HomeMy WebLinkAbout09-10-2014 Minutes Regular MeetingDr. Charles J. Shackett, Superintendent
3497 North Ammon Road, Idaho Falls, Idaho, 83401 (208) 525-4400 Fax (208) 529-0104 www.d93schools.org
Board of Trustees Annette Winchester Kip Nelson Amy Landers Brian McBride Jeff Bird
Bonneville Joint School District No. 93 is an Equal Opportunity Employer
Marjean McConnell, Deputy Superintendent
Regular Meeting
September 10, 2014
7:00 PM
I. Call to Order
Chairperson Winchester called the meeting to order at 7:07 p.m.
II. Roll Call
Those Board members in attendance were Chairperson Annette Winchester, Vice-chairperson Kip Nelson, Treasurer Amy Landers, Trustee Brian McBride, and Trustee
Jeff Bird. Others in attendance were, Superintendent Chuck Shackett, Deputy Superintendent Marjean McConnell, Director of School Improvement and Technology Scott
Woolstenhulme, Chief Financial/Operations Officer April Burton, Director of Curriculum and Instruction Michaelena Hix, Director of Human Resources Shalene French,
Director of Operations Todd Hicks, Director of Elementary Special Services and Federal Programs Rex Miller, and Board Clerk Valerie Messick.
III. Welcoming of Delegates and Visitors
Chairperson Winchester reminded those wishing to speak during public input to sign the Request to Participate Roster in the back of the room. She welcomed Tom
Hunsaker to the meeting.
IV. Approve the Agenda
Chairperson Winchester asked for a Motion to approve the agenda.
MOTION: Kip Nelson made the motion to approve the Agenda. Jeff Bird seconded. The vote was 5 in favor with 0 opposed and 0 abstentions. Motion was carried.
V. Consent Calendar
A. Minutes of Previous Meetings
1. Executive Session 08-13-2014
2. Regular Meeting 08-13-2014
3. Work Session 08-13-2014
4. Administrative Opening Meeting 08-15-2014
5. Opening Meeting 08-26-2014
6. Special Meeting-Work Session 08-27-2014
B. Financial
1. Accounts Payable
$5,101,160.58
2. Capital Construction Projects Report
3. Proposed Contracts
a. Elite Therapy Services
b. Kim Stowell - Speech and Language
c. Riverside Service Group - BI Professional Services
d. Riverside Service Group - BI Para Professional Services
e. Riverside Service Group - Behavioral Consultation
4. Surplus Pallets Sale - Child Nutrition
5. Technology Surplus
C. Employees
1. Conditional Employment
Stevan Adams Transportation Department Bus Driver 9/2/2014
John Aebischer Telford Academy Classroom Aide 9/2/2014
Rachel Ball Fairview Elementary Playground Assistant 9/2/2014
Adelfa Bauer Food Services Department Part-Time Cook 9/2/2014
Gina Baxter Special Services Department PSR 9/2/2014
Tracy Bennington Woodland Hills Elementary Playground Assistant 9/2/2014
Monica Bingham Falls Valley Elementary Playground Assistant 9/2/2014
Domenique Borg Mountain Valley Elementary Elem Media Aide 9/2/2014
Shari Bruce Discovery Elementary Playground Assistant 9/2/2014
Cathy Chudleigh Rocky Mountain Middle School Teacher 8/29/2014
Brenda Clemons Discovery Elementary Title One Para 9/2/2014
Serina Cunningham Mountain Valley Elementary Playground Assistant 9/3/2014
Nathan Dipo Sandcreek Middle School Teacher 9/2/2014
Sarah Duncan Ammon Elementary Early Childhood Para 9/2/2014
Debbie Evans Woodland Hills Elementary Playground Assistant 9/8/2014
Amber Franck Fairview Elementary Playground Assistant 9/2/2014
Erika Galindo Food Services Department Part-Time Cook 9/2/2014
Matias Gonzalez Rocky Mountain Middle School Teacher 9/2/2014
Brett Harringfeld Special Services Department BI Professional 9/2/2014
Rebekah Hilder Food Services Department Part-Time Cook 9/2/2014
Ivory Hill Falls Valley Elementary Playground Assistant 9/2/2014
MaryLee Hornberger Mountain Valley Elementary Teacher 8/25/2014
Elizabeth Johnson Special Services Department BI/PCS Paraprofessional 9/2/2014
Sarah Killgore Cloverdale Elementary Early Childhood Para 9/2/2014
Hayley Killpack Falls Valley Elementary ESL Paraprofessional 9/2/2014
Cheryl Kirchner Transportation Department Bus Driver 9/2/2014
Melissa Lake Ammon Elementary Head Custodian 9/2/2014
Jana Landon Ucon Elementary Overflow Paraprofessional 9/2/2014
Linda Larsen Bridgewater Elementary Title One Para 9/8/2014
Kristel Law Special Services Department PSR 9/2/2014
Janna Long Fairview Elementary Playground Assistant 9/2/2014
Rose Longacre Food Services Department Part-Time Cook 9/2/2014
Heather Lords Ammon Elementary Playground Assistant 9/2/2014
Tasha Murdoch Special Services Department BI/PCS Paraprofessional 9/2/2014
Kim Nakisa Food Services Department Part-Time Cook 9/2/2014
Tory Nelson Hillview Elementary Playground Assistant 9/2/2014
McKayla O'Neill Special Services Department BI/PCS Paraprofessional 9/2/2014
Tyler Parkinson Bonneville High School Near Peer Mentor 9/2/2014
Carly Peck Special Services Department BI/PCS Paraprofessional 9/2/2014
Sandra Perkins Special Services Department BI/PCS Paraprofessional 9/2/2014
Karianne Perrenoud Rocky Mountain Middle School Teacher 8/29/2014
Natalie Petersen Falls Valley Elementary Title One Para 9/2/2014
Mary Pewtress Special Services Department BI/PCS Paraprofessional 9/2/2014
Kathleen Reed Falls Valley Elementary Special Education Paraprofessional 9/2/2014
Audrey Rose Food Services Department Part-Time Cook 9/2/2014
Violet Ruesch Food Services Department Part-Time Cook 9/2/2014
Georgiann Smith Fairview Elementary PSR 9/2/2014
Kari Snedaker Discovery Elementary Elem Media Aide 9/2/2014
Mayce Somerville Special Services Department BI/PCS Paraprofessional 9/2/2014
Edith Speck Food Services Department Part-Time Cook 9/2/2014
Shannon Stevens Special Services Department Nurse 9/2/2014
Holly Ward Special Services Department Nurse 9/2/2014
Rachel Wells Food Services Department Part-Time Cook 9/2/2014
Michelle Winter Special Services Department BI/PCS Paraprofessional 9/2/2014
Nicole Zovi Rocky Mountain Middle School PSR 9/2/2014
2. Resignations and Terminations
Jared Anderson Maintenance Department Summer Paint Crew 8/22/2014
Ramona Anderson Hillview Elementary Playground Assistant 6/5/2014
Elizabeth Baker Sandcreek Middle School Lunch Duty 6/5/2014
Lindsey Ball Maintenance Department Summer Paint Crew 8/22/2014
Catherine Bingham Discovery Elementary Autism Para 9/12/2014
Dylan Boulter Maintenance Department Grounds Crew 8/29/2014
Nichole Charles Food Service Department Cook 9/12/2014
Cynthia Collins Special Services Department BI/PCS Para 6/5/2014
John Davis Custodial Department Custodian 8/19/2014
Jacob Dawson Sandcreek Middle School Special Ed Para 6/5/2014
Hailey Denkers Custodial Department Summer Custodian 8/25/2014
Rylan Forman Maintenance Department Summer Paint Crew 8/22/2014
Stephanie Goodwin Custodial Department Summer Custodian 8/19/2014
Jeanna Hansen Special Services Department SLP Assistant 6/20/2014
Jeanna Hill Iona Elementary Overflow Para 6/5/2014
Lisa Kiestler Mountain Valley Elementary Title One Para 6/5/2014
Wendy Landon Special Services Department Psychologist 6/5/2014
Simon McCarthy Maintenance Department Summer Paint Crew 8/12/2014
Zachery McDonald Maintenance Department Grounds Crew 8/22/2014
Mallory McLing Custodial Department Summer Custodian 8/22/2014
Brian Meador Special Services Department Summer School 8/25/2014
Rebecca Osai Cloverdale Elementary Computer Lab Para 9/5/2014
Sandra Perkins Iona Elementary Overflow Para 6/5/2014
Kim Perry Maintenance Department Summer Paint Crew Chief 8/22/2014
Claudia Rivas Falls Valley Elementary Playground Assistant 6/5/2014
Bruce Roberts Woodland Hills Elementary Overflow Para 6/5/2014
Marni Robertson Woodland Hills Elementary Overflow Para 6/5/2014
Kaylin Sayre Iona Elementary Overflow Para 6/5/2014
Julie Siow Iona Elementary Overflow Para 6/5/2014
Kylie Walker Woodland Hills Elementary Overflow Para 6/5/2014
Katrina Wall Mountain Valley Elementary Assistant Secretary 6/5/2014
Natosha Wilson Iona Elementary Overflow Para 6/5/2014
Grant Yearsley Custodial Department Custodian 9/2/2014
3. Transfers
From: To:
Niels Daniel Adams BI Professional at Discovery BI Professional at Summit Hills
Lorraine Bollschweiler BI/PCS Para at Discovery Elementary DRR Para at Bonneville High School
Tanya Burgess Custodian at Sandcreek Head Custodian at Iona
Michael Cherniske BI Professional at Mountain Valley BI Professional at Bonneville High School
R. James Dalton Teacher at Lincoln High School Teacher at Sandcreek
Gary Darrington Head Custodian at Ammon Elementary Evening Custodian at Sandcreek
Kevin Fox Custodian at Bridgewater Elementary Custodian at Iona
Kevin Gray Head Custodian at Iona Elementary Custodian at Mountain Valley
Katy Hall Summer School PSR PSR at Hillview
Danielle Herker PSR at Sandcreek PSR at Tiebreaker
Elena Hunting Playground Assistant at Iona Playground Assistant at Mountain Valley
Debby Lake Custodian at Ammon Elementary Custodian at Bonneville High School
Jareb Landon BI/PCS Para at Ucon Elementary PSR at Iona Elementary
Arin Layton Playground Assistant at Summit Hills Title One Paraprofessional at Summit Hills
Ericka Leon Special Education Paraprofessional at Cloverdale BI/PCS at Cloverdale
Jordan Luce Crossing Guard at Cloverdale Part-Time Cook II at Rocky Mountain
Rebecca Neher Special Education Paraprofessional at Falls Valley Special Education Paraprofessional at Mountain Valley
Nathan Porter Part-Time Counselor at Ammon Full-Time Counselor at Ammon and Hillview
Kelly Rasmussen Custodian at Iona Elementary Custodian at Bridgewater
Megan Roach PSR at Iona PSR at Summit Hills
Jessica Roberts DRR Paraprofessional at Rocky Mountain DRR Para at Summit Hills
Ted Stillman PSR at Ammon Elementary PSR at Falls Valley Elementary
Jay Van Leuven Part-Time Custodial at Bonneville High School Part-Time Custodial at Ammon
Camille Vosk Fast ForWord Paraprofessional Technician
Audra Woolstenhulme PSR at Summit Hills PSR at Sandcreek
4. Proposed Stipend Assignments
Heather Jean Schwartz Lincoln High School School Website Manager 9/2/2014
D. Students
1. Ratify Consent to Expulsion without a Hearing
2. Alternate Route to Graduation – LHS Student
Chairperson Winchester asked if any Board member would like to remove any item from the Consent Calendar to the regular agenda. Kip Nelson requested to move the
Levy Rate Certification item to New Business. Chairperson Winchester asked if there were any questions from the Board with regard to the Consent Calendar. She then
asked if there would be a motion with regard to the amended Consent Calendar.
MOTION: Jeff Bird made the motion to approve the amended Consent Calendar. Amy Landers seconded. The vote was 5 in favor with 0 opposed and 0 abstentions.
Motion was carried.
VI. Public Input
Pursuant to Board Policy #1550 Public Participation in Board Meetings Public Input shall be held to a maximum of 1 hour and will provide an opportunity for any Board
Member, administrator, staff member, student, or patron to raise issues of interest. The Board will receive such input without comment, except to ask germane questions
of those speaking. Comments should be limited to three (3) minutes. The Board will take no action relative to any items during the meeting, but may direct the
Superintendent to consider such an item at a subsequent meeting.
Chairperson Winchester asked those who present to be respectful and to not exceed their time limit. She stated those who have written comments can leave them with the
Board Clerk and indicated that she had received a letter from Angie Radford that will be entered into our minutes for this evening. Written comments must include your
name, address, and telephone number.
She then asked Janice Moore – 2991 N. Azure Drive to address the Board – She lives in Calico Sky. She has concern for students that are walking to school at Rocky
Mountain and Bonneville through the four-way stop. It is scary for them to walk across that road. There is no sidewalk or no cross walk at the four-way stop. The traffic is
scary. Students are very confused as to when they should cross. There are at least 6 to 8 or more students who walk that route. She has a message in with Mr. Pymm.
The Board will get this information to Mr. Pymm about this concern regarding students crossing the road without a cross walk or crossing guard at the four-way stops.
Chairperson Winchester then asked Charity Shaw – 2976 N. Azure Drive to address the Board – She is concerned about the lack of a crosswalk because she has a
middle school student and a high school student. She has another concern about her daughter who attended Odyssey Charter School last year. She is in 10th grade. She
heard that the bigger schools would accept their credits but it is only District 91 who will accept credits from Odyssey. She wondered why District 93 won’t accept credits
like District 91 is doing. Chairperson Winchester stated that we will have several things in place so the student can get her 9th grade credit back. Ms. Shaw has heard the
option of Lincoln High School, the option of providing a portfolio. Unfortunately Odyssey didn’t keep anything that could be used in a portfolio. The student has a 504 and
has a hard time with testing so testing out of classes would be difficult for her. Some kids are going to District 91 to get elective credit for the classes they took at Odyssey.
We have at least five students from Odyssey at Bonneville now. Grades from Odyssey should have been transferred with transcripts. We will discuss this and work to do
what is best for students. Dr. Shackett state that we have three ways in place for students to demonstrate their knowledge. Unfortunately Odyssey is not accredited and
doesn’t look like it will be. We do not take credit from non-accredited schools. We will make accommodation for students on a 504 plan so she can demonstrate her
knowledge. She will have to do it through our online courses. If she knows what she has earned credits in, she will be able to demonstrate that knowledge. The question
is, has Odyssey provided and education that is equivalent to credit at all other 9th grade schools. If the answer is no, then the parents need to address Odyssey. We will do
our best to give students an opportunity. Take your child in to talk to Mr. Jackson to see what accommodations we can make in helping her to demonstrate her abilities.
There was concern that there are only certain things that can be placed in a portfolio and the committee gets to decide whether it is acceptable. The committee members
will be made up of teachers who know what is in the syllabus and will know what the child should have learned in a particular grade. If the student hasn’t learned or
achieved what is expected, the question is should we give the student 9th grade credit from Bonneville High School? Again, your focus should be with Odyssey. But we will
do our best to work with your child to help her get what she needs and demonstrate her abilities. If she didn’t learn what she was supposed to, it is hard to accept the
credit. There people here that will work with the child.
Chairperson Winchester then read a written statement from a patron with regard to the Open Enrollment Policy.
Chairperson Winchester asked for any additional comments. Todd Hicks stated that there is a bus stop for Calico Skies for students going to Bonneville and Rocky
Mountain. One stop is on corner of Iona Road where Calico Sky exits and one stop is on the corner of Golden Rod and Ammon-Lincoln Road. It is not very well attended
but there is a bus stop. We haven’t over looked the issue with regard to safety bussing. That will help get kids across the road. If parents want to call transportation in the
morning, they will have the times available for them. If you put your address in online you will be able to find information regarding the bus stops. We have a hard time
getting a crossing guard. If there is someone interested in a minimum wage job for a few hours per week.
VII. New Business
A. Proposed Policy for 30-day Review (first reading) - Marjean McConnell
1. 1535 Written Minutes
2. 3004 Immunization Requirements
3004E Summary of Immunization Requirements
3. 3250, 4285, and 5365 Materials Distribution
3250P, 4285P, and 5365P Materials Distribution Procedures
4. 3665 Student Data Privacy and Security
Chairperson Winchester asked Mrs. McConnell to present the proposed policy and procedure for 30-day Review. These have been presented for Initial Consideration. We
did make a change to the Materials Distribution policy and added a section requiring review and approval of mass email to District staff. We are concerned that some
people have captured that mass email and sent things out. We also added a section that clarifies the PTOs and Booster Organizations can send information out to their
people without getting approval at the District level.
Chairperson Winchester then asked if there are any questions from the Board for Mrs. McConnell regarding the documents presented for 30-day Review. Hearing none,
she asked if there would be a motion with regard to moving the proposed policies to 30-day review.
MOTION: Amy Landers made the motion to approve the policies and procedure for 30-day review and to place them online for such review. Kip Nelson seconded. The
vote was 5 in favor with 0 opposed and 0 abstentions. Motion was carried.
B. Proposed Policy to Delete - Marjean McConnell
2495 Idaho Digital Learning Academy
2495P1 Idaho Digital Learning Academy Procedures
2495P2 Procedure for the Idaho Digital Learning Academy (IDLA) -Operational Steps for Counselor Use Only
2495F IDLA Tracking Form
Mrs. McConnell presented the policy to delete. The policy has been reviewed and found to be out-of-date and will be rewritten to include all online learning opportunities
that are available to students including IDLA. Chairperson Winchester then asked if there are any questions from the Board for Mrs. McConnell regarding the policy
presented.
Chairperson Winchester then asked for a motion to delete policy 2495 Idaho Digital Learning Academy along with the procedures and form for the reasons stated.
MOTION: Jeff Bird made the motion to delete policy #2495 Idaho Digital Learning Academy along with the accompanying procedures and form and direct the
administration to rewrite the policy as presented by Mrs. McConnell. Brian McBride seconded. The vote was 5 in favor with 0 opposed and 0 abstentions. Motion was
carried.
C. Levy Rate Certification - Emergency Levy
At the work session this evening, Dr. French presented enrollment numbers showing an increase of 488 students over what we had at this time last year. That will qualify
us for $1.3 million in Emergency Levy money. This levy just needs to be voted on by the Board and doesn’t need to go to patrons for approval. It won’t increase the tax
levy rate and has been incorporated into our levy rate for the past eight years because of the fact that we have been a growing district. Every year, we qualify for the
Emergency Levy and receive .006% of our actual market value. However, we will only get paid for 325 students because of the cap imposed by the state. This has been
an ongoing process for our District since 2006. Mrs. Burton asked the Board to approve the Emergency Levy for this year. The enrollment numbers are as of the date that
we had to certify to the county but our numbers continue to grow. With the closure of Odyssey Charter School and the additional enrollment of our homeschoolers through
Harmony, Mrs. Burton anticipates continued growth of at least an additional 100 students. There was discussion regarding what the levy funds can be used for. These
funds are part of our Maintenance and Operation budget so there are no restrictions on that money. We hire additional teachers and purchase additional text books and
supplies for the students. This year, we hired 100 new teachers as a result of retirements, resignations, and increased enrollment. With growth we get more funding but,
what we receive doesn’t balance what we need for each student. So, we have the supplemental levy to help with District needs. We receive approximately $4200 per
student based on last year’s funding formula that takes into account attendance and the state funding. We will start receiving money from the Emergency Levy this year in
the January tax payments. The state will pay us in the beginning of the school year based on our numbers from last year. In February, we will get the first of the payments
that we actually qualify for. The first Friday in November the state looks at the number of students enrolled in the District and what our attendance has been for those
weeks prior to that date. Our funding for the whole year is based on the average daily attendance for the first reporting period. That will determine how many teachers and
how many support units we qualify for. The amount that the District qualifies for in emergency levy funding is determined by our market value and the number of students
that the district has grown as well as what we received in last year’s state funding. If the state stayed with sheer numbers and didn’t limit the amount we can receive, we
would get almost $700,000 more but because we are maxed out we only qualify for $1.3 million.
Chairperson Winchester asked if there were any questions from the Board for Mrs. Burton. There was a question regarding how many years the District has been
receiving the Emergency Levy. It has been consecutive since 2006. But, three years ago, we didn’t qualify for the maximum amount and received only $800,000. The
maximum amount that we qualify for has remained fairly consistent. It is up about $200,000 this year.
Chairperson Winchester asked if there were other questions. Hearing none, she then asked for a motion regarding the Emergency Levy Certification request.
MOTION: Amy Landers made the motion to approve the Levy Rate Certification for the Emergency Levy as requested. Jeff Bird seconded. The vote was 5 in favor with 0
opposed and 0 abstentions. Motion was carried.
VIII. Old Business
A. Proposed Policy for Final Adoption (second reading) - Marjean McConnell
1. 1510 and 4102 Board Agenda Items
2. 1550 and 4105 Public Participation in Board Meetings
1550F and 4105F Notice for Request to Appear before the Board
3. 2620P Grading and Progress Reports Procedures
4. 5140 Evaluation of Certified Personnel
5140P Evaluation of Certified Personnel Procedures
5. 5500 Personnel Records
6. 6317 Evaluation of Building Administrators
6317P Evaluation of Building Administrators Procedures
Chairperson Winchester asked Mrs. McConnell to present the proposed policies for final adoption.
Mrs. McConnell asked the Board to approve these for final adoption. They have been posted for 30-day review and she has not received any comment with regard to the
policies, procedures, and form. We brought these policies up to the new standards and laws. We are still working on Graduation Requirements and Grade Organization
and will not ask for final adoption of those two policies tonight. They will come before you again during the October meeting.
Chairperson Winchester then asked if there are any questions from the Board for Mrs. McConnell regarding the policies presented for final adoption Hearing none, she
asked for a motion regarding the proposed policies for final adoption.
MOTION: Brian McBride made the motion to approve the proposed policies for final adoption and to be placed in the online policy manual. Kip Nelson seconded. The
vote was 5 in favor with 0 opposed and 0 abstentions. Motion was carried.
IX. Committee, Curriculum, and Administrative Reports
A. Proposed Policy for Initial Consideration - Marjean McConnell
1. 2110 Lesson Plans
2. 2367 Advanced Opportunities
2367P Advanced Opportunities Procedures
3. 2560 Elementary Field Trips
4. 2600 Promotion-Retention (K-8)
5. 2715 and 3700 Early Graduation
2715P and 3700P Early Graduation Procedures
2715F and 3700F Application for Early Graduation
Chairperson Winchester asked Mrs. McConnell to present policy for initial consideration. There are 5 policies, 2 procedures, and 1 form. We would like the Board to take a
look at these. We have a committee meeting starting this month with the BEA to talk about these and take their comments. They are mostly updates for policies that we
have had. Regarding the Advanced Opportunities policy, there was a question whether the language states that students don’t have to complete the senior project. Mrs.
McConnell will look at that to make sure the language is consistent. Mrs. McConnell reported that the policy states the students do not have to complete their senior
project early in order to receive incentives earned by completing graduation requirements early. They can finish the project during their senior year while they are working
on college credits. She thanked the Board for asking questions during Initial Consideration so we can clear up any misunderstanding.
Chairperson Winchester then asked if there were any questions from the Board for Mrs. McConnell regarding the policy presented for initial consideration. Hearing none,
she reminded Board Members of the Work Session with the Hillcrest Student Council on Wednesday, September 17th at the Hillcrest High School Library and the
Secondary Facilities Committee Meeting scheduled for Wednesday, September 17th at 6:30 p.m. at Hillcrest High School Library. She also reminded the Board members
to get information to Mrs. Messick regarding the ISBA Convention.
X. Call for Agenda Items for Upcoming Meetings
Chairperson Winchester then asked if any Board member would like to add any agenda items to any upcoming meeting
A. Work Session - Hillcrest Student Council - Wednesday, September 17, 2014 - Hillcrest High School Media Center - 11:30 a.m. - 1:00 p.m.
B. Work Session - Bonneville Student Council - Wednesday, October 1, 2014 - Bonneville High School Media Center - 11:30 a.m. - 1:00 p.m.
C. Work Session - Lincoln Student Council - Wednesday, October 22, 2014 - Lincoln High School Room #3 - 11:30 a.m. - 1:00 p.m.
D. Work Session - TCHS and BOL Student Councils - Wednesday, October 29, 2014 - District Board Room - 11:30 a.m. - 1:00 p.m.
E. Regular Meeting - Wednesday, November 5, 2014 - 7:00 p.m.
XI. Adjournment
Chairperson Winchester asked for a motion to adjourn at 7:42 p.m.
MOTION: Amy Landers made the motion to adjourn the meeting. Kip Nelson seconded. The vote was 5 in favor with 0 opposed and 0 abstentions. Motion was carried.
APPROVED: _____________________
Chairperson
ATTESTED: _______________________
Clerk
Date: _______________________