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Elementary Compliance Form

(FOR USE IN SCHOOLS SERVING ANY GRADE, K-6)

Note: as used in this form, "we" means staff members and other persons who assist staff

members in school-sponsored activities.

I, ____________________________________, Principal of the __________________________

School in the _________________________________ School District, hereby certify that:

A. DOCUMENTS ATTACHED TO THIS CERTIFICATION FORM

I have attached copies of the following documents, which we provided to parents and guardians:

1. The School Fees Notice for Families of Students in Kindergarten through Sixth Grades;

2. If fees were permitted for programs operating outside of the regular school day:

a. the fee schedule approved by the Board of Education for this school; and

b. the Fee Waiver Application (Grades K-6).

B. ASSURANCES (GENERAL)

1. I have read this Elementary School Certification of Compliance, the School Fees Notice for

Families of Students in Kindergarten through Sixth Grades, the permanent injunction issued

by the Third District Court, the school fees policy for my school district, and the school fee

schedule approved by the board of education.

2. Copies of all of the documents listed in item B.1. have been kept in the faculty lounge.

3. I gave a copy of the School Fees Notice for Families of Students in Kindergarten through

Sixth Grades to each member of the faculty.

4. I discussed school fees and fee waivers, the definitions and limitations governing school fees

set forth in the Permanent Injunction, this school's fee schedule, if any, as approved by the

Board of Education, and the terms of this Certification of Compliance Form with my staff

and advised them that they must fully comply with all laws and policies governing school

fees and fee waivers, and that no fee may be charged which is not listed on the boardapproved

fee schedule.

5. I advised the staff that no fees may be charged in connection with any class, program, or

activity that occurs during the regular school day in grades K-6.

6. Information submitted in connection with fee waiver applications, the names of persons who

have or have not paid fees, donations, or contributions, and the names of persons who have

applied for, received, or been denied waivers, are confidential. We do not make any

disclosure, without permission, of any of those names to any person lacking both the right

and the need to know, and from posting any list accessible to unauthorized persons regarding

the payment or non-payment of any fee, contribution, or donation by any student, parent, or

guardian. However, appropriate recognition may be given to any person or organization

which makes a major donation or contribution.

7. We do not permit the withholding, enhancement, or reduction of grades, or the withholding of

report cards or other school records, to enforce the payment of fees or donations. We may

withhold official copies of report cards or transcripts under Utah Code Section 53A-11-806 if

fines or other charges for lost or damaged school property have not been resolved. 

C. ASSURANCES (RELATING TO THE REGULAR SCHOOL DAY)

1. No fees are charged for textbooks, equipment or supplies, field trips, assemblies, enrichment

programs such as gifted and talented programs, snacks (other than food or drinks supplied

through the School Lunch Program in accordance with state and federal rules, including

those governing free and reduced price meals), or anything else that takes place during the

regular school day.

2. Staff are prohibited from requiring students to bring items other than common household

articles from home. If donations of school materials are requested, children and families that

fail to bring such articles are not excluded, named, or otherwise humiliated in any way.

3. Although we may permit the solicitation of donations or contributions, any solicitations

clearly state that donations and contributions are voluntary, and that we do not require a

donation in order for a given student to participate in an activity.

D. ASSURANCES (OUTSIDE THE REGULAR SCHOOL DAY)

1. Our fee schedule, and fee waiver policy are in full compliance with applicable State and

federal law and with the rules of the District and State Boards of Education.

2. If after-school or school vacation programs or activities are held for which fees are charged,

we comply with school fee rules requiring Board of Education approval, notice, waiver

application, and appeal.

3. Copies of the school district's Fee Policy, Fee Waiver Policy, and the Fee Schedule approved

by the Board of Education for this school are maintained in the school and are made available

to parents and guardians during registration and at other times upon request.

4. Prior to the time when fees became due, we sent the School Fees Notice for Families of

Students in Kindergarten through Sixth Grades; and the Fee Waiver Application (Grades K-

6) to the parent or guardian of each student who was attending, had applied to attend, or was

scheduled to attend this school.

5. We undertook a general distribution of the forms listed in Section D.4. on _______________,

20____. The forms were sent in the following manner:

___________________________________________________________________________

6. Students who apply for or receive fee waivers are allowed to register at the same time and in

the same manner as would have been the case if waivers were not involved.

7. School personnel are prohibited from asking those eligible for fee waivers to consent to

delayed or time payment plans or IOU's as alternatives to fee waivers.

8. Fundraisers offered to students as alternatives to fee waivers are appropriate to the age,

physical condition, and maturity of the student, and are conducted in such a way that students

are not subjected to stigma, unnecessary identification as fee-waiver students, or to ridicule

or humiliation.

9. Fundraising activities avoid excessive burdens on students and families and give proper

consideration to a student's transportation needs and other responsibilities. If it is not

reasonably feasible to arrange an assignment meeting those requirements, the fees in question

are waived.

10. In the case of programs, classes, and activities which are subject to fees and require “tryouts”

or “lotteries”:

a. persons involved in the selection process are not informed about the fee waiver eligibility

of any student until selections have been announced;

b. questions and discussions relating to ability to pay are prohibited during the selection

process;

c. ability to pay is not a factor in the selection process; and

d. no fees relating to the program, class, or activity in question are collected from any

student until the selection process has been completed.

11. We provide the Fee Waiver Application (Grades K-6) to each prospective, new, or current

student's parent or guardian who requests information about school fees or seeks to apply for

a fee waiver.

12. We use the Fee Waiver Decision and Appeal Form to notify applicants about decisions

relating to their applications for waivers.

13. We do not collect school fees, whether class, project, or activity fees, or require students to

purchase materials or supplies, unless the fees or other requirements have been approved by

the district's School Board and are listed on this school's approved fee schedule.

14. We waive fees for eligible students if a class or program outside of regular school hours is

established or approved which requires payment of fees or purchase of materials, special

clothing, tickets to events, etc., in order for students to participate fully.

15. We use confidential application and notice procedures regarding school fees and school fee

waivers to avoid stigmatizing or embarrassing students or families applying for or receiving

fee waivers. The procedures for confidentiality include, but are not limited to, the following:

a. we do not use a separate line during registration for families or individuals seeking to

obtain a school fee waiver;

b. we do not discuss or determine a student's eligibility for school fee waivers in the

presence of other parents or children;

c. we do not use students to collect fees or assist in the fee waiver application process.

16. We do not ask any student, parent, or guardian why school fees cannot be paid or why fees

cannot be paid later or in installments when information about school fee waivers is sought

or an application is submitted for a school fee waiver, except that a school will require

documentation consistent with Section 53A-12-103(5) and local board policies and/or

guidelines requiring documentation, if the affected student is eligible for a school fee waiver

under any of the following categories:

a. the student is eligible based on income verification;

b. the student receives (SSI)* Supplemental Security Income (only for blind or disabled

children);

c. the family receives AFDC (currently qualified for financial assistance or food stamps);

d. the student is in Foster Care (under Utah or local governmental supervision); or

e. the student is in State Custody.

17. Persons not included under Section D.16. who request waivers because of exceptional

financial hardships are given the opportunity to meet privately with a school administrator to

discuss their ability to pay and their eligibility for fee waivers.

18. We provide reasonable assistance to persons who lack sufficient mastery of the English

language to understand the provisions of the fee schedules, disclosures, and waiver

application forms.

19. Our school (if the school charges fees of any kind as defined under R277-407-1A or Doe v.

Utah State Board of Education, Civil No. 920903376), adequately required fee waiver

eligibility documentation consistent with Section 53A-12-103(5).

20. OUR SCHOOL DOES NOT RETAIN DOCUMENTATION OF FEE WAIVER

ELIGIBILITY.

NOTE: Schools may transfer fee waiver eligibility information to other schools to which

students advance or transfer.

FINAL NOTE: If your district does not require parents in the entire district area or parents and

students in specific schools or sections of the district to "apply for fee waivers," district

administrators NEED NOT require verification of eligibility under this section.

I HEREBY CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT

TO THE BEST OF MY KNOWLEDGE AND BELIEF.

DATED this _______ day of _________________, 20___ ______________________________

(Signed) School Principal

USOE 4/17/06