA- Brochure/Services

Asbestos Notification

Family Educational Rights and Privacy Act (FERPA)

The Family Educational Rights and Privacy Act (FERPA), a Federal law, requires that Pekin Community School District, with certain exceptions, obtain your written consent prior to the disclosure of personally identifiable information from your child's education records. However, Pekin Community School District may disclose appropriately designated "directory information" without written consent, unless you have advised the District to the contrary in accordance with District procedures.

Physical Restraint and Physical Confinement

Yearly Notice on Level One Investigator

PPRA Model Notice and Consent - EXAMPLE ONLY

ON-LINE REGISTRATION:

Click here for instructions on PowerSchool log-in.
 If you have completed single sign-on with PowerSchools, please click here: https://pekin.powerschool.com/public/ and you can complete registration on-line without having to come to the school for registration. If you have NOT completed single sign-on with PowerSchools, please call any school secretary for assistance, after August 6th, 2019.

Di Parcell, Elementary Secretary, 319-695-3707 ext. 101
Marla Graham, Middle School Secretary, 319-695-3707 ext. 150

Christy Gambell, High School Secretary, 319-695-3705 ext. 208