Staff/Teacher-Led Shutdown

First Name *

Last Name *

Building *

Room Number *

Please check off each item after completion to ensure your room is ready for the shutdown. *

	Completed
Windows are closed tightly including both sets for sliding windows.	Completed
Blinds or shades are pulled down or venetian blinds are utilized (turned upwards, downwards).	Completed
Unplug absolutely everything in the room including appliances, electronics, printers, smartboards, RedCat Audio, Doc Cameras, and computers. The only exception is a fax machine.	Completed
Turn off your lights including any peripheral lighting.	Completed
Close door (if applicable).	Completed
Make sure personal refrigerators are cleaned out for the shutdown and unplugged so that food does not spoil when the refrigerator is unplugged.	Completed
If you have an individual thermostat, please turn it to 55 degrees (heating), 85 degrees (cooling).	Completed

Please list any exceptions. (For example, #341 Consolidated Science Refrigerator w/ Science kits.)

NON-DISCRIMINATION STATEMENT:

The Sioux City Community School District offers career and technical programs in the following areas: Business & Marketing, Family & Consumer Science, Health Science, and Industrial Arts, Technology, & PLTW.

The Sioux City Community School District is an equal opportunity/affirmative action employer and does not discriminate on the basis of race, creed, color, sex, sexual orientation, gender identity, genetic information (for employment), national origin, religion, age (for employment), disability, socioeconomic status (for programs), marital status (for programs), or veteran status (for employment) in its educational programs and its employment practices. The District is required by Title IX and 34 CFR Part 106 not to discriminate on the basis of sex in its programs, activities, or employment.

Inquiries or grievances under Section 504 and Title II of the Americans with Disabilities Act may be directed to Dr. Dora Jung, Director of Student Services & Equity Education/Title IX Coordinator at 627 4th Street, Sioux City, IA 51101, (712) 279-6075, jungd@live.siouxcityschools.com. Inquiries about the application of Title IX and its regulations to the District may be referred to the Title IX Coordinator, the Assistant Secretary of the U.S. Department of Education, or both. Please see District Board policies 103 and 504.4 for additional information on available grievance procedures