APS School Health Advisory Board
2018-19 Membership Form

Please complete the following form to join the APS School Health Advisory Board for the 2018-19 school year. Any prior year memberships will be cancelled unless you complete this form.

Parents, students, APS employees and community members are welcome to join. SHAB meets every other month (5 times per year) and members are expected to attend at least 2 in-person meetings.

Member information will be used to create an email distribution list for meeting announcements and news, and a membership roster for the School Board. SHAB membership requires appointment by the School Board, so this form entry is your way of nominating yourself for School Board approval. Your appointment will be formalized at an upcoming School Board meeting.

Members can opt-in to having their names also posted on the SHAB website. For more information about SHAB, please visit the website: www.apsshab.weebly.com or visit the Facebook page: www.facebook.com/apsshab.

Priorities this school year include:

1. Assisting schools with the new Wellness Policy and Policy Implementation Procedures. They will require each school to form a Wellness Council, conduct a standardized self-assessment, and report annually on wellness activities and progress.

2. School bus and automobile anti-idling campaigns around schools, plus indoor air quality awareness in schools (use of fragrances, candles, etc).

3. Screentime/personal device use in schools - health effects and healthy practices.

4. Promoting the APS Food Allergy Guidelines developed by SHAB and supporting farm to school and healthy eating initiatives.

5. Advising on the PE and health education curriculum

PLUS

Any health and wellness issues brought to SHAB by the members. These can include substance abuse, vaping/e-cigarettes, socio-emotional health, physical activity, etc.

About You

I hereby: *

Renew my existing membership in SHAB for the 2018-19 school year

Request new membership in SHAB for the 2018-19 school year

I wish to have my membership information made available (select all that apply): *

To SHAB leadership (required)

To the School Board (required)

On the SHAB website (optional, name and degrees only)

First Name *

Last Name: *

Any relevant degrees or credentials to include after your name? (i.e. RN, MPH, MD, RD, MPP, etc.)

Email: *

Are you a: (select all that apply) *

Title or Occupation (optional)

Organization/Employer (optional)

Which APS schools do you or your children currently attend? *

Name the schools referenced above: (insert a comma between each school)

SHAB Participation

Do you wish to serve on any SHAB Work Groups? (select up to 2)

Are there specific topics you want SHAB to address this school year?

Are you interested in serving in any of the following leadership roles on SHAB? (select all that apply) *

SHAB Vice-Chair

Work Group Chair or Co-Chair

Secretary

No

Does the current SHAB meeting schedule work reasonably well for you? Meetings are held the third Wednesday of every other month from 9:00-10:30 a.m. at the Syphax Education Center, Sequoia Plaza 2, 2110 Washington Blvd (near Rte 50). *

Yes

Not ideal, but OK

No

If no, what meeting schedule options would you prefer? (select all that apply)

How do you get information about SHAB? (select all that apply) *

Facebook page (facebook.com/apsshab)

SHAB Website (apsshab.weebly.com)

SHAB emails from Chair

SHAB postings on Arlington Education Matters (AEM) Facebook Group

Other: Other:

How many years have you been a member of SHAB? *