Student’s Name: __________________ DOB: ____________ Age: ______ Grade: ______
School: ____________________________ School Contact & Phone:_________________
WHEREAS, upon a student accruing fifteen (15) absences in a single school year, the school district Attendance Policy requires an Attendance Cooperation Meeting between the student, parent or guardian, and school administrators or their designees to execute an Attendance Cooperation Agreement; and
WHEREAS, at such Attendance Cooperation Meeting, in accordance with Section 299.12 of the Iowa Code and the school district Attendance Policy, the parties reached and executed an Attendance Cooperation 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. This Agreement shall remain in full force and effect until Iowa Code Allows. 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 Attendance Policy, violation of the terms and conditions of this Agreement may result in referral of the student and parent to the County Attorney’s Office for mediation and potential criminal prosecution.
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. Tardies will accrue and be counted as absences.
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 acknowledgment of school administration.
6. Ensure that you and the student abide by the following policy requirements 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 or a form of documentation provided directly by the licensed doctor or medical professional's office.
b. All doctor’s notes must be turned into the school no later than three (3) school days afterthe 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:
School Official: Date:
School Resource Officer: Date