Jefferson Academy Secondary School

Jeffco Connect Acknowledgement
I acknowledge and confirm that I have updated all contact information in Jeffco Connect, including email, phone and address information. *
I acknowledge and confirm that I have completed the Agreements tab in  Jeffco Connect  (click link)

I understand that if I choose to Opt Out of FERPA Publishing Jeffco Directory information my student will not be included in Jeffco Publications including yearbook, graduation programs, theatre playbills, athletic team rosters, school website, social media and other school and district publications.

* If you Opted IN your student will be included in all school directory and photo options.   *

JA Community COVID-19 Health Promise
I promise to keep my JA Community healthy by doing my part.  We will not attend school or any school event, including athletic games, practices or club events, if my student or I have tested positive for COVID-19 within the prior 14 days, or any of the following is true:
  • My student or I have been exposed to someone who has tested positive for COVID-19, or am subject to a federal or local travel or quarantine advisory due to COVID-19;

  • Within the prior 48 hours, if my student or I have experienced symptoms of COVID-19 (e.g., fever of 100.4⁰F or higher, cough, shortness of breath or difficulty breathing, chills, repeated shaking, muscle pain/achiness, headache, sore throat, loss of taste or smell, nasal congestion, runny nose, vomiting, diarrhea, fatigue or any other symptoms identified by the CDC) (and if they have been fully vaccinated but experience any of the above symptoms within 48 hours, we will consult a healthcare provider and get tested for COVID-19 and keep the student home from school).

  • We understand that if we are not vaccinated, masks are recommended to be worn inside the building and durning events for our community safety.  

  • We promise to communicate to the school any exposure or confirmation of COVID-19 in our family.  

Conduct Code and Parent/Student Handbook
The Jefferson County Public Schools Student and Family Handbook (Code of Conduct) has been prepared to provide you with information relating to your rights and responsibilities.
In order for our policies and procedures to have the greatest positive effect, please sign and submit this form.
I understand that the Code of Conduct and the Jefferson Academy Student/Parent Handbook will be available on-line at: and at for me to access at my convenience.
I will access the Code and the Handbook.
I understand that it is my responsibility to read the contents therein.
I understand that copies of the Handbook may also be accessed for review in the main office at school.
If I have questions I may contact Mr. Maurice Williams, Dean of School Culture.
I have read and will comply with the rights, responsibilites, policies and procedures as outlined in the Jefferson County Schools Student and Family Handbook (Code of Conduct) and Jefferson Academy Student/Parent Handbook.

Honor Code
At Jefferson Academy our mission is to encourage all students to reach their highest academic and character potential. To do so, all students must pursue their academic endeavors with integrity and honor.

The honor code of Jefferson Academy addresses academic dishonesty such as cheating, plagiarizing, lying and stealing.

Cheating encompasses, but is not limited to, the following:
- Willful giving or receiving of an unauthorized, unfair, dishonest, or unscrupulous advantage in
   schoolwork belonging to other students or sources.
- Some examples are: deception; talking, the use of signs, or gestures during a test; copying from
  another student or allowing the copying of an individual assignment; passing test or quiz information
  during a class period; using technology, i.e. text messaging, IM, or camera phones for an unethical

Plagiarizing encompasses, but is not limited to, the following:
- Knowingly copying or using the academic work of another and presenting it as your own without
  proper attribution to the original author.
- Some examples are: having a parent or another person write an essay or do a project which is then
  submitted as one's own work; using another author’s words or ideas and presenting them as your
  own; failing to use proper citation and bibliography.
- Sharing / receiving computer files from another student and presenting as your own.

Lying encompasses, but is not limited to, the following:
- Willful and knowledgeable telling of an untruth or falsehood as well as any form of deceit, attempted
  deception, or fraud in an oral or written statement.
- Some examples are: lying or failing to give complete information to a teacher; feigning illness to
  gain extra preparation time for tests, quizzes, or assignments due; forging notes; purposely
  accessing prohibited websites and unethical use of the internet.
Stealing encompasses, but is not limited to, the following:
- Taking, without the right or permission to do so and with the intent to keep or make use of
  wrongfully, the school work or materials of another student.
- Some examples are: stealing copies of tests or quizzes, illegitimately accessing the teacher's answer
  key; stealing another student's homework, notes, or handouts.
Consequences of Academic Dishonesty

Academic and or administrative sanctions may be applied in cases of academic dishonesty.
Academic consequences may include:

   1. Receive a failing grade on the test, paper or exam;
   2. Have an overall course grade lowered;
   3. Receive a grade of F in the course.
   4. Loss of privilege to be in an honors course or loss of Honors credit.
Administrative consequences may include:
   1. Disciplinary probation;
   2. Disciplinary suspension; or
   3. Expulsion.
I understand the Jefferson Academy Honor Code and accept it in its entirety and promise to pursue my educational endeavors with integrity and honor.

Computer, Laptop, Tablet & Camera Use Agreement
Rules of Use
   * Use of computer and network resources is a privilege, not a right. Treat this privilege with care.
   * Students can expect their computers and laptops to be inspected and monitored for appropriate
   * The student shall abide by Jefferson Academy’s Acceptable Use Policies as outlined in the
      Parent/Student Handbook.

Terms of Use
   * Jefferson Academy will provide for computer repairs on school owned devices resulting from a software or            hardware malfunction.
   * Students will be liable for physical damage to school owned computers, chromebooks, or laptops and                  peripheral equipment.

Care of Equipment

The student will exercise all due and reasonable care in handling and use of said equipment and agrees to return the equipment in good condition.
The student and parent/guardian will be responsible for damages when:

   a) The student’s negligent use or misuse causes damage to the equipment.
   b) The damage to the equipment is intentional or accidental.
   c) The damage, depreciation, or wear and tear is outside the terms of this Agreement.
Students and parents/guardians agree to pay for any reasonable cost of repair or replacement of the equipment caused by the user's lack of care, negligence, or misuse.
By initialing this form and acknowledging receipt of the EQUIPMENT, the USER accepts full responsibility for all expenses due to damages and/or loss as defined by this Agreement.

Library Use Agreement
* In accordance with Jeffco Schools policy, students need to have a JEFFCO library card & have that
number on file in order to access paid database subscriptions for research, place holds on JCPL books,
etc. at school.
Note: Families may apply for library cards on the Jeffco library website (
Please email Mrs. Buechner at with the student’s library card # when received.
Loan Periods, Overdue Fees and Renewals:
Note: Students may renew items multiple times if another student has not placed a hold on it. Individual library accounts can be accessed through our website (library page).
Books – non-fiction & fiction: Loan period – 21 days; Fines apply only if books are not returned.
Reference Materials: Loan period – overnight; Fines = .25 per day, up to $10
Fees and Charges
Students will be charged to replace damaged or missing books, reference materials or similar items.
Costs will vary based on the material being replaced.

Copying or Computer Printing
Each student is allowed to print or copy (black & white only) 2-3 pages per day.
Beyond that, the cost is .10 per page (black & white) and .25 per page for color printing (and must be pre-paid to Mrs. Buechner).

By initialing the Library Use Agreement, the student agrees to return borrowed materials on time pay any applicable fees and be responsible for lost or damaged materials.
All students must sign this Agreement before they are allowed to check out materials from the JA
library. Students with delinquent fines may be prohibited from checking out additional materials from the library.

Jefferson County Public Schools Exhibit JS-E1 Student Use of the Internet
(Acceptable Use Agreement)
In order to provide for the appropriate use of the Internet in accordance with district policy JS, "Student Use of the Internet", and other applicable district policies, the following "Acceptable Use Agreement" has been developed. A copy of this agreement will be distributed to students and must be completed and signed by the student and the student's parent/legal guardian before a student is allowed to access district computing resources.

Acceptable Use Agreement for Students
All computers having Internet access must be used in a responsible, efficient, ethical and legal manner. Failure to adhere to this agreement will result in revocation of access privileges; restitution for costs associated with damages; and, may result in disciplinary action as indicated the paragraphs below, and/or legal action.

From the Jeffco Code of Conduct: Grounds for Suspension or Expulsion - #320. Misuses of district computers and technology, including but not limited to the unauthorized reproduction of school or legal documents, copyright violations, attempts to harm or destroy data of another user, improper use of the Internet or electronic mail, vandalism, solicitation, uploading, downloading or creation of computer viruses, and tampering with operating systems or data.

1.  Acceptable use: The use of the Internet must be consistent with the educational objectives of the Jefferson County School District. Thus, use of school computers to access the Internet is only authorized for school-related academic purposes. Use which involves violation of governing law, and/or district policy or regulations, will result in appropriate actions by the school administration.
Such prohibited use includes, but is not limited to:
a. Searching, viewing, editing or retrieving materials that are not related to educational
(therefore, searching or viewing sexually explicit, profane, violence promoting or
materials is not permitted).
b. Accessing, viewing, or altering any official record or file of the school or district.
c. Sending or displaying offensive messages or pictures.
d. Using obscene language.
e. Harassing, insulting or attacking others.
f.  Damaging computers, computer systems, or computer networks.
g. Violating copyright laws.
h. Using the passwords of other users.
i.  Trespassing in the folders, work or files of other users.
j.  Intentionally wasting computer system resources.
k. Using the network for commercial purposes.
l.  Sharing of student or district staff home addresses, phone numbers, or other private
m. Any activity that violates a school policy, district policy, or local, state or federal law.
2. Privilege: The use of the Internet is a privilege, not a right, and inappropriate use will result in a cancellation of those privileges, restitution for costs associated with damages, and may result in school disciplinary action (including suspension or expulsion) and/or legal action.
The system administrator(s) will deem what is inappropriate use and that decision is final. The system administrator(s) may close an account at any time, as required. The administration, faculty and staff may request the system administrator to deny, revoke or suspend specific user accounts.

3. Right to inspect/monitor: The district’s network administrators may review student files and communications to maintain system integrity and to ensure that users are using the system appropriately and responsibly.
Students shall have no expectation of privacy in any information stored on the district’s servers, or in their use of school computers.

I have read and understand this Acceptable Use Agreement and agree to abide by its terms. I further understand that violation of this Acceptable Use Agreement may result in my loss of Internet access and/or computer use privileges, and school discipline (including suspension or expulsion) being taken against me, legal action being taken against me, and/or restitution by me for costs associated with any damages caused by such violations.

Parent / Student Grievance Process - Parent Code of Conduct
The Jefferson Academy Schools Parent Code of Conduct policy has been prepared to provide you with information relating to parent rights, responsibilities, and policy when filing a complaint with Jefferson Academy schools.
In order for these guidelines to have the greatest positive effect, we need your support.
Any questions may be directed to any JA Board member.

Thank you for your cooperation.
By initialing below I agree that I have read, understand, and will comply with the rights, responsibilities, policies and procedures as outlined in the Jefferson Academy Board Policies #11.2 & 11.3, Parent/Student Grievance Process and Parent Code of Conduct.

Parent Participation Pledge
At Jefferson Academy, our goal is to create a collaborative effort in the education of your child.
To accomplish this objective, we seek the full cooperation and support of parents, families, and each child that attends Jefferson Academy.
You have made a personal decision to enroll your child at Jefferson Academy in order to provide them with a unique and content-rich education that seeks to teach character, commitment, and love of learning.
This Pledge signifies my understanding of the aforementioned goals and is an agreement with all other parents in the school to support the faculty, staff and volunteers, as we work to help my child become a productive, cooperative member of the school and community.

Parent/Guardian Rights
   - My child will learn in a safe and healthy environment.
   - My child’s teacher will communicate with me regularly about my child’s progress through Infinite

   - I may vote for members of the Governing Board at the annual members meeting.

   - I will have access to Governing Board meeting agendas, meetings and minutes.

   - I will be offered a variety of volunteer opportunities to allow me to actively participate at JA.

   - I may give input on curriculum, leadership and other decisions about the school through proper
     channels as provided in the school bylaws and policies.
   - I may give staff feedback about the strengths and weaknesses of the school’s program by
      completing the parent survey at the end of the school year.
I will commit my family to Jefferson Academy for this school year
and assist in its further development and success.
Parent/Guardian Responsibilities

Please initial the “’Parent/Guardian Responsibilities” items below
I agree to read and abide by the current Jefferson County School District R-1 Code of
Conduct Handbook. (Refer to this handbook online at
I understand the Jefferson County School District’s truancy policy:
     • Four (4) unexcused absences in a month or ten (10) in a year is considered "habitually
     • Four (4) unexcused late arrivals in a semester are considered "excessive tardiness."
I will support the school and teachers per the JA Parent Code of Conduct and Parent/Student
Grievance Process – by dealing with differences of opinion appropriately, respectfully
interacting with others, and understanding that the teachers are responsible for the class and
the parents’ role is to support the teachers and/or Principal publicly and privately.
I agree to read and abide by the Attendance & Absences Policies in the JA
Parent-Student Handbook.
I will demonstrate my commitment to Jefferson Academy by:
     1. Ensuring that my child regularly attends school and will be on time and prepared to
         work (including attendance for the October funding count timeframe and state mandated
         testing days); if my child must be absent, I will follow handbook procedures for notifying
         the school.
     2. Making sure my child has a quiet place to study at home, monitoring all homework
         assignments for completion and accuracy (Detailed expectations for homework will be
         given by each teacher), and supervising my child's daily recommended reading. (Based
         on Grade Level Requirements).
     3. Ensuring that my child has proper hygiene, nutrition and rest.

     4. Ensuring that my child is dressed properly in adherence to the JA dress code.

     5. Attending all education/discipline related conferences and communicating with my
         child's teacher(s) to monitor progress and to address questions and concerns.

     6. Reading and returning on time, as requested, all informational materials sent by the
        school in order to ensure good communication.

     7. Actively participating in Jefferson Academy by:

         a. Attending at least one Board of Directors’ meeting per school year.
         b. Attending at least one School or PTO/Boosters sponsored event (other than
             Back-to-School Night or Parent Teacher Conferences) per school year.
         c. Volunteering a minimum of 20 hours per family at the school or at home.
I agree to support the “No Rescue” policy in order to foster the independence of our students.
I agree to pay any fees or other financial obligations in a timely manner or work out the
appropriate arrangements to do so.

Boosters - PAY YOUR DUES
Boosters is a parent run organization that assists in supporting our students and teachers in their academic, athletic and cultural endeavors.  Last year your dues granted scholarships to two graduating seniors, sent students to different academic and athletic acivities, assisted in providing prizes and ribbons for the science fair and the arts, ran the school bus and concession stands, and supported our teachers with classroom supplies and conference meals throughout the year. Additionally, boosters serves as the accounting arm of all clubs and activities providing the structure for taking in and sending out funds for each individual sport or club.  This year, we hope to extend our impact on student life by providing even further support. In order to do so, your dues are essential in helping us to continue our good work.  But we can't do it without your help! Feel free to come to any of our meetings or volunteer to help at one of our events. Each meeting is the first Monday of the month. Thank you in advance for your support of our children and community.
Click the link below to renew your membership and pay your dues.
I understand how Boosters supports the school and have paid my membership dues.


By typing your name and providing your initials you are providing the electronic representation of your signature and initials for all purposes when used on this document - just the same as pen and paper signature or initials. Parent/Guardian Signature: *