I PS MI SSI O N ST AT EMEN T I PS BEL I EF...

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The International Programs School اﻟﻌﺎﻟﻤﯿﺔ اﻟﺒﺮاﻣﺞ ﻣﺪرﺳﺔBoys & Girls واﻟﺒﻨﺎت ﻟﻠﺒﻨﯿﻦAmerican Curriculum اﻷﻣﺮﯾﻜﻲ اﻟﻤﻨﻬﺞAl Khobar, Saudi Arabia اﻟﺴﻌﻮدﯾﺔ اﻟﻌﺮﺑﯿﺔ اﻟﻤﻤﻠﻜﺔ اﻟﺨﺒﺮ،IPS MISSION STATEMENT In partnership with the school community, the mission of the International Programs School is to: Engage students from diverse cultural backgrounds in a comprehensive, American and international college preparatory program, that challenges, and encourages high expectations for success. Empower students to become independent, critical thinkers with the skills to participate positively in a global society. Promote understanding, tolerance, and compassion for others, and develop students of integrity and principle. IPS BELIEFS We believe that every child is a unique individual with potential for growth. We believe that the best learning and teaching takes place in a safe and orderly environment that is free of prejudice, violence, and bullying. We believe in students striving to achieve their full potential guided by caring, professional staff. We believe that the skills to utilize technology are essential to prepare students for the future. We believe that all students are responsible for active participation in their own learning. We believe in developing responsibility and service to others by modeling and teaching ethical and moral issues. We believe that high standards of excellence in teaching are necessary to challenge students. We believe in respectful, honest, and constructive communication among all members of the school community. IPS GRADUATE PROFILE International Programs School graduates are academically, intellectually, and technologically competent. Through creativity and innovation, they are able to conceptualize, analyze, and solve problems. Expressing themselves intelligently and interestingly both orally and in writing, they possess the necessary 21st century skills to advance to a higher level of education and be successful in the school of their choice. Furthermore, they have the ability to be productive members of society. Being adaptable to change they are capable of thinking independently as well as working and engaging in teams. Being able to take risks and explore new ideas they are able to accept, appreciate, and work in harmony with culturally diverse peoples and able to inspire and motivate others. Our graduates are responsible for their actions. While reflecting on their own performance, they will be successful in their personal goals. They selflessly serve to make the world a better place and are instilled with the desire to use their education to serve society. Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A. Girls’ School L.N. 4322340008 Boys’ School L.N. 085 سC.R. 2051024474 P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

Transcript of I PS MI SSI O N ST AT EMEN T I PS BEL I EF...

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

IPS MISSION STATEMENT

In partnership with the school community, the mission of the International Programs School is to:

● Engage students from diverse cultural backgrounds in a comprehensive, American and international college preparatory program, that challenges, and encourages high expectations for success.

● Empower students to become independent, critical thinkers with the skills to participate positively in a global society.

● Promote understanding, tolerance, and compassion for others, and develop students of integrity and principle.

IPS BELIEFS

● We believe that every child is a unique individual with potential for growth. ● We believe that the best learning and teaching takes place in a safe and orderly environment that is free of

prejudice, violence, and bullying. ● We believe in students striving to achieve their full potential guided by caring, professional staff. ● We believe that the skills to utilize technology are essential to prepare students for the future. ● We believe that all students are responsible for active participation in their own learning. ● We believe in developing responsibility and service to others by modeling and teaching ethical and moral issues. ● We believe that high standards of excellence in teaching are necessary to challenge students. ● We believe in respectful, honest, and constructive communication among all members of the school community.

IPS GRADUATE PROFILE International Programs School graduates are academically, intellectually, and technologically competent. Through creativity and innovation, they are able to conceptualize, analyze, and solve problems. Expressing themselves intelligently and interestingly both orally and in writing, they possess the necessary 21st century skills to advance to a higher level of education and be successful in the school of their choice. Furthermore, they have the ability to be productive members of society. Being adaptable to change they are capable of thinking independently as well as working and engaging in teams. Being able to take risks and explore new ideas they are able to accept, appreciate, and work in harmony with culturally diverse peoples and able to inspire and motivate others. Our graduates are responsible for their actions. While reflecting on their own performance, they will be successful in their personal goals. They selflessly serve to make the world a better place and are instilled with the desire to use their education to serve society.

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

SCHOOL PROFILE

Located within the Eurovillage Compound in Al Khobar, IPS offers an exceptional education for students in Kindergarten through Grade 12. The school is fully accredited by the Middle States Association of Colleges and Schools, and is licensed by the Saudi Ministry of Education. IPS is a gender-segregated school. Founded in 2000, IPS offers an American curriculum. Graduates earn an American High School Diploma that qualifies them for admission to colleges and universities in the US, Canada, Europe, and elsewhere. IPS’ programs are carried out under the guidance of certified and experienced teachers from all over the world with high quality texts, materials, and services. As an international school, we value the diversity of our families and staff. Teachers and staff pride themselves on maintaining high standards which they accomplish through small classes, a personal touch, and dedication to the success of their students. As a result, IPS has become one of the leading schools in the Eastern Province. The student population is multinational representing over 35 countries from around the world. Student numbers have grown substantially over the recent years, and IPS is preparing for the construction of a new purpose-built campus that will enable the school to expand in size and enhance its academic curriculum offerings. Elementary students from KG1 through Grade 5 are grounded in the IPS core curriculum: English language (comprehensive reading skills and 6 + 1 Traits writing skills): Mathematics (including computer skills); Science (Life Sciences, Physical Sciences, Earth Sciences); Social Studies (history, geography, civics); Arabic Language (First and Second Language); Islamic Studies; and Physical Education. In addition, elementary students take classes in Art, and Computer skills. All subjects are taught in a carefully organized curriculum sequence that emphasizes real conceptual learning and critical thinking. Whenever possible, teachers employ cooperative groups for interdisciplinary projects. Elementary students from Grade 1 are also eligible to participate in a range of after-school clubs throughout the year, which might include choices like drama, arts and crafts, foreign language, sports activities, educational board games, etc. Middle school students from Grade 6 through Grade 8 continue with the IPS core curriculum of English, Mathematics, Science, Social Studies, Arabic (First and Second) Language, Islamic Studies, Saudi History & Geography and Physical Education. Students apply and develop their computer skills in the core subjects; in addition to Art, they also have the opportunity to take French. ESL is offered as much as possible to students who need English language support. The curriculum continues to emphasize critical thinking and cooperative, interdisciplinary projects including the popular Week Without Walls program. Middle school students can also choose from a wide array of after-school activities. High school students from Grade 9 through Grade 12 take the courses they need to fulfill the IPS graduation requirements in English (English Literature and English Composition); Mathematics (Algebra I, Algebra II, Geometry, Precalculus, and Calculus); Science (Physical Science, Biology, Chemistry, and Physics); Social Studies (US History, World Geography, World History, and Saudi History & Geography); Business and Economics; Physical Education and Health; Art; Islamic Studies; Computer Studies; and Language (Arabic or French). Extra-curricular activities include Yearbook, Sports, Model United Nations and Week Without Walls. All juniors and seniors are required to take Guidance classes to prepare them for college or university.

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

The International Programs School is seeking authorization to become an IB (International Baccalaureate) World School and offer the Primary Years Programme (PYP) and the Diploma

Programme (DP). Once IPS becomes an IB authorized school, all KG through G6, and 11th and 12th courses will be part of the IB program, with the addition of Saudi requirements (Arabic Language,

Saudi History and Geography, Islamic Studies, and Islamic Culture.)

Owner: Ms. Haifa Mubarak Al Suwaiket

Director: Mr. Jim Leahy KG-G3 Principal: Ms. Linda Amin

G4-G12 Boys’ Principal: Mr. Mark Decker G4-G12 Girls’ Principal: Ms. Lorraine Els Saudi Girls’ Principal: Ms. Elham Al Jaafar

The International Programs School in Al Khobar, Saudi Arabia offers programs for Kindergarten I through Grade12. The school is accredited by the Middle States Association of Colleges and Schools (MSA) and licensed by the Ministry of Education – Saudi Arabia. The language of instruction is English and the school features:

● A high quality American and international curriculum that is well-articulated and suited for the 21st century.

● Fully certified and experienced teachers. ● Suitable premises with good facilities to accommodate our formal academic program as well as our

extra-curricular activities program.

We advise all potential families to review our Mission, Beliefs, Graduate Profile, and Family handbook featured on our website.

For further information about IPS please visit www.ipsksa.com, contact the School, or visit the office in the EuroVillage Compound in Al Khobar.

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

Yearly Tuition Fees 2016-2017

Grade Enrollment Fee (non-refundable)

Annual Tuition 1st Installment due Sept 25, 2016

2nd Installment due Feb 12, 2017

KG1 (1/2 day program)

SR 4,000 SR 28,000 SR 14,000 SR 14,000

KG2 SR 4,000 SR 39,250 SR 19,625 SR 19,625

G1 – G3 SR 4,000 SR 44,000 SR 22,000 SR 22,000

G4 Girls SR 4,000 SR 44,000 SR 22,000 SR 22,000

G4 Boys SR 4,000 SR 39,000 SR 19,500 SR 19,500

G5 - G6 Girls SR 4,000 SR 46,750 SR 23,375 SR 23,375

G5 - G6 Boys SR 4,000 SR 41,750 SR 20,875 SR 20,875

G7 - G8 Girls SR 4,000 SR 47,750 SR 23,875 SR 23,875

G7 - G8 Boys SR 4,000 SR 42,750 SR 21,375 SR 21,375

G9 Girls SR 4,000 SR 51,750 SR 25,875 SR 25,875

G9 - G12 Boys SR 4,000 SR 46,750 SR 23,375 SR 23,375

G10 – G12 Girls SR 4,000 SR 51,750 SR 25,875 SR 25,875

Notes:

● Above fees are quoted in Saudi Riyals. ● Tuition fees include the use of books. ● Tuition fee discounts are given to parents with three or more children:

25% discount for the third child 50% discount for the fourth and fifth child

● Students are allowed to attend school only after 1st installment tuition fees have been paid. ● Payment may be made by Wire Transfer, Cash or Bank Draft to the following:

Account Name: International Programs School Bank Name: Riyad Bank Account #: 3160751039940 IBAN #: SA22 2000 0003 1607 5103 9940 SWIFT Code: RIBLSARIXXX

**Personal checks will not be accepted.**

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

Uniform

The IPS uniform consists of:

● Polo Shirt with IPS Logo (Boys & Girls: all grade levels), short sleeves and long sleeves ● Navy Blue Dress Pants (Boys & Girls: all grade levels) ● Checkered Blue Culottes Skirt (Girls: KG1 – G6) ● Navy Blue Dress Shorts (Boys: KG1 – G5) ● Blue P.E. T-Shirt with IPS Falcon Logo (Boys & Girls: all grade levels) ● Navy Sports Trousers (Boys & Girls: all grade levels) ● Navy Sports ¾ Bermuda (Boys &Girls: all grade levels) ● Navy Sports Jacket (Boys & Girls: all grade levels) ● Navy Winter Jacket (Boys & Girls: all grade levels)

**Uniforms are on sale at this location:**

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A.

Licensed by the Ministry of Education – Eastern Province, K.S.A. Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

IPS Enrollment Procedures

A. Registration – The following documents MUST be submitted when applying for enrollment: (**Submission of the application form and documents does not guarantee that a child will be accepted to IPS. **)

(1) Fully completed application form (form enclosed) with all required signatures. (2) Signed IPS Mission Statement and Beliefs (form enclosed). (3) IPS requires photocopy of the Academic report cards for the previous three years (current year + last two years) in English. (4) Academic records must meet the Ministry of Education requirements (see the diagram on the next page) (5) High School applicant must submit a complete Transcript of Records with stamp and signature. (6) Current School Confidential Recommendation Letter. (Click on the links below & follow grade- specific document). Kindergarten Recommendation Letter Grade 1-5 Recommendation Letter Grade 6-12 Recommendation Letter (7) Photocopy of parents’ and child’s passports. (8) Photocopy of child’s birth certificate. (9) Photocopy of parents’ and child’s Iqama / Saudi family I.D. (front and back)/ GCC ID.

Note: If the student’s Iqama is in process, there should be a copy of the resident visa and a letter from the Company stating the Iqama is in process. (10) Employment letter from parent’s company in Saudi Arabia (for expats only).

B. Testing – When application forms and documents have been completed and submitted, your child will be given an admissions test schedule and payment of the testing fee will be collected. Incomplete application forms and documents will not be accepted and admission testing will not be scheduled. An admissions test is administered to assess student's levels of reading, writing, and mathematics. The testing fee of 750 SAR is non-refundable. In the event testing for admission is not possible, then this fee will be refunded. C. Acceptance & Enrollment Fee – After completing the assessment to the required standard, the school will contact you to offer a place in your child’s age-appropriate class, provided that there is an opening. Once contacted, in order to confirm and hold your child’s place, you must come in to pay the non-refundable enrollment fee. It is not possible to defer this fee for any reason. Your child’s enrollment is not official until this step is completed.

Failure to attend school within 2 weeks of enrollment and/or start of the school year will result in withdrawal from IPS.

B. Tuition Fees – Once officially enrolled, the school’s accounts department will provide you with an invoice that states the payment guidelines and due dates of installments. No child can attend school until the first installment of tuition fees has been received. We accept only wire transfer, cash, or bank drafts. Under no circumstances will personal checks be accepted. C. Refund – If a student attends up to 20 days of a semester, semester tuition will be prorated by week. If a student attends 20-40 days of the semester, 50% semester tuition is refunded. If a student attends 40 or more days of a semester, full semester tuition applies and there is no refund. D. Other Required Documents – Please submit these additional documents upon acceptance before the start of the school year (soft or hard copy):

1. Copy of Standardized Test Results if any. 2. Most Current, Complete and Final Report Card from previous school meeting all Ministry of Education or equivalent. (See the diagram). 3. Statement of Checkout or Leaving/ Transfer Certificate from previous school in K.S.A. (should indicated that all fees has been paid) 4. Photocopy of student’s Ministry Approval, if coming from a school in K.S.A. 5.IPS Medical form (enclosed), to be completed, signed, and stamped by a physician from within K.S.A.

E. Waiting List – Because there is high demand for enrollment in IPS, there may be a wait-list. When this is the case, we will put your child’s name on the list and contact you when/ if space is available.

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

Application Form for Student Enrollment

STUDENT NAME (AS WRITTEN ON THE PASSPORT) First Name _______________ Middle Name _____________ Last Name _______________ What name would you like the teacher to call your child? ______________________ Sex _____ Religion _____________ Date of Birth M _____ D _____ Y _____ Place of Birth _______________________ Citizenship _____________________ Passport No. _____________________ Iqama No./ ID No. _____________________ PARENT DATA Guardian (if other than parent) __________________________________________ Name of Father __________________________ Name of Mother ________________________ Citizenship __________________________ Citizenship ________________________ Occupation __________________________ Occupation ________________________ Employer’s Name __________________________ Employer’s Name ________________________ Type of Business __________________________ Type of Business ________________________ Home Address __________________________ Home Address ________________________ Home Tel. __________________________ Home Tel. _________________________ Mobile __________________________ Mobile ________________________ E-Mail ___________________________ E-Mail _________________________ Business Tel. ___________________________ Business Tel. _________________________ Business Fax ___________________________ Business Fax _________________________ BROTHERS & SISTERS DATA Name Grade

School ____________________________ ____________________ ____________________ ____________________________ ____________________ ____________________ ____________________________ ____________________ ____________________ EMERGENCY CONTACT (other than parents/ guardian)

Name Telephone Address Relationship to Applicant

_______________ __________________ ________________ _________________

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

ACADEMIC DATA

Previous School(s) Year Grade Attended Language of Instruction

Telephone Country/ City

APPLYING FOR GRADE _______________ Academic Year ______________ Term _______________

OTHER INFORMATION Language(s) spoken at home ______ ____________________________________________________________

Has the applicant skipped or repeated a grade? Yes No If yes, which grade? _________________

Has the applicant received services for learning disorder/ special education? Yes No

If yes, which grade and for which condition? ______________________________________________________

Please be aware that as a small school we do not have Special Education Facilities. Are you aware of any Special Needs – physical, social or academic – your child might have? Please sign below and state any Special needs. Failure to notify the school of special needs or previous assessments may result in immediate dismissal. Special Needs _________________________________ Parent’s Signature __________________________

Any medical conditions ______________________________________________________________________ Any other information ______________________________________________________________________ With whom does the child live? Both Parents Father Mother Other ________________________________ Can we use photos of your child for school purposes such as brochures and website? Yes No Can we take photos of your child for the school yearbook? Yes No Parent’s Signature ____________________________ Date _____________________

In order to assist the school’s accounting department, please tick one of the options below to indicate how the school fees will be paid:

Company will cover full tuition fee I will cover full tuition fee Company will partly subsidize tuition fee

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

From our Mission and Beliefs come four Basic Principles that guide us:

1. Be Kind 2. Be Respectful 3. Be Responsible 4. Be Safe

Our Family Handbook contains many policies and procedures and it is important to review these each year. We feel it is important to note the following:

● Attendance Students are expected to attend school and classes at all times. The published school calendar should be used by families when planning holidays. Students who miss more than 10% of class days may not be eligible for promotion.

● Communication Open and honest communication is expected. Our offices must be contacted when children are absent or if early dismissal is necessary. Notes from doctors must be presented after illness.

● Proper Attire Students are required to wear the school uniform at school or during school functions. Students not wearing a proper school uniform will be sent home to change, and recorded as late upon their return.

● Electronics Cell phones, laptops, iPads, etc. may be used on campus ONLY for educational purposes.

The IPS Mission Statement, Beliefs, Graduate Profile, as well as the IPS Family Handbook are sent to parents via email and are posted on the school website (www.ipsksa.com). Please read these carefully and discuss with your child/ren. My signature below indicates my agreement with the IPS Mission Statement, Beliefs, Graduate Profile, and school policies as stated in the Family Handbook. I accept that authority for disciplinary action lies with the school administration. This includes a requirement that all students are expected to participate fully in our Physical Education program as part of the curriculum. IPS values all faiths and ethnicities within the school community and responds to issues using a kind, respectful, responsible, and safe approach. I hereby confirm that all statements made in this application and all documents submitted are true and authentic, and agree that any misrepresentation may lead to immediate withdrawal. Student’s Name & Gr. _____________________________ Parent’s Name __________________________ Student’s Signature ______________________________ Parent’s Signature _______________________

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

MEDICAL FORM (Must be completed, signed and stamped by an Attending Physician in Al Khobar)

Student’s Full Name: __ Date of Birth: _________ Gender:(circle) M / F Gr:__________ DD/MM/YY

**Please complete the vaccination history below and kindly attached a copy of the most recent vaccination record.** Immunizations: (The following are mandatory for admission to IPS.)

Dates (dd/mm/yy) Booster (dd/mm/yy)

1st 2nd 3rd 4-6 years 14-16 years DPT (Diptheria, Pertussis, Tetanus) Td ( Tetanus, Diphtheria) OPV/IPV (Polio) MMR (Measles, Mumps, Rubella) BCG Student’s Health History Does the student have a history of any of the following? If yes, specify treatment, cause/ allergies and severity.

HEALTH PROBLEMS YES NO DETAILS 1. Allergies – Food/Medicine/Environmental 2. Asthma 3. Attention Deficit Disorder/ Hyperactivity 4. Anxiety/Depression 5. Blood/Bleeding Disorders/Nosebleed 6. Bowel Problems 7. Chickenpox 8. Diabetes/Endocrine Problems 9. Frequent Ear Infections 10.Frequent Headaches/Dizziness 11.Gyne/Menstrual Problems 12. Hearing/Speech Difficulties 13. Heart Disease/ Problems 14. Kidney/Urinary problems 15. Musculoskeletal Disorder 16. Neurological Problems 17. Skin Problems 18. Seizure Disorder/Epilepsy/Convulsion 19. Vision Problems/Glasses/Contact Lens 20. Other Health Problems:

● Please state any past or present serious illness, fractures and surgeries _______________________________________ ● Restrictions: Medical/Gym/Swimming/Recommendations pertaining to educational program or school management?

(specify) _________________________________________________________________________________________ ● Does the student have any learning disabilities and developmental delays that need special education? YES/ NO

If YES, please give details____________________________________________________________________________ ● Is the student on psychotropic or any regular medication? YES /NO. If Yes, please list: ___________________________

________________________________________________________________________________________________ Based on a current history and physical examination, I find the above named student free of contagious disease, vaccinated in accordance with the above mandatory school requirements and fit for all usual school activities. Doctor’s Signature: ____________________________ M.D. Date: ___________________

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

STUDENT HEALTH RECORD

(Must be completed, signed, and submitted by the Parents on or before the first day of school.)

**Please fill in appropriate information and return to us as soon as possible. It is very important for the school nurse to know the medical condition of your child, especially if he/she becomes ill at school. It is also essential for the staff and the nurse to know of children who have allergic conditions and requiring medical attention.** Name of Student: ___________________________ Age: ____ Gender: M/F DOB: ________ Gr: ________ Medical Alert: _______________________________ Allergies: ____________________________________ Home Information: Phone: _________________ Address: _____________________ City: ________________________ Care Provider Information: Father: _____________________________________ Mobile Phone: _____________________

Mother: _____________________________________ Mobile Phone: _____________________ Emergency contact person if parent cannot be reached: _________________________________________ List of siblings attending IPS: Name: ____________________________ Grade: ____ Name: _________________________ Grade: ____ Name: ____________________________ Grade: ____ Name: _________________________ Grade: ____ Name: ____________________________ Grade: ____ Name: _________________________ Grade: ____ Family Doctor: ____________________________ Clinic: _____________ Phone: _____________________ ------------------------------------------------------------------------------------------------------------------------------------------------------------ **In the event of an extreme medical emergency the nurse will use the closest hospital services (Procare and Saad Specialist Hospital**) ------------------------------------------------------------------------------------------------------------------------------------------------------------ **If your child has a chronic condition such as asthma, an allergy, diabetes, seizure disorder, bleeding or other health problems and student requiring medication during school hours please contact the school nurse.** Current Medications: (include dosage/ time) _________________________________________________________________________________________ _________________________________________________________________________________________ ------------------------------------------------------------------------------------------------------------------------------------------------------- Date of Last Physical Exam: ______________ By: _____________________________ Date of Last Dental Exam: ______________ By: _____________________________ Date of Last Vision Exam: ______________ By: _____________________________

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

Permission for Medication: IPS has my permission to give my child the following medications if necessary (in age appropriate doses): Please circle: Paracetamol (Panadol, Fevadol, Tempra),Ibuprofen for mild aches & menstrual cramps YES NO Strepsil Lozenges for sore throat YES NO Loratadine/Claritin/Zyrtec for allergy YES NO Domperidone for nausea and bloated stomach YES NO First Aid Medications for Minor Wounds, Insect Bites YES NO Creams for burns, bruising and muscle pains YES NO Opthalmic/Refresh Eye drops YES NO Others: ___________________________ YES NO

● Students with medical conditions such as asthma, diabetes and allergies should have necessary medications (i.e. inhalers, topical creams, etc.) stored in the Nurse’s Office at all times.

● For severe life threatening allergies please provide prescribed medicine (Epi-pen) in a pharmacy labeled container for emergency use.

**Any medication to be given at school must be sent to the Nurse’s Office in the original container, properly labeled by the Pharmacy or Physician with written instructions including: Student Name & Grade, Current Date, Dosage, Route, Time of Administration and Parents Signature. Long-Term medication must be accompanied by a note from your Child’s Doctor or signed Consent for Prescribed Medication signed by the healthcare provider and parents.** **I hereby give permission for emergency measures to be initiated in case of accident or sudden illness with the understanding that I will be notified as soon as possible. I also understand that IPS or their designee cannot be held liable for their actions while performing their duties in a responsible manner.** Signature of Parent: _________________________ Date: ___________________ **All information provided will be kept confidential. Our goal is to provide the healthiest and safest environment at IPS. We will be happy to assist you with any questions or concerns. **Note: All medical records must be completed and on file in the Nurse’s Office on the date the student enters school. If the health status of your child changes, please update this form so that we may better serve your child.**

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com

The International Programs School مدرسة البرامج العالمیة

Boys & Girls للبنین والبنات

American Curriculum المنهج األمریكي

Al Khobar, Saudi Arabia الخبر، المملكة العربیة السعودیة

ADMISSION TESTING TICKET (Parent Copy)

TO BE FILLED BY OFFICE PERSONNEL ONLY:

● Your child _____________________________ applying for Grade ____________ will be tested on:

Wed, February 10, 2016 Wed, March 2, 2016 Wed, March 30, 2016 Wed, April 13, 2016 Wed, April 27, 2016 Wed, May 11, 2016 Wed, May 25, 2016 Mon, Sept 19, 2016 Wed, September 28, 2016

● Testing will begin promptly at 4:00 pm. Please arrive in the school at least 15 minutes early. Gates will close 5 minutes

before the exam starts. No student will be permitted to come into the campus after the gates are closed. ● Admissions decisions/ information will be sent to parents via email no later than seven (7) school days after testing. ● While IPS does offer testing dates to choose from, we advise testing at the earliest possible opportunity. Admissions

decisions will be made after every testing schedule. ● Please note that if we are unable to test your child due to unavailability of spaces, the 750 SR testing fee will be refunded to

you. Otherwise, the testing fee of 750 SR is non-refundable. ● This form serves as confirmation for admissions testing at IPS on the scheduled date. Please bring it on the day of

testing. Signature: ______________________ Signature: ______________________ Admissions Office Finance Office

Date: ______________________ Date: ______________________

--------------------------------------------------------------------------------------------------------------------------------------------------------- ADMISSION TESTING TICKET (Office Copy)

TO BE FILLED BY OFFICE PERSONNEL ONLY:

● Your child _________________________________ applying for Grade ____________ will be tested on:

Wed, February 10, 2016 Wed, March 2, 2016 Wed, March 30, 2016 Wed, April 13, 2016 Wed, April 27, 2016 Wed, May 11, 2016 Wed, May 25, 2016 Mon, Sept 19, 2016 Wed, September 28, 2016

● Testing will begin promptly at 4:00 pm. Please arrive in the school at least 15 minutes early. Gates will close 5 minutes

before the exam starts. No student will be permitted to come into the campus after the gates are closed. ● Admissions decisions/ information will be sent to parents via email no later than seven (7) school days after testing. ● While IPS does offer testing dates to choose from, we advise testing at the earliest possible opportunity. Admissions

decisions will be made after every testing schedule. ● Please note that if we are unable to test your child due to unavailability of spaces, the 750 SR testing fee will be refunded to

you. Otherwise, the testing fee of 750 SR is non-refundable. ● This form serves as confirmation for admissions testing at IPS on the scheduled date. Please bring it on the day of

testing. Signature: ______________________ Signature: ______________________ Admissions Office Finance Office

Date: ______________________ Date: ______________________

Accredited by the Middle States Association of Colleges and Schools – Philadelphia, U.S.A. Licensed by the Ministry of Education – Eastern Province, K.S.A.

Girls’ School L.N. 4322340008 Boys’ School L.N. 085س C.R. 2051024474

P.O. Box 691, Dhahran Airport 31932 Tel: +966 (13) 857-5603 Email: [email protected] Kingdom of Saudi Arabia Fax: +966 (13) 857-0076 Website: www.ipsksa.com