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About Siletz news / (Siletz, OR) 199?-current | View Entire Issue (May 1, 2003)
TRIBAL PROGRAM NEWS Siletz Tribal Head Start Enrollment Application Return this application to: Siletz Tribal Head Start, P.O. Box 549 Siletz, OR 97380. For more information, call 1-800-922-1399, ext. 264, or 541-444-8264. 1. Child’s name:2. SSN:- 3. Child’s sex: M F Returning student: Yes No 4. Child’s date of birth:// 5. Does your child have any condition that may be considered a disability or special need? No Yes, explain:_______________________________ _________ __________________________ (please attach verification) 6. Is child member/descendent of a federally recognized Indian tribe? Y N Roll #:------------- Tribe(s):(please attach verification) Primary language spoken in the home 7. Parent/Guardian (1): SSN:- Street and mailing address: ____________________________________ City/State/ZIP:__________________________________________________ Telephone (h):(w):(msg): Parent/Guardian (2):SSN:- Street and mailing address:________________________________________ City/State/ZIP:______ ____________________________________________ Telephone (h):______________ (w):(msg): L A preference for enrollment can be given to families that face any of the following conditions: single-parent household, parent separated or divorced, child is a victim of abuse or neglect, or child suffers from a non-handicapping condition. If your family meets this criteria and you would like to claim that preference, please list the condition(s) here: 9. List all other household members by name: 1. 2. 3. 4. 5. 6. 10. Financial statement: Monthly income (attach verification of these benefits). Check all that apply: Dear Chairperson Delores Pigsley, Confederated Tribes of Siletz: I would like to thank you for providing me with the opportunity to take a trip to Washington, D.C., and participate in the first American Indian and Alaska Native Head Start and Early Head Start conference. My children have attended Siletz Tribal Head Start since 1997 and just recently I became secretary for our Policy Council. The conference, held February 20-22, was extremely thorough in explaining the importance of my position as a Head Start Policy Council representative. I have a much higher regard and understanding of my role as a representative for the parents and children of Siletz Tribal Head Start. 1 learned a great deal about Head Start performance standards, bylaws, and Policy Council’s involvement in these procedures. Years of experience as a volunteer and parent in the classroom have demonstrated to me that we have the best teachers and staff in our Head Start program in Siletz. This trip added an opportunity for me to be with and to observe the professionals working behind the scenes. Many federal employees and agencies make this program available, but I observed a local force that truly makes it all possible. Lori Jay Linstrom, our parent involvement coordinator, is the extraordinary lady who organized and prepared every detail of our trip. Her well-thought-out preparation and care made a significant contribution to the experience for me. I was apprehensive about being away from my home and family. Lori Jay gave me the confidence and assurance I needed to strengthen my enthusiasm and completely enjoy my experience. This is what she brings to Siletz Tribal Head Start and her dedication to our parents is admirable. We are very fortunate to have her as a part of our program. During this conference, I also became deeply aware of how devoted and well- informed DeAnn Brown is as our Head Start director. Her passion and affection for our children has had a direct impact on the quality of service our children, families, and communities receive. She provides an enormous amount of knowledge and accomplishes many endeavors to ensure the future of our children. 1 truly appreciate the time and involvement dedicated to our families. As a result of all I learned during this conference, I’m confident it has enhanced my ability to make a significant contribution to the Siletz Head Start Policy Council. I will make it my endeavor to assist other parents and community members to recognize the value of this position and their ability to contribute. I’m honored to be a part of this remarkable team. Thank you for the opportunity to participate! Brenda Bisson Siletz Tribal Head Start Parent Siletz Tribal Head Start Policy Council Secretary Unemployed TANF Disability Employed Child Support Social Security General Assistance Veteran’s Benefits College Grants/ Scholarships Other (explain): ____________________________________________________ 1. With my signature I certify that the above information is accurate: Signature: For office use only Date : Date received:Staff initials: Siletz Tribal Head Start is an equal opportunity program and open to all children regardless of race, age, sex, handicap, or national origin. Any person who believes he/she has been discriminated against should write to the Secretary of Agriculture, Washington, DC 20250. 8 □ r, Siletz News • .♦ r.H □ May 2003 . Owux * Above: Shannon Jackson, Teacher Jayne, and Sarah Naegele get ready for Indian tacos.
