OPEN CAMPUS LUNCH PRIVILEGE – JUNIORS

(Please Keep for Your Records)

Terms and Conditions:  “Open Campus Privilege” is defined as a privilege to leave the Austin HS campus during lunch.  The junior must “qualify” for this privilege.  A “qualifying junior” is one that is in good standing with his/her credits and has had good attendance in the previous school year and in the current school year.  Be aware that during the student’s exercise of the open campus privilege, the school administration may not know the destination, whereabouts, and/or activity of the student; however, the student is still bound by the rules and regulations pertaining to personal conduct as outlined in the HISD Code of Student Conduct and the SFA Student Handbook and will be subject to disciplinary action for violations thereof.

The “qualifying” junior must:

ð        Have a signed parental permission form on file in their AP office, Rm A201.

ð        Maintain a minimum passing grade of 70 in all classes each progress report and report card.

o   Failure to maintain a 70 average will result in loss of privilege for three weeks until next report card or progress report shows a minimum passing grade of 70 in all classes.

ð        Maintain good attendance of not more than 5 total absences per semester

o   Make sure your attendance is accurate every day. Use grade speed to track your attendance and grades.

ð        Follow all rules and regulations as outlined in the SFA Student Handbook and the HISD Code of Student Conduct, for both on and off campus.

ð        Present a picture ID and “Off Campus Lunch Pass”, or will not be allowed to leave.

o   School ID can be used as picture ID

o   Replacement cost for “Off Campus Lunch Pass” is $15. Please do not lose it.

ð        If a student temporary loses privilege, “Off Campus Lunch Pass” must be turned in to A201 until privilege is restored.

ð        Return to school on time by 12:10 pm and return to A3/B3 class on time before 12:15p.m.

ð        Not bring back any food items.  Any food, drinks or snacks will be confiscated and disposed of immediately. 

ð        Not take any other students off campus; it is a serious offense and will result in suspension

ð        Immediately report if “Off Campus Lunch” pass is lost or stolen. Failure will result in indefinite loss of “Off Campus Lunch” privilege for rest of semester.

If you qualify, here is your “to do” list

ð        Have completed all Power Up forms and secured laptop. Casupang or Nino signature required.

ð        Have completed Lunch Application. (Even if not interested or qualified) Barahona signature required

ð        Have completed NextTier account. Salinas signature required.

ð        Have completed a college essay. (Pick up handout from B203) Salinas signature required.

ð        Have earned at least 12credits and be classified as 11^th grade

ð        Complete form on next page and submit to Ms. Ibarra or Andrade in main office with $15 payment.

Remember, “Off Campus Lunch” is a privilege. Violation of any of the above will result in individual loss of open campus privileges, and forfeiture of the nonrefundable $15.00 fee. 

LUNCH PRIVILEGE FORM – JUNIORS

Non-refundable Fee - $15.00 per semester

STUDENT NAME: ________________________           HISD ID NUMBER: ____________

Collect applicable signatures below and submit this form with payment to business office (located in main office.) “Off Campus Lunch” privilege will be effective the Monday following receipt of this form and $15 payment. Student’s “Off Campus Lunch” pass will be delivered to student before lunch on effective date.

*Signatures can only be acquired during lunch hour.

ð        Lunch Application Confirmation: ___________________________________               

A207 Barahona Signature  & Date (Have completed application with you)

ð        Power Up Confirmation: __________________________________

Main Office Nino or B210 Casupang & Date

ð        Next Tier Account & College Essay Confirmation: __________________________________

B203 Salinas & Date

Student/Parent Agreement

I, _____________________________ (student name) have read, understand, and agree to comply with the terms and conditions of the junior open campus lunch privilege.  Furthermore, I acknowledge that while exercising my open campus privilege, I am bound by the rules and regulations pertaining to personal conducts as outlined in the HISD Code of Conduct and SFA Student Handbook and I realize that violations of the aforementioned rules and regulation, or the “Terms and Conditions” will be subject to disciplinary action, up to and including loss of open campus lunch privileges and loss of the $15.00 funds paid.

By signing this agreement, the student and parents agree to release Stephen F. Austin Senior High School from any and all liability for a student’s actions during his or her exercise of the open campus privilege.  Furthermore, this signed agreement also releases Stephen F. Austin Senior High School for any personal injury or loss of life while the student is exercising his or her open campus privilege.

I/We have read, understand and agree to the “Terms and Conditions” of the junior open campus lunch privilege and grant our permission for the above named student’s participation therein.

______________________   ______________________   __________             _______________________        Student Name                   Student Signature                       Date                       HISD ID #

______________________   ______________________   __________             _______________________

Parent 1 Print Name                  Parent 1 Signature            Date                            Phone Number

_____________________     ______________________   __________             _______________________

Parent 1 Print Name                  Parent 1 Signature            Date                            Phone Number

***FOR OFFICE USE ONLY***

CREDITS CHECKED BY: ______________   PAYMENT REC’D BY: _______________ DATE: ____________