APS School Health Advisory Board

2019-2020 Membership Form

Instructions

Please complete the following form to join the APS School Health Advisory Board for 2019 and 2020. 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 3 in-person meetings. Full SHAB membership now requires appointment by the School Board, so this form is your way of nominating yourself for School Board approval. Your appointment will be formalized at an upcoming School Board meeting.

If you wish to stay involved, but not as a Board-appointed member, you can:

1. Join a SHAB workgroup (also adds you to distribution list), OR

2. Request to be added to the SHAB communications distribution list.

For more information about SHAB, please visit the website: www.apsshab.weebly.com.

Current SHAB priorities 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 or request new Board Appointed membership in SHAB for 2019-2020

Decline full membership in SHAB, but request to join a SHAB Workgroup

Decline membership in SHAB and Workgroups, but request to be added to the SHAB distribution list

I acknowledge the requirement that School Board appointed membership in SHAB requires attendance at in-person meetings (at least half - meetings are every 2 months). *

Yes

No

Please provide a brief paragraph explaining why you wish to be appointed to SHAB.

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

To SHAB leadership (required)

To the School Board (required of full SHAB members)

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 semicolon 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 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 else would you like to get information about SHAB? *

How many years have you participated in SHAB? *