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Keith Middle-High School
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School Forms
Title 1 Annual Parent Survey 2022-2023
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Keith Middle-High Annual Title I Parent Survey
The Annual Title I Parent survey is confidential and will be used to assist us with future planning for parental involvement activities and events at Keith. We appreciate your feedback and thank you for taking the time to complete this survey.
Parent/Guardian Forms
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Flu Vaccine Consent Form
A flu shot (influenza) vaccine consent form is a written authorization that gives a nurse or other medical practitioner the go-ahead to administer the flu vaccine. It should be signed by the student's parent or legal guardian.
COVID-19 Vaccine Permission Slip
On Tuesday, October 19th, Wal-Mart will offer free Vaccines on Keith’s campus for students age 12 and up. This COVID-19 Vaccine form asks permission for Wal-Mart’s Medical team to vaccinate the student. Students ages 12-14 must have a parent or guardian present in order to receive the Vaccine. For students age 15 and above. The signed permission slip will serve as permission for the COVID-19 vaccination on Keith’s campus.
Technology Devices
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Chromebook Checkout Form
The Chromebook Checkout Form is to be completed before a Chromebook is checked out to a student. For the 2022-2023 School Year, Keith Middle-High School offers to loan students a Chromebook to take home. Chromebooks are to be brought to class daily for the school year. In order to take a school Chromebook home, parents, guardians, and students must sign this form acknowledging that they are financially responsible for the Chromebook until it is returned to the school.
Technology Take-Home Permission Form
Keith Middle-High Curbside Pickup for Laptops/Chromebooks Pickup Dates: September 02-03 2020
Dual Enrollment
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Wallace Community College Selma Admissions Process and Dual Enrollment Registration Information
Dual Enrollment allows high school students to get a jump start on their college career. Students are afforded the opportunity to earn college credit while earning a high school diploma. Dual Enrollment provide students the ability to adjust to the college environment and course expectations before becoming a full-time college student. College credit will be awarded immediately upon successful completion of the course.
Dual Enrollment Eligibility Form
Acceptance to the Dual Enrollment for Dual Credit program at Wallace Community College Selma will be official only upon receipt of this form, completed and signed by the counselor of your local school, and a completed Application for Admission for Dual Enrollment for Dual Credit.
Dual Enrollment Admissions Applications Form
The Summer Semester Registration has begun for [Dual Enrollment]. All forms must be submitted for registration by May 8, 2020. Keith's school counselor, Mrs. Mitchell has provided a form with the Admission Process for new students.
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Keith Middle-High ACIP Plan
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Keith Middle-High School Continuous Improvement Plan (ACIP) Strategy Map
The Alabama Continuous Improvement Plan (ACIP) is an ongoing, working document that is designed to guide the school improvement effort of the school. Open Keith Middle-High School's ACIP. It is reviewed regularly and revised as needed in response to the school’s progress on the identified goals and strategies. These goals are created by the school's leadership team through data analysis and parent/teacher/student feedback. Below is for the latest version of the ACIP
Keith Middle-High School Continuous Improvement Plan (ACIP) Strategy Map
The Alabama Continuous Improvement Plan (ACIP) is an ongoing, working document that is designed to guide the school improvement effort of the school. Open Keith Middle-High School's ACIP. It is reviewed regularly and revised as needed in response to the school’s progress on the identified goals and strategies. These goals are created by the school's leadership team through data analysis and parent/teacher/student feedback. Below is for the latest version of the ACIP
Dallas County Schools Jamari Terrell Williams Student Bullying Prevention Act Policy
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BULLYING COMPLAINT FORM Jamari Terrell Williams Student Bullying Prevention Act
It is required by ACT #2018-472 that this form be submitted by the affected student or the parent or guardian of the affected student, and not by an education employee on behalf of an affected student or his or her parent or guardian. The affected student, or the parent or guardian of the affected student, must submit this form to the school’s Principal or his/her designee in person or by United States postal mail. The principal/designee is responsible for the investigation. Incomplete forms will not be considered for investigation.
Dallas County Schools Jamari Terrell Williams Student Bullying Prevention Act Policy Form
Jamari Terrell Williams Student Bullying Prevention Act The Jamari Terrell Williams Student Bullying Prevention Act has been signed into law by Governor Kay Ivey; it became effective on June 1, 2018. This new Act replaces the Anti-Harassment Policy that had previously been adopted by school systems throughout the state of Alabama beginning with the 2010-11 school year. The major change in this new Act is that it expands the current law to include student against student bullying, intimidation, violence, and threats of violence that occur off school property. In addition, the new Act specifically includes cyber-bullying, which may also occur off school property.
Counselor Forms
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Transcript Request Form
Official Document Request Release address and waiver Transcript fee is $5.00
KMHS Dual Enrollment Flyer for Wallace Community College Selma WCCS
Important Information about Dual Enrollment
WCCS Dual-Enrollment-Admissions-Process
Dual Enrollment allows high school students to get a jump start on their college career. Students are afforded the opportunity to earn college credit while earning a high school diploma. Dual Enrollment provided students the ability to adjust to the college environment and course expectations before becoming a full-time college student. College credit will be awarded immediately upon successful completion of the course.
Important Dual Enrollment Information about Wallace Community College Selma (WCCS)
The Dual Enrollment/Dual Credit for High School Students Program allows qualified students the opportunity to receive both high school credit and college credit. The program is restricted to qualified students in Alabama public and private high schools who have signed a working agreement with WCCS.
DUAL ENROLLMENT FAQ
What is Dual Enrollment? Dual Enrollment is a program that allows high school students to enroll in college coursework and earn college credits.
WCCS Statement of Eligibility for Dual Enrollment for Dual Credit Students
Your acceptance to the Dual Enrollment for Dual Credit program at Wallace Community College Selma will be official only upon receipt of this form, completed and signed by the counselor of your local school, and a completed Application for Admission for Dual Enrollment for Dual Credit.
WCCS Application-for-Admission-for-Dual-Enrollment-for-Dual-Credit
Application for Admission for Dual Enrollment for Dual Credit This application is for accelerated credit and/or dual enrollment purposes. Once you have graduated high school, you must complete the regular College Application for Admission to be admitted as a college student.
PARENT PERMISSION FORM AND HOLD HARMLESS AGREEMENT
The undersigned student and the undersigned parent(s) or legal guardian(s) of the student grant permission for the student to participate in the Wallace Community College program...
Discipline
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Keith Middle High School Discipline Referral
Attendance
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Truancy Referral
Conference Forms
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Parent-Teacher Conference Form