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Printable Guidance Forms

AUTHORIZATION FOR RELEASE OF RECORDS

AUTHORIZATION FOR RELEASE OF RECORDS -- Download/Print Copy: AUTHORIZATION FOR RELEASE OF RECORDS

BROCKTON HIGH SCHOOL

I HEREBY REQUEST THE TRANSFER OF ALL SCHOOL RECORDS OF MY CHILD

FROM:

_____________________________________________________

NAME OF SCHOOL

_____________________________________________________

STREET ADDRESS

_____________________________________________________

CITY, STATE, ZIP CODE

_____________________________________________________

PHONE NO.

_____________________________________________________

FAX NO.

TO:

BROCKTON HIGH SCHOOL

ATTENTION: CATHERINE A. LEGER

470 FOREST AVENUE

BROCKTON, MA 02301

PHONE: 508-580-7477

FAX: 508-580-7499

_____________________________________

NAME OF STUDENT

______________________________

DATE OF BIRTH

____________________________________

SIGNATURE OF PARENT OR GUARDIAN

____________________ ______________________

DATE PHONE NO.

Dates Faxed ____________________, _____________________, ________________

Date complete records are received________________________________________

Date Parent Contacted________________ Approval for registration_____________

REQUESTING: ____Transcript ____Transfer Grades ____Health Record ____Discipline ____IEP/SPED

____MCAS Scores ____Other


WEEKLY PROGRESS REPORT

Download/Print Copy here: WEEKLY PROGRESS REPORT

City of Brockton

BROCKTON PUBLIC SCHOOLS

Kathleen A. Smith, JD w Superintendent of Schools

BROCKTON HIGH SCHOOL

GUIDANCE DEPARTMENT

GREEN HOUSE: 508-580-7415
RED HOUSE: 508-580-7425
AZURE HOUSE: 508-580-7435
YELLOW HOUSE: 508-894-4405

Student Name: _________________________ Counselor Name: _____________________ Date:___________

Teacher Name

Class

Level of Class Effort

1 = Low/None

5 = On Task / Focused

Homework Submission

1 = Low/None

5 = Consistent

Student’s Current Grade

Missing Assignments and/or Additional Comments

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

1 2 3 4 5

Review what your teachers wrote above and circle how you think your week went academically:

-1- Not at all satisfied -2- Not very satisfied -3- Somewhat satisfied -4- Completely satisfied


WORK PERMIT INSTRUCTIONS

NECESSARY PROCEDURES TO RECEIVE A WORK PERMIT

16 AND 17 YEARS OF AGE:

1. HAVE A JOB

2. Receive a “Promise of Employment” form from your employer (job).

This form must signed by your employer (job) and your parent/guardian.

3. Once completed bring the completed promise of employment form along with a valid student ID or school record and One of the following: official birth certificate, a current passport, a current driver’s license or current learner’s permit.

4. Go to Brockton High School, 470 Forest Avenue, Brockton, MA 02301.

 Current BHS students may come during their lunch or after school until 3:30 p.m.

 Non-current students may come after school until 3:30 p.m.

5. All students attending any Alternative schools must go to the School Department Central Offices, 43 Crescent Street, Brockton, MA 02301 (508) 580-7000.

14 AND 15 YEARS OF AGE:

1. HAVE A JOB

2. Receive a “Promise of Employment” form from your employer (job).

This form must signed by your employer (job), your physician (Doctor’s office) and your parent/guardian.

3. Once completed bring the completed promise of employment form along with a valid student ID or school record and One of the following: official birth certificate, a current passport, a current driver’s license or current learner’s permit.

4. Go to Brockton High School, 470 Forest Avenue, Brockton, MA 02301.

 Current BHS students may come during their lunch or after school until 3:30 p.m.

 Non-current students may come after school until 3:30 p.m.

5. All students attending any Alternative schools must go to the School Department Central Offices, 43 Crescent Street, Brockton, MA 02301 (508) 580-7000.

WORKERS' PERMIT APPLICATION (for 14-17 year olds)

Download/Print Application here: Workers' Permit Application (for 14-17 year olds)

Employment Permit Application for 14 through 17 Year-Olds Instructions: After completing the form and obtaining the required signatures as indicated, take this completed form to the Superintendent of Schools, or the person your school (including a charter school) has authorized to issue work permits, in the school district where you live or attend school. You should bring with you proof of your age, such as your birth certificate, passport, or immigration record. The Superintendent, or the person your school (including a charter school) has authorized to issue work permits, will then issue you an Employment Permit. Bring the signed work permit back to your employer who must keep it until you leave the job.

Questions about this application should be directed to the Department of Labor Standards at (617) 626-6952.


If you are under 18 years of age, you must obtain a work permit before starting a new job.1 G.L. c. 149, §§86-89. The following are the steps you should take; please note that a Physicians Certificate of Health is required only of 14 and 15 year-olds.

Steps for Getting an Employment Permit
1. Obtain a job offer from an employer.
2. Ask the employer to complete the following section:

Promise of Employment

Name of Minor:
Name of Employer:
Business Address:
Job Title & Primary Duties:

Number of Hours per day Minor is to be Employed:
The undersigned agrees to employ this minor as stated above and in compliance with state law.
A summary of laws governing minors’ hours of work and hazardous occupations can be found at the end of this application form.

_________________________________________ & ______________________
Signature of Employer or Authorized Agent & Date

Minors who are 17 years of age, who can show documented proof of a high school diploma or the equivalent to the school official authorized to issue work permits, do not need a signed work permit, but must still complete this permit application.

NOTE: If the minor seeking an employment permit resides outside of Massachusetts, the minor should obtain a work permit from the superintendent of schools in the city/town in Massachusetts where the minor is to be employed.

3. For 14 and 15 year-olds only (16 and 17 year-olds may skip this step): Ask your doctor to complete the following section: Note: The following Certificate of Health must be signed within 12 months of the date this application is presented to the school official issuing the permit.

Physician’s Certificate of Health:

I hereby certify that I have made a thorough physical examination of the following named 14 or 15 year-old minor: ______________________________________________________________________
and that, in my opinion, said minor is in sufficiently sound health and physically able to perform the work indicated above. A summary of laws governing minors’ hours of work and hazardous occupations can be found at the end of this application form.

__________________________________________ & ______________________
Signature of Physician & Date Signed

4. Ask your parent, guardian, or custodian to sign below.

I hereby approve the issuance of a permit for the work indicated above. A summary of laws governing minors’ hours of work and hazardous occupations can be found at the end of this application form.
__________________________________________
Name of Parent, Guardian, or Custodian
__________________________________________ & ______________________
Signature of Parent, Guardian, or Custodian & Date

5. Sign this application below:

__________________________________________ & ____________________
Signature of Minor & Date

TRANSCRIPT RECORDS RELEASE

Download/Print copy here: BHS Transcript Form

CITY of BROCKTON

BROCKTON PUBLIC SCHOOLS

Kathleen A. Smith, JD Superintendent of Schools

PLEASE SIGN & DATE BELOW & PROVIDE A PHONE NUMBER

Please Print Clearly to Expedite the Process

BROCKTON HIGH SCHOOL TRANSCRIPT REQUEST FORM

First Name:

Middle Name:

Last Name (Maiden Name):

Date of Birth:

Year of Graduation:

If NOT a Graduate, please list the YEAR you SHOULD have graduated ________________

I authorize Brockton High School to release my ____Day School transcripts

____IEP (Individual Education Plan) ____MCAS Scores ____Other:

____ Home Address (Please fill in below signature).

____Pick up at Main Office (Allow 2-3 days).

____The Party or School (Please fill in below address).

FAX TO: ------------------------------------ at ------------------------------------------------------------

Name of Party or School(s)

Address

City, State, Zip Code

Number of transcript requested: ____

I understand that this information will be treated as confidential.

Signed___________________________________________

Student or Parent (lf student is 18 or older only, student may sign)

Street Address ____________________________________

City, State, and Zip Code ____________________________

Telephone Number _________________________________

Date: ----------------

PLEASE NOTE: There is a $3.00 fee (cash or money order only) per transcript request. Please make money order payable to: BROCKTON HIGH SCHOOL. Mail to BROCKTO N HIGH SCHOOL, 470 Forest Ave, Brockton, MA 02301 ATTN: RECORDS OFFICE

Brockton High School 470 Forest Ave. Brockton, MA 02301 www.brocktonpublicschools.com Brockton. Education. Industry. Progress.


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