Pinecrest Academy Charter South Elementary School
Pirate Safety Patrol Information & Application
The Pinecrest Academy Charter South Elementary School Safety Patrol Team has been established to recognize those students who possess and demonstrate positive leadership skills, personal responsibility, dedication to their school work and a commitment to serve others at the school. The goal of the safety patrol is to allow its members to explore and develop such important leadership skills as responsibility, dependability, assertiveness and cooperation. The safety patrol assists the school's teachers and administrators in morning arrival and afternoon departure of students.
In order to become a member of the Pinecrest Academy Charter South Safety Patrol:
1) Students must meet the following qualifications:
The student must:
have a good attendance record
be punctual (7:55 a.m.)
be responsible
be a good leader and show leadership potential
be a positive role model
have self-control
follow directions
pay attention
be respectful to self and others
be reliable
be mature
2) Students must complete an application and write an essay as to why they desire to be a member of the safety patrol. “I would like to be a Pinecrest Academy Pirate Patrol member because…”
Patrols must be 5th grade students who are willing to come to school early for morning arrival and stay late for afternoon dismissal. They are selected by recommendation from teachers, administrators, and patrol sponsors. Attendance and tardiness are also seriously considered. Consideration is based on student interest, attendance, academic achievement, behavior, conduct, commitment, sense of responsibility, leadership potential, and attitude toward others. In most cases, students who are dedicated to their school work will be dedicated to patrol responsibilities. The job of safety patrol is one that is taken seriously at Pinecrest Academy South.
Safety Patrol Application
Student Name ______________________________________________________
Classroom Teacher __________________________________________________
All patrol students must receive training prior to serving as a patrol.
I hereby apply for membership in the Pinecrest Academy Charter South Elementary School.
If accepted, I will obey the pledge below and other rules and regulations of the Patrol.
Pledge
I promise to do my best to:
Set a good example in all areas of school life
Obey my teachers and leaders of the patrol.
Earn the respect of fellow students.
Perform my duties faithfully.
Prevent accidents.
Report dangerous practices of students.
Report for duty on time.
I hereby accept that the above mentioned responsibilities will be mine to uphold. I understand that as a Pirate Patrol, I am responsible for being a role-model for my peers and will advocate my pirate values to the highest esteem.
_________________________________ __________________
Student Signature Date
Please attach Student Essay about “I would like to be a Pinecrest Academy Charter South Patrol member because…” Be sure to use correct spelling and punctuation.
Pinecrest Academy Charter South Elementary School
Pirate Safety Patrol Information & Application
Pirate Safety Patrol Disciplinary Action:
Consequences for not wearing safety uniform or for neglecting to do your duty properly:
Consequences for misbehaving and being a poor role model for other students to follow:
1st Offense: one week suspension from Safety Patrol
2nd Offense: dismissal from Safety Patrol
Office Referrals for misbehavior at school or on the school bus: (at the discretion of the teacher/advisor or principal)
Disrespect and inappropriate or unsafe behavior will result in automatic dismissal from the Pirate Safety Patrol.
To the PARENT OR GUARDIAN:
The position of Safety Patrol is taken seriously at Pinecrest Academy. A desire to participate does not mean a student is qualified to assist in this position. It is important that a Safety Patrol knows and understands the seriousness of safe practices. If students do not abide by classroom rules or they receive an office referral they may be dismissed from their Patrol position. If Patrol members are disrespectful or put themselves or others at risk they will be removed from their patrol position. Safety Patrol members must set positive examples for other students to follow in their behavior and work ethic. Having read the Safety Patrol pledge and explanation of the duties, responsibilities and consequences for inappropriate actions of the AAA Pirate Safety Patrol outlined on this form, I hereby give my consent to have my (son/daughter) ________________________________________ apply and/or serve as a member of the AAA Pirate Safety Patrol. As a parent of a patrol member I will do my best to obey drop off, pick up and crossing guidelines as well as school rules. I realize that it is my responsibility to set a good example for my child to follow. I understand that these guidelines were established to provide safety for the Pinecrest South Community.
Name: ___________________ Phone: __________________ (home) ___________________ (cell/work)
Address: ______________________________________________________________ (include zip code)
E-mail address: ________________________________________________
Parent/Guardian Signature: ___________________________ Date: ________________________
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