COMPULSORY ATTENDANCE MEDIATION AGREEMENT

Student’s Name: __________________ DOB: ____________ Age: ______ Grade: ______

School: ____________________________ School Contact & Phone:_________________

WHEREAS, pursuant to Section 299.5A of the Iowa Code and in accordance with the School Truancy Policy, if a parent or guardian or student refuses to accept the school district’s attempt to assure the student’s attendance or the school’s attempts to assure the student’s attendance are otherwise unsuccessful, the truancy officer shall refer the matter to the County Attorney for mediation or prosecution; and

WHEREAS, the student has accrued more than fifteen (15) absences during the course of a single school year and has either failed to agree to, or has violated an Attendance Cooperation Agreement; and

WHEREAS, as a result of the violation of the Attendance Cooperation Agreement, the school district's Truancy Policy requires the matter to be referred to the County Attorney for mediation or criminal prosecution; and

WHEREAS, at such mediation, in accordance with Section 299.5A of the Iowa Code and the school district's Truancy Policy, the parties reached and executed a Compulsory Attendance Mediation Agreement, the terms and conditions of which are set forth below.

NOW THEREFORE, in consideration of the foregoing, the parties agree as follows:

I. TERM. Mediation agreement will be enforceable under Iowa Law until the child turns 16 on or before September 15 of that year or until the end of the school year if child turns 16 after September 15. This includes if the student changes or transfers school districts or schools or enters into a homeschool program within the State of Iowa.

II. VIOLATION. Pursuant to Chapter 299 of the Iowa Code and the school district's Truancy Policy, violation of the terms and conditions of this Agreement will result in the parent or guardian being prosecuted for the crime of Violation of a Compulsory Attendance Mediation Agreement, in violation of Section 299.6 of the Iowa Code, a simple misdemeanor for first offense and a serious misdemeanor for any second or subsequent offenses.  As outlined in Iowa law, the following violations result in the following punishments: 

a. A first offense is a simple misdemeanor and a conviction is punishable by imprisonment not exceeding ten days or a fine not exceeding one hundred dollars. The court may order the person to perform no more than forty hours of unpaid community service instead of any fine or imprisonment.

b. A second offense is a serious misdemeanor and a conviction is punishable by imprisonment not exceeding ten days or a fine not exceeding one hundred dollars. The court may order the person to perform not more than forty hours of unpaid community service instead of any fine or imprisonment.

c. A third or subsequent offense is a serious misdemeanor and a conviction punishable by imprisonment not exceeding thirty days or a fine not exceeding one thousand dollars, or both a fine and imprisonments. The court may order the person to perform unpaid community service instead of any fine or imprisonment.

d. If community service is imposed as part of a sentencing order, the court may require that part or all of the service be performed for a public school district or nonpublic school if the court finds that service in the school is appropriate under the circumstances.

III. REQUIREMENTS. The student and parent or guardian will comply with the following terms and conditions:

A. The Parent or Guardian Shall:

1. Ensure the student arrives on time to, and attends, all classes every school day during the school year with no unexcused tardies. If more than three (3) Tardies occur, it will be counted as one absence.

2. Ensure all homework is completed and returned to school promptly as assigned.

3. Attend all meetings scheduled by the school.

4. If deemed necessary and appropriate by the school administration, escort and attend school with the student.

5. Not allow the student to be absent or remove the student from school prior to the end of the school day, without previously contacting the school to provide a reason for the absence and obtain the acknowledgement of school administration.

6. Ensure that you and the student abide by the following policy regarding absences for medical reasons or illness:

a. Have the student examined and/or treated by a licensed doctor or medical professional and provide the school with written verification of said examination and/or treatment using the school-approved Doctor's Note form.

b. All doctor's notes must be returned into the school no later than three (3) school days after the absence or missed class time.

c. Sign and provide a release of information to the medical provider for the school as requested.

d. If a licensed medical professional has not been consulted to excuse the student from school, ensure the student attends school and consults the school health professional to determine if the student should be excused for that specific day.

7. Allow the County Attorney’s Office access to the student’s attendance and/or discipline records via written or electronic means.

8. Other: ______________________________________________

B. The Student Shall:

1. Attend school and all assigned class periods, on time, every school day during the school year.

2. If not examined and/or treated by a doctor or medical professional, attend school and consult the school health personnel.

3. Use appropriate and acceptable behavior with the school staff and other students at all times as outlined in the school handbook.

4. Take the necessary materials and completed assignments to each class every day.

5. Following an absence, ask for, complete, and turn in make-up work to the assigning teacher in a timely manner.

6. Go to bed and wake up by a reasonable time on school days.

7. Arrive at the bus stop on time, if applicable.

8. Other: ________________________________________________

Student:                                                                  Date:

Parent/Guardian:                                                    Date:

County Attorney:                                                     Date:

*Adopted: 11/14/16

*Revised: 5/8/17

*Revised: 11/11/19

*Revised: 7/17/23

*Revised: 3/25/24

DOCTOR’S NOTE TO SCHOOL

Note: All items must be filled out completely by the Doctor/Nurse. 

TYPE OF VISIT:                ꭐ IN OFFICE                     ꭐ TELEPHONIC

DATE:                              ___________________________________________

NAME OF STUDENT:        ___________________________________________

LOCATION OF VISIT:       ___________________________________________

PARENT/GUARDIAN:       ___________________________________________

DR. SEEN:                        ___________________________________________

TIME IN/OUT:                   ___________________________________________

MAY RETURN TO SCHOOL:      ꭐ IMMEDIATELY     ꭐ__________________________                                                                                                                                                                                     (Specify date for return)

WITH THE FOLLOWING RESTRICTIONS (if any)

_________________________________________________________________

_________________________________________________________________

DOCTOR’S SIGNATURE:  ____________________________________________

Note to Parents: The school may verify this note with the doctor’s office to ensure accuracy.

*Adopted: 11/14/16

*Revised: 11/11/19

Any person who violates a mediation agreement under Iowa law, who is referred for prosecution under Iowa law and is convicted of a violation of any of the provisions of Iowa law, who violates any of the provisions of Iowa law, for first offense, is guilty of a simple misdemeanor.

A first offense conviction is punishable by imprisonment not exceeding ten days or a fine not exceeding one hundred dollars. The court may order the person to perform not more than forty hours of unpaid community service instead of any fine or imprisonment.

A person convicted of a second violation is guilty of a serious misdemeanor. A second offense conviction is punishable by imprisonment not exceeding twenty days or a fine not exceeding five hundred dollars, or both a fine and imprisonment. The court may order the person to perform unpaid community service instead of any fine or imprisonment.

A third or subsequent offense is a serious misdemeanor and a conviction is punishable by imprisonment not exceeding thirty days or a fine not exceeding one thousand dollars, or both a fine and imprisonment. The court may order the person to perform unpaid community service instead of any fine or imprisonment.

If community service is imposed as part of a sentencing order, the court may require that part or all of the service be performed for a public school district or nonpublic school if the court finds that service in the school is appropriate under the circumstances.

If a parent, guardian, or legal or actual custodian of a child who is truant, has made reasonable efforts to comply with the provisions of sections 299.1 through 299.5, but is unable to cause the child to attend school, the parent, guardian, or legal or actual custodian may file an affidavit listing the reasonable efforts made by the parent, guardian, or legal or actual custodian to cause the child’s attendance and the parent, guardian, or legal or actual custodian shall not be criminally liable for the child’s nonattendance.

*Adopted: 11/14/16
*Reviewed: 04/12/21
*Revised: 07/17/23

500.16F1 ATTENDANCE COOPERATION AGREEMENT (FORM 1)

ATTENDANCE COOPERATION AGREEMENT (FORM 1)

Child’s Name: ____________________________   DOB:__________   Age: ______   Grade: ______

School: _________________________   School Contact & Phone: ___________________________

THE PARENT/GUARDIAN SHALL:

___ 1. Get your child to school every day and on time.

___ 2. Escort and attend school with your child (if deemed appropriate).

___ 3. Do not remove your child from school early without providing the school a valid excuse.

___ 4. Follow the agreed upon plan in regards to absences due to medical issues/illness:

          ___ Provide school with written verification by doctor/medical advisor. Written verification should include exact nature of illness and the

                exact date and times the student will need to miss school. Child must be seen in the office by a Doctor/LMHP/Physician Assistant. 

         ___ Send your child to school to be seen by school health worker and checked/released if ill. 

         ___ Have your child examined/treated by doctor/medical advisor. 

         ___ Inform the school/nurse/principal about medication prescribed and taken by the child.

___ 5. For all absences, contact the school to explain the absence.

___ 6. Participate in the following parenting and counseling programs:

___ 7. Ensure all homework is completed and returned to school promptly as directed.

___ 8. Attend all meetings scheduled by the school.

___ 9. The parent will sign a release of information to the Doctor/LMHP/Physician Assistant/Nurse for the school if requested.

___ 10. Other: THE STUDENT SHALL:

          ___ 1. Attend school and all assigned class periods every day.

          ___ 2. See the school nurse or other medical professional for all illness absences.

          ___ 3. Participate in the following counseling and educational programs:

          ___ 4. Other:

The following signatures indicate an agreement to the Attendance Cooperation Agreement and of the above expectations. I/we understand that if I/we fail to abide by its terms, I/we can be referred to the County Attorney for Truancy Mediation as provided in 299.5A Code of Iowa.

Student: __________________________________________ Date: ________________

Parent Guardian: ____________________________________ Date: ________________

School Official: ______________________________________ Date: ________________

School Officer Liaison/Truancy Officer: _________________________ Date: ________________

*attach School Intervention Plan if applicable

*Adopted: 08/11/14

*Revised: 11/14/16

*Reviewed: 04/12/21

*Reviewed: 07/17/23

500.16F2 STUDENT MEDIATION AGREEMENT
STUDENT MEDIATION AGREEMENT

Student:_____________________________ DOB:____________ Grade: __________

School: ________________________________

DATE OF MEDIATION: __________________________

PARENT CONTRACTED ACTION: __________________________

1. Parent will have the child attend all classes everyday during the school year, unless properly excused with a physician’s note, or by the school administration. This includes:

a. The physician’s note must include the exact nature of the illness and the exact date and times that the student will need to miss school. Any follow up appointments should be noted, as well as limitation of involvement/activity during the school day. Child must be seen in the office by a Doctor/LMHP/Physician Assistant.
b. The parent will sign a release of information to the Doctor/MHP/Physician Assistant/Nurse for the school if requested.
c. If the student is sick or feeling sick, and a physician has not been consulted to excuse the student, the student is expected to go to school and consult the school health personnel. This person will make the determination as to whether the student should be excused from school for that specific day.
d. All doctor’s notes must be turned in to the school no later than 3 days after the missed class time.

Parent will cause child to attend school on time with no unexcused tardies. Tardies can be counted as truant and may result in legal action being taken.

Parent agrees to allow the Mills County Attorney’s office access to attendance/ discipline records of the child. This information may be accessed via written or electronic access.

CHILD EXPECTED BEHAVIOR:

1. To use appropriate and acceptable behavior with the school staff and other students. This behavior is outlined in the GCSD Code of Conduct and each school's handbook.
2. To ask for make-up work when absent, to complete that work, and turn it into the individual teacher in a timely manner.
3. To take the necessary materials and completed assignments to each class, each day.
4. To be in bed and wake up by a reasonable time on school days.
5. To be at the bus stop on time, if applicable.

The following signatures indicate an agreement to the Mediation Contract and of the above expectations.

Student ________________________________________ Date:__________________

Parent(s) ____________________________ SS#________________ DOB:_________

School Admin ______________________________________ Date:_______________

Mediator___________________________________________ Date:_______________

*Adopted: 11/14/16
*Reviewed: 04/12/21
*Reviewed: 07/17/23

500.16F3 RECOMMENDATION FOR REFERRAL TO COUNTY ATTORNEY FOR VIOLATION OF STATE MANDATORY ATTENDANCE LAW
RECOMMENDATION FOR REFERRAL TO COUNTY ATTORNEY
FOR VIOLATION OF STATE MANDATORY ATTENDANCE LAW

Date:_____________________ Referring Administrator: ____________________________

Name of Student: _____________________ DOB: _______ School: ___________ Grade Level: ______

Father’s Name: ______________________ Mother’s Name: _______________________

Address: __________________________ Address: ____________________________

__________________________ _____________________________

Phone: __________________________ Phone: _____________________________

*Total current school year full absences: _______

*Total current school year partial day absences: _______

*Total current school year tardies: _______

Previous year attendance issue(s) (optional): __________________________________ ______________________________________________________________________
______________________________________________________________________

The following attempts have been made by the school to notify the parent(s)/guardian(s) of concerns and attempt to resolve attendance concerns:

Dates of written notice to parent(s)/guardian(s): ____________________

Dates of phone contacts and individual initiating contact: ____________________

Dates of meetings at school and names of staff conducting the meeting: ______________

Dates of home visits and name of individual conducting visit: ________________________

Other interventions: __________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Other concerns (i.e. inadequate medical excuses). May include additional attachments:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Date: ________________________________

*Adopted: 11/14/16
*Revised: 11/11/19
*Reviewed: 07/17/23

Attendance in school is considered extremely important for the success of students in their academic work. Students will be required to be in school a minimum number of days. This number will be no less than 160 days. The following action will take place with absences that are considered as truant from school.

The School Officer Liaison/Truancy Officer/school administrator will contact the parent/guardian of a student who has missed five (5) cumulative days at their respective attendance center and has not had previous mediation for truancy. Contact will be made only if the student has reached five (5) absences by the end of the first semester.

If the student reaches ten (10) absences, the building principal will send a letter and/or the School Officer Liaison/Truancy Officer will contact the parent/guardian and the student regarding the absences. An Attendance Cooperation meeting will take place between the parent, School Officer Liaison/Truancy Officer and building principal/designee, and student as appropriate, when the student has missed fifteen (15) unexcused days of school, as determined by the building principal and/or School Officer Liaison/Truancy Officer. At this meeting a detailed student specific Attendance Cooperation Agreement will be developed. This Agreement will include such terms as consequences for breach of the Agreement up to and including referral to the County Attorney for formal Mediation Contract development which may happen upon the student missing the twentieth (20) unexcused days of school.

The School Officer Liaison/Truancy Officer will be responsible for the attendance of students in kindergarten through 16 years of age. (Students who turn 16 years of age during the school year after September 15 must complete that year under compulsory attendance law.) The School Officer Liaison/Truancy Officer will do the following:

- Monitor daily attendance w/assistance from building secretaries;

- Mediate at required parent conferences;

- Refer parents to the County Attorney;

- Investigate and monitor persons referred to the County Attorney;

- Represent the Glenwood Community School District in any court proceedings.

*Adopted: 03/12/12

*Revised: 05/14/12

*Revised: 08/11/14

*Revised: 09/14/15

*Revised: 11/14/16

*Revised: 11/11/19

*Revised: 07/17/23