US Department of Education Blue Ribbon School Program

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Catholic Academy of Sussex County

Please see below the following two forms:


From the Nurse's Office

Immunization & Medical Entrance Requirements

Children need to receive the minimum number of age appropriate vaccines prior to entering school/preschool.   Proof of vaccination MUST be submitted directly to the school nurse NO LATER THAN AUGUST 15.

Pre-K Requirements

Minimum Immunization:

  1. DTaP - 4 doses

  2. Polio – 3 doses

  3. Hep B - 3 doses

  4. Hib – 1-4 doses (a minimum of 1 dose on or after the first birthday)

  5. PCV 13 –1-4 doses (a minimum of 1 dose on or after the first birthday)

  6. MMR - 1 dose after the first birthday

  7. Varicella – 1 dose after the first birthday

  8. Influenza – a minimum of 1* dose every school year between September 1 and December 31 for children 6 months to 5 years old.

    * (Your child may require a second dose if there has been no prior Flu vaccination)

Kindergarten Requirements

  1. DTaP -5 doses (4 doses only if the 4th dose was received after the 4th birthday)
  2. Polio -4 doses (3 doses only if the 3rd dose was received after the 4th birthday)
  3. Hep B - 3 doses
  4. Hib – 1-4 doses (a minimum of 1 dose on or after the first birthday)
  5. PCV 13 –1-4 doses (a minimum of 1 dose on or after the first birthday)
  6. MMR – 2 doses
  7. Varicella –1-2 doses (a minimum of 1 dose after the first birthday)

    *A TB test may be required if a child is transferring from out of state or a high risk area.  Please consult your physician.

Physical Examination

A current physical exam is required for all students entering Reverend Brown School.  Please use the PK-4 form below for all students.  Students entering Grade 1 or higher for the first time will not be held to having their physical completed between May 15 and August 15 during their first year.  Returning students, please schedule your well care visits accordingly.

Physical Forms:

Allergy Action Plan

Asthma Action Plan

Consent and Authorization for Administration of Medication

Authorization for Administration of Emergency Medication

Request for Medication to be Administered by School Nurse

Authorization of Release of Information

Physical Pre-K-4

Health History Update

Heads Up Concussion Fact Sheet

Notes from the Nurse

Sports Injuries Fact Sheet

Media Violence and Youth

Requirements for Volunteers/Chaperones:

In order to become a volunteer or chaperone at Reverend Brown School a three-step process is required by the Diocese of Paterson. The individual must:

1. Please read the attached Code of Pastoral Conduct, complete and return page 12.

2. Complete the Sterling background check form and submit it to the main office.

3. Attend a Virtus (Protecting God’s Children) Course.

Once steps one and two are complete, the person has 90 days in which to complete the Virtus training. A list of available classes and registration can be found at www.virtusonline.org. The volunteer must submit the certificate of completion to the Main Office.
The forms for steps one and two are available on the website and at the Main Office.