Biotech Disclosure and Forms (Required)
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Student's First Name *
Student's Last Name *
High School ID# (This is your lunch number) *
Utah Valley University student# (This is the number you received after you completed the admission process for UVU and paid the admission fee) *
Parent Email *
Student Email *
Student Cell Phone *
Parent Phone Number *
Parent Cell Phone Number *
Home Address (Number and Street) *
Home Address (City) *
Home Address (Zip Code) *
Long Term Activity Authorization
 Activity Description: Biotechnology TSA state competition (optional) and End of Year Student University of Utah Field Trip          

Transportation: Transportation arranged by the school for TSA State and use of TRAX for U of U fieldtrip.

 Parent/Guardian Authorization: My name typed below signifies that I authorize my student to participate in the activities identified above. I recognize that I have full responsibility for my student during the time he/she is off a public school site and for the transportation to and from the activity. *
Utah State Board of Education (Board Approved July 10, 2017) Parent/Guardian Consent Form Human Sexuality Instruction
Biotechnology taught by Mary Carlson at the Jordan Academy for Technology and Careers, 801-256-5900.

Dear Parent/Guardian:

As part of your child’s education, he/she has enrolled in a course that includes instruction on topics related to human sexuality. You are receiving this consent form because instruction and/or discussion of human sexuality topics are controlled by state law and/or Utah State Board of Education rule. Please read the form carefully, select one option, sign, and return to the teacher identified above. Your student will not be allowed to participate in class activities without this completed and signed form on file. Thank you.

INFORMATION

All instruction related to human sexuality and/or sexual activity will take place within the context of Utah State Law (53A-13-101) and Utah State Board of Education rule (R277-474-3) as follows:

The public schools will teach sexual abstinence before marriage and fidelity after marriage.

There will be prior parental consent before teaching any aspect of contraception and/or condoms.

Students will learn about communicable diseases, including those transmitted sexually, and HIV/AIDS.

Program materials and guest speakers supporting instruction on these topics have been reviewed and approved by the local district review committee.

The following are NOT approved by the State Board of Education for instruction and may not be taught:

1. The intricacies of intercourse, sexual stimulation or erotic behavior;
2. The advocacy of premarital or extramarital sexual activity; or
3. The advocacy or encouragement of the use of contraceptive methods or devices;

In accordance with Utah State Board of Education Rule R277-474-6-D, teachers may respond to spontaneous student questions for the purposes of providing accurate data or correcting inaccurate or misleading information or comments made by students in class regarding human sexuality.

DISCLOSURE: The curriculum for this course includes instructions and/or discussions about the topics listed below:

1. Reproductive anatomy and health
2. Contraception, including condoms*
3. Human reproduction
4. HIV and AIDS (including modes of transmission)
5. Information on self-exams
6. Sexually transmitted diseases
7. Date rape (terms of a sensitive/explicit nature may be defined)

*Factual, unbiased information about contraception and condoms may be presented as part of this course (only if the box above is checked). Demonstrations on how to use condoms or any contraceptive means, methods, or devices are prohibited and are NOT authorized. This consent form may be sent to parents within 2 weeks after the beginning of the course, but not less than 2 weeks prior to instruction of the identified topics. Under state law, your child cannot participate in the scheduled instructional activity specified above unless and until this signed letter of permission is returned to the teacher identified on this form. Signed forms will be kept on file at the school for a minimum of one year.


CHOOSE ONLY 1 OPTION *
Submit Topic that is the exception for option 2 permission.
Policy on Transmitted Diseases
Students in health occupations should always be aware of potential contamination from infectious agents in the health care environment. It is important that everyone be alert to prevent accidental exposure. Since it is not possible to identify all patients with transmissible disease, especially in emergency situations, health care providers should treat all patients at all times as if they are a potential source of infection. This approach includes precautions for contact with patients’ blood and body fluids. This is referred to by the CDC (Center for Disease Control) as “Universal Precautions”. Practice of these precautions will provide protection against HIV (Human Immunodeficiency Virus), the cause of AIDS, HBV (Hepatitis B virus), and other blood-borne infectious agents. Rigorous adherence to these guidelines will be required of all students and faculty.

Basic aseptic technique practiced by health care students/faculty in conjunction with the following blood and body fluid precautions can prevent the transmission of HIV, HBV, and other blood-borne agents.

1. All patients, their blood, and other body fluids, will be considered to be infectious at all times.

2. Regardless of patient status, the student and faculty will:

a. Wash hands thoroughly with soap and water BEFORE and AFTER contact with patients, their blood, urine, or other body fluids.

b. Consider sharp items (needles, instruments, etc.) as being potentially infective and handle with extreme care to prevent accidental injury.

c. Wear gloves when handling patient blood, body fluids, and/or items soiled with blood or other body fluids.

d. Wear gown, mask, and eye covering when performing procedures where splashing or spraying is likely to occur.

e. Clean up spills of blood or body fluids immediately (while wearing gloves) with a disinfectant such as 1:10 dilution of chlorine bleach.

Procedure for Reporting Potential Exposure

1. Any incident of potential contamination must be reported to and fully documented by the clinical instructor on-site and then to the classroom instructor at the Jordan Applied Technology Center.

2. Assessing the situation and recommending action will be a joint responsibility of the clinical instructor, classroom instructor, JATC administration, and Risk Management specialist.

Each student is required to get the Hepatitis B series of injections. This protects the students from contracting Hepatitis B. The student is responsible for setting up the appointments and following through with the series of injections. The injections can be obtained from the County Health Department or through a private physician.

My student and I have read the Policy on Transmitted Diseases and understand the student’s responsibility in following these guidelines.
Parent Signature (Type Legal Name) Policy on Transmitted Diseases *
Student Signature (Type Legal Name) Policy on Transmitted Diseases *
TSA as a Student Organization
The Technology Student Association (TSA) is a national organization of students engaged in science, technology, engineering and mathematics (STEM). Open to students enrolled in or who have completed technology education courses, TSA’s membership includes over 233,000 middle and high school students in approximately 2,000 schools spanning 49 states. TSA is supported by educators, parents, and business leaders who believe in the need for a technologically literate society. Members learn through exciting competitive events, leadership opportunities and much more. The diversity of activities makes TSA a positive experience for every student. From engineers to business managers, our alumni credit TSA with a positive influence on their lives.

JATC has an active chapter:

The fee to join is $5.00 and must be paid  by mid Sept.

Students may participate in the following activities:
o Leadership training (for officers) in Oct.
o CTSO socials
o State competitions in all STEM areas (Mid-March)
*First place finishers will have the opportunity to compete at Nationals
  3rd week in June.

AUTHORIZATION FOR PARTICIPATION IN A STUDENT LEADERSHIP ORGANIZATION
Leadership Organization: Technology Student Association (TSA)

I am the custodial parent or legal guardian of the above named student. I understand that my student wishes to participate in the above named, student leadership organization at the Jordan Academy for Technology and Careers. I understand that membership and participation in this organization are voluntary. During approved student leadership meetings, a supervisor will be present to provide supervision and sponsorship and to ensure compliance with applicable school policies.

This student leadership organization has been authorized by the school based on its stated purposes and activities as set forth in the organization’s application and charter. I understand that I may make arrangements to inspect a copy of the application and charter of this organization which describes the nature, purposes, structure, and other information about this organization. I am satisfied that by either obtaining this information from my student and/or inspecting the organization’s charter, I have sufficient information about this organization to make an informed decision regarding my student’s participation. With all of these considerations in mind, I authorize my student’s participation in this student leadership organization. I further understand that my consent may be withdrawn at any time if I notify the school in writing of that withdrawal of consent.
Parent Signature (Type Legal Name) Authorization for Participation in a Student Leadership Organization *
TSA CODE OF CONDUCT
A good reputation enables members to take pride in their organization. HOSA members have an excellent reputation. Your conduct at any HOSA function should make a positive contribution to the reputation that has been established.

1. Your behavior should be professional at all times and reflect positively of you, your school/college, your state and HOSA.
2. Student conduct is the responsibility of the student monitored by the local chapter advisor. Students shall keep their advisors informed of their activities and whereabouts at all times. (HOSA conference name badges shall be worn at all times.) Students should stay in groups and not leave with strangers.
3. You are expected to attend all general sessions and other scheduled conference activities. Please be prompt and show respect to those in the audience and on stage.
4. Members are to report any accidents, injuries or illnesses to their local and state advisor immediately.
5. Members are expected to observe the designated curfew. (Curfew means being in your own room by the designated hour.)
6. Students are responsible for paying any additional room charges-phone calls, movies, food, etc. - as well as any charges incurred for vandalism, damage or theft.
7. Members/participants attending the HOSA event may not purchase, consume or be under the influence of alcohol or drugs at any time. Violators will be subject to stringent disciplinary action.
8. Smoking or chewing tobacco is not allowed.
9. Students who disregard the rules will be subject to disciplinary action and will be sent home at their own expense. Parents will be notified.
10. Students are not to have access to vehicles during the HOSA activity. In case of exception approved by the high school principal and the parent, the student is not to transport or be transported by other students.
11. Members should abide by the dress code during the entire event. Tank tops, mini-skirts, mini-shorts, bikinis, spaghetti straps are unacceptable during the conference.

GENERAL SESSIONS PROTOCOL

The general sessions should be enthusiastic, but must not be rude or obnoxious to those in the audience or on stage. It is important to remain seated until the end of the session. People that do not adhere to general session protocol will be asked to send a representative to a special meeting of the State Executive Council.

I have read the above Code of Conduct for HOSA conferences and activities and agree to abide by these rules as indicated by my signature below.
Parent Signature (Type Legal Name) TSA Code of Conduct Agreement *
MEDIA RELEASE FORM
Students at the Jordan Academy for Technology and Careers are periodically filmed, photographed or interviewed regarding programs and/or activities at the school. These are used for educational purposes including: the school web site, news articles, pamphlets, brochures, class activities and projects or to promote the courses offered at the school.
Media Release Permission: I am the parent/legal guardian of the student named above, and agree to the following: *
Permission for viewing of movies and/or videos that are educationally relevant and rated PG/PG-13: I am the parent/legal guardian of the student named above, and agree to the following: *
Permission for students to access various sites:  Biotechnology activities and college and career readiness activities that are promoted at the JATC may require the assessment and sharing of student information to education-related entities outside of Jordan School District as listed below:                                    
•      UtahFutures website: https://utahfutures.org/
Comprehensive School Counseling Program needs assessment questions:
         https://docs.google.com/a/jordandistrict.org/document/d/14cVV3U2v6TmsmeAP2N6jQgaKFmnIk9VQEMgCMSK- 
          4xA/edit?usp=sharing
FAFSA information and completion events: https://stepuputah.com/id/students/apply-for-the-fafsa/
Utah Scholars program: https://stepuputah.com/id/students/utah-scholars-the-first-step-to-college/
Utah College Application Week: https://stepuputah.com/id/schools-educators/get-ready-utah-college-application- 
         week/
Utah Valley University Concurrent Enrollment Admissions: https://www.uvu.edu/concurrent/
Aug. 2021: Websites/apps for learning: Decktoys.com, Kahoot.com, Flipgrid.com, Teachermade.com, Socrative.com


I am the parent/legal guardian of the student named above, and agree to the following:     *
Biotechnology Lab Safety Contract
Biotech Lab Safety Contract


For success in our laboratory, everyone must agree to respect the same laboratory rules, to obtain and use the proper safety equipment, and to take appropriate precautions during a lab activity.  

Very Important things to remember:

1. ABSOLUTELY NO food or drink in the laboratory.  Never eat or drink in the laboratory.
2. NEVER taste chemicals.  NEVER directly touch chemicals.
3. No pipetting by mouth.
4. Never work alone in the laboratory.
5. Never perform any experiment not specifically assigned by your teacher.
6. Use lab equipment properly and only after training and instruction.
7. Do not apply cosmetics in the laboratory.
8. It is best not to wear contact lenses in the lab.  Chemical vapors can get between the lenses and the eyes and cause permanent eye damage.
9. Know the location of all safety and emergency equipment used in the laboratory.
10. Become familiar with the specific hazards of an experiment before you begin.
11. Before beginning work: tie back long hair, roll up loose sleeves and put on any personal protective equipment required by your teacher.
12. Report any accidents, incidents, or hazards to the teacher immediately.
13. Keep your work area neat and uncluttered.
14. Clean your work area at the conclusion of a lab activity, disinfect your station with an ethanol or bleach solution.
15. Follow the proper disposal of all reagents, sharps, and broken glass.
16. Wash your hands with antibacterial soap and water.
17. Always respect lab work.  Due to the amount of students that will utilize the biotech lab, there will be other experiments at or around the workstations.  Please leave them alone.


Your commitment to the lab safety rules and your respect of the property in the laboratory are absolutely necessary.  If intentional misuse or abuse of the lab and its property is intended, you may be removed from the course.


I understand the items listed in this safety contract and the importance of safety in the laboratory and agree to conduct myself appropriately by adhering to safe laboratory practices as instructed.

I agree to abide by the above mentioned Lab Safety Rules:  Students- sign below: *
Concurrent Enrollment
Concurrent Enrollment Program Terms and Conditions

1. Concurrent Enrollment (CE) provides high school students an opportunity to take classes that earn both high school and college credit.
2. CE classes are college classes that require rigorous academic work. Course content may include controversial cultural, religious, political, aesthetic and human sexuality topics. Students must have the maturity to engage with the material in an academically appropriate manner and the organization and time management skills to complete more rigorous and demanding work than is required in high school. Students must also meet all college/university prerequisite requirements before enrolling in a CE class.
3. The CE program is open to students in grades 11 and 12; students in grades 9 and 10 may be admitted on a case-by-case basis. Students must be enrolled in a Utah public high school and be counted in the average daily membership. Students who have received a diploma, whose class has graduated from high school, or who have participated in graduation exercises are not eligible to participate in the CE program. Home-schooled students are eligible to participate in CE classes with permission from their local resident high school. Home-schooled students are subject to the same obligations as any student in the CE program.
4. Students may enroll in up to 30 CE credits per year. A CE class may not be repeated.
5.   CE class registrations and grades, including withdrawals, are recorded on permanent high school and college transcripts, which may later impact eligibility for scholarships and financial aid and admission to certain college or university academic programs.
6. Withdrawing from or failing a CE class may impact a student’s ability to receive financial aid in the future or enroll in additional CE classes.
7. SUBMITTING THIS FORM DOES NOT ENROLL THE STUDENT IN CE CLASSES. Students must complete the college or university’s online enrollment process and pay CE class tuition.
8. A student who wishes to withdraw from a CE class must do so through his/her high school AND the college/university.
9. Although CE credit transfers from one Utah public institution to another, students should consult a college/university academic advisor to make class choices that meet their educational goals and transfer as equivalent credit.
10. CE students must abide by the college/university Student Code of Conduct and the high school Student Code of Conduct.  
11. Students must contact the college/university CE administrator to request accommodations for a disability that may be required under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act.

STUDENT ACKNOWLDGEMENTS
I have read and understand the terms and conditions of the CE program and wish to participate.
I agree to abide by the terms and conditions of the CE program or risk loss of CE credit or removal from the CE program.

 
PARENT/GUARDIAN PERMISSION TO PARTICIPATE
I have read and understand the terms and conditions of the CE program and give permission for my child to participate.
I understand that my child must abide by the terms and conditions of the CE program or risk loss of CE credit or removal from the CE program.
Student Acknowledgement of Concurrent Enrollment Terms and Conditions (type name) *
Parent Acknowledgement of Concurrent Enrollment Terms and Conditions (type name) *
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