Allied Health Careers
Opportunity Program
2005 Student Handbook
Sponsored by:
East Carolina University School of Allied Health Sciences
&
The Interdisciplinary Rural Heath Training Program
AHCOP Contact Information
This Student Handbook Belongs to:_________________________
Dorm: Umstead Hall Telephone:____________________
Neighborhood Desk: _____________________________________
AHCOP Staff Contact Information
*The AHCOP office is open M-Thurs. from 8:00am – 5:00pm
**When leaving a message please leave your name and the student name along with
a telephone number.
AHCOP Coordinator
Ms. Howell 328-0887
howellc@mail.ecu.edu
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Welcome to AHCOP!
Dear student:
We're very happy to welcome you to East Carolina University and the
Allied Health Careers Opportunity Program (AHCOP). Thank you for
joining us again! We want your second year experience with the AHCOP
to be even better than last year.
This handbook provides answers to most of the questions you may have
about the summer program, as well as university policies and
procedures that we will follow. The AHCOP has a responsibility to you
and you have a responsibility to the AHCOP. You are responsible for
reading and understanding this Student Handbook in order to make
your summer experience a fun, educational, and safe one.
The next six weeks will be filled with many opportunities to expand
your knowledge base and to gain new insight on the college experience.
Please take each educational opportunity seriously and apply yourself
to the tasks at hand so that you are successful.
We, the AHCOP staff are looking forward to sharing in this second
year experience and wish to extend our best wishes for your success
with the AHCOP Summer 2005 program.
Sincerely,
Dr. Richard Bamberg, AHCOP Director
Cathy D. Howell, Coordinator
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Receipt & Acknowledgement
Of Student Handbook
This Student Handbook is an important document intended to help you
become acquainted with the Allied Health Careers Opportunity
Program and East Carolina University. This Handbook will serve as a
guide; it is not the final word in all cases. Individual circumstances
may call for individual attention.
Please read the following statements and sign below to indicate your
receipt and acknowledgement of the summer 2005 Student Handbook.
• I have received and read a copy of the AHCOP Student Handbook.
I understand and accept the policies, rules and student
expectations described in the handbook.
• I understand that my signature below indicates that I and my
parents or guardian have read and understand the handbook and
have each received a copy of the Summer 2005 Student Handbook.
_______________________ ___________________
Student Signature Date
_______________________ ___________________
Parent/Guardian Signature Date
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Table of Contents
An Overview of the Allied Health Careers Opportunity Program
About AHCOP .................................................................................................................... 6
Summer Staff ................................................................................................................. 6
What You Can Expect This Summer ................................................................... 7
What the AHCOP Expects From You ................................................................. 7
1. Standards of Conduct
Class Attendance ............................................................................................................. 9
Visitors and Dating .......................................................................................................... 9
Transportation ................................................................................................................. 9
Drugs, Alcohol, and Tobacco ....................................................................................... 10
Dress Code ...................................................................................................................... 10
Disciplinary Actions....................................................................................................... 10
Dismissal……………………………………………………………………………..………………………………………...11
Withdrawal ...................................................................................................................... 12
2. Residence Hall Living
Registration……..…………………………………………………………………………………………………………..12
Roommate Selection ...................................................................................................... 12
Student Rooms ............................................................................................................... 13
Meals ................................................................................................................................. 13
Curfew .............................................................................................................................. 13
Laundry Facilities/ Vending Machines ...................................................................... 14
Mail Delivery ................................................................................................................... 14
Keys ................................................................................................................................... 15
Telephone Use ................................................................................................................ 15
Unacceptable Items ...................................................................................................... 16
Damages ........................................................................................................................... 16
Appliances ........................................................................................................................ 16
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3. Health, Safety, and Security
Health Services.............................................................................................................. 16
Notification of Parent/Guardian................................................................................ 17
Insurance ......................................................................................................................... 17
Fire Safety ...................................................................................................................... 18
Residence Hall Safety .................................................................................................. 18
Student Safety on Campus……………………………………………………………………………………….18
4. Stipends ..................................................................... 18
5. List of Things to Bring .................................................. 19
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An Overview of the
Allied Health Careers Opportunity
Program
About AHCOP
The Allied Health Careers Opportunity Program is a grant funded project designed
to take high school rising juniors through a process of career exploration and
progressive narrowing of their serious interest during their junior and senior years
of high school, to the point that they identify a specific allied health career that
they wish to pursue by the time they enter their freshmen year of undergraduate
college.
The AHCOP consists of two 6-week summer programs combined with clinical
observation during the school year. At the completion of the AHCOP program
students will be prepared, upon high school graduation, to pursue a Bachelor of
Science in Allied Health Sciences at East Carolina University.
Summer Staff
Gregory Hedgepeth
Caroline Mungai
Nadia Payne
January Russell
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What You Can Expect This Summer
The AHCOP is designed to assist students in career exploration in a specific allied
health career and develop their own career and education plan. This summer will
be more academically rigorous than the previous summer. Over the six-week
period students will receive counseling in allied health science careers, preliminary
health science education, training in health research, diversity training, and an
exposure to university life.
What AHCOP Expects of You
The AHCOP summer program is designed to enhance the skills and abilities of its
participants through structured learning activities. Over the six-week period,
students will participate in a wide range of campus-based activities as well as
recreational opportunities on campus and in Greenville.
The following are of great importance to us:
1. Honor and Truth
We expect students to be honest with each other and with faculty and staff
members. Therefore, lying, cheating, and theft will not be tolerated, and
may result in dismissal from the program.
2. Motivation and Commitment
Students should remember that the AHCOP is a full time six-week
commitment, including weekends on campus. We ask that each participant
strive for excellence in his or her social and personal development.
3. Respect
Everyone deserves to be treated with respect and courtesy. Offensive,
disruptive, or abusive behavior of a physical, visual, or verbal nature will
absolutely not be tolerated and may result in dismissal from the program.
4. Health and Hygiene
We advocate good physical and mental well being for all members of our
program. We prohibit sexual intimacy between students while they are
under our jurisdiction. In addition, we prohibit the use of drugs and/or
alcohol. Use of drugs and/or alcohol, as well as engaging in sexual intimacy
while in the program, shall result in dismissal from the program, even on the
first offense.
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5. Safety and Security
We expect students to take responsibility for themselves and their
environments. Students must abide by residence hall rules and policies.
6. Responsibility and Accountability
Students participating in the AHCOP program will have the opportunity to
make many decisions. Students will be held accountable for the decisions
they make while they are on and off campus. The AHCOP Coordinator has
the authority to dismiss any students, who violates these expectations,
rules, and regulations cited in the Handbook, as well as those not specifically
covered in the regulations, but which, in the Coordinator’s professional
judgment, are contrary to the educational goals of the AHCOP program.
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1. Standards of Conduct
Class Attendance
Students are required to attend all classes and report to class on time. Any
absences must be coordinated with the AHCOP Coordinator and Residence Hall
Assistant prior to the absence.
Visitors and Dating
Students will NOT be allowed to:
▪ Have unscheduled visitors.
▪ Date or receive visits from friends who are not the AHCOP
participants.
The AHCOP program involves a full schedule of daily activities. Therefore, family
members will not be allowed to visit students, except by special permission from
the Coordinator of the AHCOP.
Students of the AHCOP program are not permitted in any other residence hall or
campus for any reason. No students will be allowed to leave campus in a private
vehicle without prior written approval of the AHCOP Coordinator.
We will be providing numerous chances for you to get to know lots of people
through our co-ed program. We would like you to use your time at ECU as an
opportunity to make many new friends and not become attached to one or two
individuals.
Transportation
Students are not allowed to have possession or access to a car, motorcycle, moped,
or other motorized vehicle while in the summer program. This includes the storage
of vehicles on the campus and surrounding area. Likewise, students are not
allowed to leave campus in an unauthorized vehicle.
If a student must return home because of dismissal, illness, or a family emergency,
it is the parents/guardians responsibility to pick up the student.
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By enrolling students in the AHCOP program, parents extend permission for them
to travel in state or other approved vehicles that are operated by the faculty,
staff, or any professional driver hired by the program, and by other adults
officially connected to the program.
Drugs, Alcohol, and Tobacco
The use of alcohol, drugs, drug paraphernalia and all tobacco products (cigarettes,
cigars, pipes, snuff, and chewing tobacco) are prohibited while attending the
AHCOP summer program at ECU. This includes the purchase, sale, distribution,
possession, or use of any of these products. Violation of this rule shall result in
immediate dismissal from the program.
Dress Code
We expect students to dress in clothing that is neat, clean, “in good taste,” and is
appropriate for the occasion. While we recognize that definitions vary, in general,
dress or grooming that attracts undue or negative attention is not acceptable.
Thus the AHCOP will follow the guidelines outlined by Pitt County Schools
concerning dress.
Dress and Appearance Guidelines
The specifics below are not intended to be all-inclusive, but shall apply as basic
guidelines for all students.
1. Shorts, skirts, dresses, and other clothing shall be modest and of sufficient
length. The preferable length of these articles of clothing is that they be
no shorter than three inches above the top of the knee when standing, and
definitely at no time shorter than the length of a dollar bill placed as a
measuring tool at the top of the knee.
2. Shirts, tops, and dresses shall cover the top of the shoulder and shall not
gap below the armpit, or they shall be worn with a covering top or jacket
that has sleeves. No tank tops, spaghetti straps, halter tops and the like
shall be worn.
3. Shirts and tops shall be long enough to cover the midriff when sitting or
standing.
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4. The chest and back of the body shall not be inappropriately exposed.
Shirts, tops and dresses shall cover the chest and back.
5. Pants shall not be worn with the waistband below hipbone.
6. Undergarments shall not be visible at any time.
7. No see-through or mesh clothing that will reveal the body or will reveal
undergarments shall be allowed.
8. No gang-related clothing, accessories, symbols or intimidating manor of
dress, as identified by local law enforcement agencies, shall be allowed.
9. No adornment that reasonably could be perceived as, or used as, a weapon
shall be allowed (such as chains, spikes, etc.)
10. No armbands, buttons or symbols shall be allowed if school officials
determine that the wearing of such may be reasonably lead to substantial
disruption of a school function.
11. No headwear (such as hats, caps, hoods, kerchiefs, curlers, picks, combs, do-
rags, sweatbands, etc.) and no sunglasses shall be worn inside school
buildings.
12. No bandanas shall be allowed.
13. No clothing shall be allowed that promotes alcoholic beverages, tobacco, or
the use of controlled substances; depicts violence, profanity, vulgarity, or
obscenity; is of a sexual nature; or is otherwise of a disruptive nature.
14. Shoes shall be worn at all times, and, as needed, shoes shall conform to
special requirements (such as P.E. classes, ROTC, science labs, etc.). Shoes
that have laces shall be laced and tied. No bedroom shoes shall be allowed.
15. Clothing shall be worn appropriately (not inside-out or backwards; no rolled
up pants legs or unfastened bib overalls, etc.) and belts much be buckled.
Shoes are required in all areas of campus except in the residence hall. Sunbathing
is allowed in designated areas, but students should “cover up” when walking to and
from these areas. When students are at the pool girls are expected to wear one
piece bathing suits – no bikinis and guys are to wear swimming trunks – no Speedo’s.
Items of clothing that might prove beneficial include; rain gear, such as a light
jacket or raincoat, an umbrella, and a warm jacket or sweater. Above all, clothes
should be comfortable and something in which the student can feel good in when
doing a number of activities.
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Disciplinary Actions
The AHCOP program has specific guidelines for behavior that all members of the
group are expected to follow. Sanctions imposed due to infractions of these rules
or inappropriate behaviors include; but are not limited to:
Conferences and or warnings
Notification of parent or guardian
Program dismissal
The purpose of these responses is not merely punitive in nature; they are also used
to help students make a positive change in their behavior. All infractions and
responses will be placed in the student’s AHCOP file and kept for the length of the
program. All violations covered by North Carolina law, including, but not limited to
certain infractions involving alcohol and drugs, will be reported to local law
authorities as is legally required.
Dismissal
The AHCOP Coordinator has the authority to dismiss any student for behavior that
is not specifically covered in the regulations, but which, in the Coordinator’s
professional judgment, is contrary to the educational goals of the Allied Health
Careers Opportunity Program. Some examples of infractions that warrant full
dismissal from the program, even on the first offense, include but are not limited
to the following:
1. Alcohol, drugs, drug paraphernalia, and tobacco products: purchase, sale,
distribution, use or possession.
2. Sexual Intimacy.
3. Vandalism or theft.
4. Curfew Violation.
5. Off-limits area or visitation violations.
6. Cutting class, non-participation in activities, or chronic failure to complete
assignments.
7. Falsification: lying, cheating etc.
8. Car access: Unauthorized access to a car or other motorized vehicle while
under the jurisdiction of the University.
9. Tampering with fire safety equipment, i.e. deliberately setting off a fire
alarm, setting off a fire alarm by another illegal act such as fireworks or
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setting a fire; vandalizing a fire apparatus; or discharging a fire
extinguisher.
10. Movies: The viewing of R-rated movies is prohibited.
11. Threatening or otherwise inappropriate behavior.
12. Misuse of academic facilities or equipment.
13. Breaking restrictions given to you under a previous offense.
14. Repeated violations of any nature or any single gross or excessive violation.
15. Misuse of Residence Hall facilities or equipment.
Other Responses: the faculty or counselors who will determine the appropriate
disciplinary action will handle violations of a less serious nature than those cited
above.
When dismissal is warranted, parents/guardians are expected to remove the
student immediately from the campus.
Withdrawal
The successful completion of the AHCOP summer program is based on daily
involvement in classes and activities. Students who leave the program for any
reason, except for family emergencies, will not be allowed to return. In addition, a
letter will be sent to the high school of any student who does not complete the
entire program.
2. Residence Hall Living – Umstead Hall
Registration
Students may check in between 5:00pm and 5:30pm on Sunday, June 5, 2005.
Upon your arrival at ECU, you should proceed to your assigned residence hall.
After parking, proceed through the main entrance of the residence hall and a
registration table will be in the lobby. At registration you will fill out the
necessary housing forms and receive your room key.
All students will live in the assigned Residence Hall. Daily commuting is not allowed.
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Individuals requesting accommodation under the Americans with Disabilities Act
(ADA) should contact the Department for Disability Support Services at least
48 hours prior to the event at (252) 328-6799 voice/(252) 328-0899 TTY.
Check-Out
Students must sign a check out form prior to leaving the ECU campus. A
parent/guardian signature or an authorized designee signature must accompany
that of the student(s). Return times may vary and timeliness is expected.
Closing Session
As part of the 6 week program students are expected to participate with the
closing session. Planning for the closing session develops over the course of the
summer program.
Roommate Selection
The Student Questionnaire, which you will complete prior to arrival, will assist the
AHCOP staff in making room assignments. Once a room has been assigned, the
assignment will be considered permanent for the duration of the summer program.
We do not accept requests for specific roommates.
Getting to know others is as much a part of personal development as a particular
class or workshop. Opportunities will be available to improve such skills as
becoming comfortable in different settings and environments, making
conversations with new acquaintances, and building new friendships.
Student Rooms
Each room is air conditioned, has bunkable beds, carpeted rooms, a closet and a
microfridge (microwave and small refrigerator). Since the rooms do not come with
sheets, pillowcases, and other such accessories, it is recommended that students
bring two sets of bed linens and at least a week’s supply of towels and other
personal items.
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Students may bring fans. The dorm does have AIR CONDITIONING. Fans,
lights, and other electrical appliances (curling irons, etc.) must be turned off when
students leave their rooms. Students may also find it desirable to bring cameras, a
radio, or sports equipment. However, during their stay, students must assume
responsibility for the security of all personal property, as the university does not
carry insurance on personal items of the students. ECU and the AHCOP are not
responsible for any loss and/ or damage to a student’s personal property.
Males and Females will be housed on the same floor of the residence hall.
Unsupervised Visitation is not allowed between males and females on the residence
hall floors. This includes visitation between other summer camp program
attendees.
Residence hall rooms are to be kept neat and clean. Rooms will be checked on a
scheduled basis. Students are responsible for cleaning up after themselves in the
residence hall, lobby, corridors, and bathrooms. This will be strictly enforced.
Meals
Meals will be provided for you at the campus-dining hall. You will receive a meal
card at registration. Meal times will be scheduled.
Curfew
Curfews are designed to promote the safety of the students, allow adequate time
for evening study, and provide for adequate sleep. Therefore, students shall
observe the following curfew hours that are subject to change due to planned
activities:
Lights Out 11:30 PM
* These hours are subject to change due to evening activities.
Laundry Facilities and Vending Machines
Laundry facilities are located on the first floor of the residence hall. You will
need to bring your own detergent and laundry products the use of the facilities is
free. Students are responsible for their belongings when using laundry facilities.
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Snack machines and ice machines are located in the residence hall. Students will
need to bring money to use when purchasing snacks from the machines. Ice is
available at no cost; however for the first day of camp it is advisable to bring a
cooler full of ice.
Mail Delivery
Mail will be delivered Monday through Friday to the Allied Health Careers
Opportunity Program office. Resident Assistants will pick up mail daily to take to
the residence hall and deliver mail to the students.
Summer Mailing Address:
Student Name
C/O AHCOP
218 Carol Belk Building
East Carolina University
Greenville, NC 27858-4353
Keys
Students are responsible for program issued items. A key will be issued when you
check in each Sunday and must be returned each Friday prior to leaving campus on
weekends off. In the event that you lose the key, report the loss immediately to
your Resident Assistant.
Students should lock their room doors when they leave their room for any reasons
and should carry their room key with them at all times. Replacement of a lost room
key will cost the student $85.00. (No exceptions) Any keys not returned at the
end of the program will also be charged the price of the lost key as well as a
$30.00 service charge. (This charge is subject to change)
Students have the right of privacy in their rooms. No one will be allowed access to
his or her room unless the student is present. A passkey is used for normal, non-
emergency conditions, such as maintenance and room inspections or in cases
involving the immediate safety of occupants. If there is reason to believe
violations of school laws and criminal laws are occurring, the University police will
be contacted and appropriate action will be taken.
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Telephone Use
Students will be permitted to use the telephone during free time. Students will
not be allowed to make or receive telephone calls between the hours of 11PM and
6AM. We request that family and friends observe these hours. In an emergency,
the Resident Assistant or the AHCOP Coordinator should be notified so that the
student can be contacted. Program participants are not permitted to have a
cellular phone or pagers. Students in violation of this policy will be subject to
confiscation of the telephone or pager.
Students placing a long distance call through methods of trick, device, or fraud
with intent to avoid payment will be subject to action under the laws of the
telephone company and the university.
Unacceptable Items
All firearms (including, but not limited to, handguns, rifles, pellet guns,
BB guns)
All other weapons (including, but not limited to, swords bow and
arrows, balloon slingshots, martial arts weapons, hunting knives)
Pets
Candles
Skateboards and roller skates/blades
Pagers and cell phones
Hand held games, headphones and CD players are not permitted
outside of the residence hall.
Laptop computers
Damages
All students are responsible for the proper care and use of all equipment and
furniture in the residence hall; whether in their room, another student’s room, or
public area. When damages to furniture, equipment etc. occur, the students
involved will be responsible for the repair costs. Any damages to East Carolina
University property caused by the student will be billed to the parents or
guardians.
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Appliances
Residence halls at ECU are wired for electrical appliances which produce minimum
heat or which have closed element-heating units. Students may bring fans to cool
the rooms because there is no air conditioning. Fans, lights, and other electrical
appliances (curling irons, etc.) must be turned off when students leave their rooms.
3. Health, Safety and Security
Health Services
In case of illness, injury, or other emergency, students must notify a Resident
Assistant or faculty member immediately. Should a resident become ill or injured
during his or her stay, Pitt County Memorial Hospital (PCMH) will provide health
care. The parent/guardian will be notified by telephone.
Students on medication of any kind are required to provide this information on
their health form. Students are not allowed to keep prescribed medication in their
residence hall rooms without approval of the parent/guardian and the AHCOP
Coordinator.
Student medical forms will be kept in the AHCOP office and a copy in the
residence hall for quick reference. Each Resident Assistant will review his/her
group’s medical forms to take note of any special needs or allergies. All medical
information will be considered confidential and will be available only to staff or
medical personnel as necessary.
If a student is ill and unable to participate in scheduled activities for more than 24
hours, the parents/guardians will be contacted to take the student home.
Notification of Parent or Guardian
Parents/guardians will be notified at all times of any incidents involving their child.
Parents will be notified by telephone anytime a student is seen or admitted to Pitt
County Memorial Hospital. Notification will also take place any time a student
violates the rules and regulations, or is experiencing problems of an academic or
residential nature.
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We realize that families are frequently away from home during the summer for
vacations and for many other reasons. At such times, it is most important that the
AHCOP office staff be notified and given alternate emergency contacts. We will
be glad to keep on file any alternate phone numbers at which you might be reached
or the names of relatives or neighbors who will assume responsibility for the
AHCOP student should the need arise.
Insurance
Parents are responsible for insuring their child while participating in the
AHCOP summer program and activities.
Fire Safety
It is extremely important that all residents be thoroughly informed of proper
evaluation procedures in case of fire or another emergency. Each Resident
Assistant will review these procedures with all of his or her residents during the
first residence hall floor meeting. At least one fire drill will be conducted to
ensure proper evacuation of residents should the need develop.
Any student found guilty of tampering with fire safety equipment, i.e. pulling a fire
alarm or intentionally setting off the system, will be subject to immediate
dismissal from the program and possibly incur criminal charges.
Residence Hall Safety
Pets, weapons, open flames, etc. are not allowed in the residence hall for health and
safety reasons. Archery and martial arts equipment are prohibited. Violations will
result in dismissal from the program.
Student Safety on Campus
Students should walk in groups of at least two to three in the daytime. An AHCOP
staff member must accompany students at all times. Students should not be
anywhere beyond the residence hall unaccompanied.
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4. Stipends
Students will receive their full stipend if they have: arrived on time for events,
completed all assignments, followed the rules and regulations of the summer
program, demonstrated a positive attitude by being polite, respectful, cooperative,
and have participated in activities.
Partial and up to the total amount of the stipend will be forfeited if you withdraw,
or are asked to leave the summer program for disciplinary reasons. Once
forfeited, stipend money will not be returned.
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5. List of Things to Bring
Sheets and pillow cases (twin size bed)
Pillow
Bedspread or blanket
Towels and washcloths
Personal toiletries (soap, shampoo, toothpaste, deodorant, etc.)
Shower shoes
Container to carry personal items to shower
Sports water bottle or insulated mug
Hair dryer
Iron/ironing board
Laundry hamper
Cups/plates/utensils (for snacking in the room)
Clothing hangers
Alarm clock
Desk lamp
Fan
Extension cord
Camera and film
Detergent and laundry products
Spending money
Variety of clothes for classes, recreational, and outdoor activities
Comfortable shoes
Rain gear (umbrella and raincoat)
Coat hangers
Sunscreen
Hat for sun protection
Sunglasses
Spare pair of prescription glasses
Personally prescribed medications
Swim suit and cover up
Stationary and stamps
Book bag or back pack
Calling card or pre-paid phone card
Touch-tone, non-cordless telephone
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Allied Health Careers Opportunity Program
Summer 2005
Cell Phone Usage
Cell phones are Not Allowed at the Allied Health Careers Opportunity Program
(AHCOP). After review of the previous summer program, it is necessary to
enforce a ban on cell phone use during the summer program.
In the event that that purchasing a telephone card or making collect calls is
absolutely impossible a student will be allowed to make a five minute call from the
AHCOP office.
All students who reside in the residence halls are allowed to bring a telephone
similar to that which is in their homes. Telephone cards may be purchased at most
convenience stores.
Dismissal Process
I understand that any incurred debts and fees are my responsibility and must be paid in
full. I also understand and will comply to:
Authorizing my child’s/ward’s stipend check to pay for the cost of housing
and dining.
Immediate removal of my child/ward from the campus of East Carolina
University and his/her belongings in other words the student must
completely vacate assigned AHCOP housing by removal of personal
belongings.
Return AHCOP issued materials.
Return ECU issued materials, specifically university issued housing keys.
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Withdrawal Form
Student Name: __________________________________________________
(Print) Last First MI
I, ______________________________________ give permission for my
Parent/Guardian
child/ward, _______________________________ to withdrawal his/her
Student Name
participation from the Allied Health Careers Opportunity Program.
Reason for Withdrawal: _________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
I understand that any incurred debts and fees are my responsibility and must be paid in
full. I also understand and will comply to:
Authorizing my child’s/ward’s stipend check to pay for the cost of housing
and dining.
Immediate removal of my child/ward from the campus of East Carolina
University and his/her belongings in other words the student must
completely vacate assigned AHCOP housing by removal of personal
belongings.
Return AHCOP issued materials.
Return ECU issued materials, specifically university issued housing keys.
Authorization Signatures:
Student: _____________________________________________ Date:___________
Parent/Guardian: _______________________________________ Date:___________
AHCOP Director: ______________________________________ Date:___________
AHCOP Coordinator: ____________________________________ Date:___________
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