BLOCK Y AWARD: 2023-2024 VERIFICATION FORM

Name: _____________________________ Grade: ________ Teacher: ________________ *Please see the attached pages for explanations of each category and those that require signatures.

MIND | POSSIBLE POINTS | POINTS EARNED
Principal’s Honor Roll (GPA 4.0) | 2 per quarter |
High or Honor Roll (GPA 3.0-3.99) | 1 per quarter |
Met Expected Growth on iReady (Math) | 1 per year |
Met Expected Growth on iReady (ELA) | 1 per year |
Met Stretch Growth on iReady (Math) | 1 per year |
Met Stretch Growth on iReady (ELA) | 1 per year |
Oral Interpretation | 1 per year |
Spelling Bee Y.E.S. Finalist | 1 per year |
CUSD Essay/Art Contest | 1 per semester |
Science Fair | 1 per year |
History Day | 1 per year |
School-Sponsored Academic Club/Activities | 1 per club/ activity |
Bonus Point (see attached details) | 1 per year |
TOTAL MIND POINTS | MIN. OF 8 PTS. REQUIRED |

BODY | POSSIBLE POINTS | POINTS EARNED
School Sports | 1 per season |
Dance Club | 1 per club |
Spirit, Pep, & Cheer | 1 per semester |
PFT Healthy Fitness Zone | 1 per year |
PFT Presidential Award | 1 per year |
Bonus Point (see attached details) | 1 per year |
TOTAL BODY POINTS | 4^th MIN. of 4 PTS. REQUIRED 5^th & 6^th MIN. of 5 PTS. REQUIRED |

SPIRIT | POSSIBLE POINTS | POINTS EARNED
Student Council Position | 1 per semester |
Run for Student Council | 1 per semester |
Junior Flight Crew | 1 per year |
Care Chip Award | 1 per year |
Aviator Badge | 1 per year |
Drama | 1 per production |
School-Sponsored Service Club/Activities | 1 per club/activity |
Bonus Point (see attached details) | 1 per year |
TOTAL SPIRIT POINTS | MIN. OF 7 PTS. REQUIRED |

TOTAL MIND POINTS | TOTAL BODY POINTS | TOTAL SPIRIT POINTS | TOTAL BLOCK Y POINTS
Circle One:	Plaque	Medallion

Student Signature: __________________________________________________________________ Date: ________________

Teacher Signature: _________________________________________________________________ Date: ________________

BLOCK Y GUIDELINES, DETAILS, AND REQUIRED SIGNATURES

The Block "Y" Award is an award that recognizes students involved in all areas of the school. The Block "Y" can be earned by all fourth, fifth and sixth grade students and is available one time per year. The criteria for this award reflects well-rounded participation and service, as well as achievement. Block “Y” recipients will be honored at our Block “Y” award ceremony at the end of the school year. In keeping with the spirit of the Clovis Unified School District philosophy to be the best you can be, the areas and activities in which students can earn points have been grouped into these three domains: Mind, Body and Spirit.

 Mind: Activities in this domain have to do with intellectual and artistic development.

 Body: Activities and requirements in this domain have to do with physical fitness and athletics.  Spirit: The activities grouped in this domain have to do with character development. They are
designed to provide opportunities for the development of such character attributes as caring for and service to others, active citizenship, cooperativeness, responsibility, and dedication.

In order to receive this award, a student need not be the "star" of his or her activity, but he/she must be an active and enthusiastic participant in the activities of the school, engaged in the pursuit of excellence, and have met certain standards of achievement and performance. Individuals earning this prestigious award will receive a Block "Y" engraved plaque. Thereafter, a student will receive a medallion to be added to their plaque upon meeting the Block "Y" requirements once again. If a student has a plaque from another school already, they may choose to ad a Young medallion to their existing plaque or accept a brand-new Young plaque.

It is not necessary for a student to participate in every activity to achieve this award. There are numerous ways a student may receive the Block "Y" award. It is suggested that students, along with their parents and teacher, discuss/plan for this award at the beginning of each year. This helps eliminate students over-extending themselves, while encouraging others to participate. In the sections that follow, specific details and requirements governing the earning of points in each category are discussed.

In order to receive points for each category, students must follow through on all commitments for each activity, and signatures must be provided to verify participation/completion for the indicated activities below. All on-site signatures will be gathered during our annual “Block Y Signing Day.” Any off-campus signatures must be gathered prior to the due date for Block Y Forms. Students need to earn at least the minimum points indicated for each category to qualify for the award.

It is our hope that all students will actively pursue this award, making it a part of their planning for their total school experience. Whether or not the student actually receives this award, striving for it will hopefully enrich and enhance his or her educational foundation.

*Special Note: This is a working document. As time passes, activities and points will be modified as needed.

MIND | DETAILS | SIGNATURE REQUIRED
Principal’s Honor Roll | Students who earn a 4.00 GPA receive 2 points per quarter. | Verified by front office when preparing Block Y awards.
High Honor Roll | Students who earn a 3.50-3.99 GPA receive 1 point per quarter. | Verified by front office when preparing Block Y awards.
Honor Roll | Students who earn a 3.00-3.49 GPA receive 1 point per quarter. | Verified by front office when preparing Block Y awards.

Met Expected Growth on iReady

Students who meet their expected growth in ELA or Math can get 1 point per subject

Teacher’s Signature – 1 per subject

______________________________

______________________________

Met Stretch Growth on iReady

Students who meet their stretch growth in ELA or Math can get 1 point per subject

Teacher’s Signature – 1 per subject

______________________________

______________________________

Oral Interpretation Oral Interp Advisor: Katie Chavez (Room 25) Start Date: TBA Performance: TBA | Oral Interpretation is an organized activity where students perform a choral reading of a literature selection. Students in grades 4-6 may try-out for the Oral Interpretation Team. Students who make the team, participate, and follow the “Co-Curricular Code of Excellence” will earn 1 point per year. | _________________________________ *Oral Interpretation Advisor’s Signature
Spelling Bee Y.E.S. Finalist Spelling Bee Advisor: Amanda Binz (room 2) Starts: February | Students in grades 4-6 are invited to participate in the written spelling bee to qualify for the Young Elementary School-wide On-stage Spelling Bee. Those who qualify for the Y.E.S. Spelling Bee will earn 1 point per year. | _________________________________ *Spelling Bee Advisor’s Signature

CUSD Essay/Art Contest CUSD Contest Advisor: Melissa Peterson (room 5) These contests get sent out to the students as soon as they are released.

Participation in any (or all) of the essay/art contests throughout the year will earn the student 1 point per semester. Participation means submitting a completed essay/project, meeting all of the requirements set forth in the contest guidelines.

*Teacher’s/Advisor’s Signature – 1 per semester

_________________________________

_________________________________

Science Fair Science Fair Advisor:
Sayge Davis (room 20) Starts: November

Students that participate and enter a completed science fair project in the school or county Science Fair will earn 1 point per year.

_________________________________ *Teacher’s/Advisor’s Signature

History Day History Day Advisor Jason Kelm Starts: TBA | Students that participate and enter a completed history day project in the school or county history day will earn 1 point per year. |

School-Sponsored Academic Club/Activities

Robotics Advisor: Melissa Tanaleon (room 12)
Starts: September

*Includes any of the offered clubs/activities; 1 point per completed club/activity can be earned

 	Robotics (5^th and 6^th grade only)
 	Destination Imagination

*Teacher’s/Advisor’s Signature – 1 per club/activity

_________________________________ _________________________________ _________________________________

DI Advisor: Denise Shaffer (room 1)
Starts: TBA

Chess Club Advisor: Caitlyn Hemman (room 9) Starts: September

Chess Club (must attend at least 8 sessions)
 	Reading Buddies with preschool (organized with classroom teacher & preschool)
 	Other: ________________________

_________________________________ _________________________________ _________________________________ _________________________________

Bonus Point

*Only 1 point per year can be earned in this category and used toward the Total Mind Points

 	Award from CUSD Essay/Art Contest
 	Science Fair Top 3
 	History Day Top 3 per category
 	Spelling Bee County finalist
 	Regional or State Qualifier in School-Sponsored Academic Club/Activities
 	Off-Campus Music Class/Lessons
 	Other: ________________________

_________________________________ *Teacher’s/Advisor’s Signature

*For any off-campus activities, please complete the attached Off-Campus Bonus Point Verification Form.

BODY | DETAILS | SIGNATURE REQUIRED

School Sports

Participation on a school sports team for the full season in accordance with the "Code of Excellence" will earn a student 1 point per season. Students who enroll at Young Elementary after the season has begun may receive a participation point if they participate for at least 50 percent of the season.

*Coach’s Signature – 1 per season

_________________________________

_________________________________

_________________________________

_________________________________

Dance Club

Dance Club Advisor: Paula Prendergast (room 8)
Starts: November

Young Elementary School offers Dance Clubs throughout the year that are designed teach students different dance styles from different cultural backgrounds. There are not tryouts for these clubs and no dance experience is needed, only a student’s commitment to learn and parent/guardian permission. Participation in the dance club requires attendance at the practices and dance performance in accordance with the "Code of Excellence.” Students will earn 1 point per club.

*Advisor’s Signature – 1 per club

_________________________________

_________________________________

Game, Pep, & Cheer

Game Squad Madison Ehresman (Room 17)

Cheer Advisors: Lauren Napier (room 16)
Nicolette Santos (room 15)

Pep Advisor: Sayge Davis (room 20)

Spirit, Pep, & Cheer is open to students in grades 4-6 and participants are selected based on tryouts. Participation on a team for the full season in accordance with the "Code of Excellence" will earn a student 1 point per semester.

*Coach’s Signature – 1 per semester

_________________________________

_________________________________

_________________________________

PFT Healthy Fitness Zone | PFT stands for Physical Fitness Testing. The Healthy Fitness Zone is based on state criteria for males/females based on age | _________________________________ *Teacher’s Signature

and will be published at scheduled test times. Students who place in the Healthy Fitness Zone in all five areas on the spring assessment will earn 1 point per year. |
PFT Presidential Award | PFT stands for Physical Fitness Testing. Grade level Presidential Awards are based on district criteria determined and announced at scheduled test times. Students who place in the Presidential Award range on the spring assessment will earn 1 point per year. | _________________________________ *Teacher’s Signature

Bonus Point

We recognize that many students participate in athletic programs sponsored by various community organizations (e.g., soccer clubs, baseball programs, gymnastics classes/teams, etc.). Participation in a community-sponsored activity means signing-up, participating in all scheduled practices, games/meets, etc. Students must participate in the same number of hours (four hours) per week as the school sports teams in order to receive points. The sport must also have some competition event. Points will not be given on a sliding scale for participation of less than four hours a week.

In order to obtain these points the student MUST submit to his/her teacher a school form filled out and signed by the sponsor or leader of the non-school sport, activity, or class. This form will verify the student's involvement in the sport, activity, or class and certify that the student's participation meets the requirement for this bonus point.

*Only 1 point per activity can be earned in this category and used toward the Total Body Points

 	Off-Campus Sports Team
 	Off-Campus Dance/Gymnastics Class/Team
 	Other: ________________________

*For any off-campus activities, please complete the attached Off-Campus Bonus Point Verification Form.

SPIRIT | DETAILS | SIGNATURE REQUIRED
Student Council Position Student Council Advisor: Rhonda Luna (room 22) | A student will receive 1 point for being elected to a student body office and serving for the full term. Semester 2 officers must successfully serve the entire Block Y period. | Verified by front office when preparing Block Y awards.
Run for Student Council | A student will receive 1 point for RUNNING for a student body office, even if not elected. Student must give a speech to be eligible for the point. | Verified by front office when preparing Block Y awards.

Junior Flight Crew JFC Advisor:
Ray Gamez (principal) Starts: Octoberand meets the 1^st Thursday of every month

The Junior Flight Crew is a group of students in grades 4-6 who have been recommended by their classroom teacher. Students on this council work to promote cultural diversity for all students at Young Elementary School, as well as in the Clovis East Area. Meetings are held bi-weekly at Young, and participation on this council will earn students 1 point per year.

Verified by front office when preparing Block Y awards.

Care Chip Award PBIS Advisor:
Melissa Tanaleon (room 12)

The Care Chip will be awarded to students who demonstrate through their words and actions that other people matter. Each month, there will be three students from each upper grade class who will be granted the Care Chip. The
Care Chip is represented by a two-sided coin, and students selected for this award by their classroom teacher will earn 1 point per year.

Verified by front office when preparing Block Y awards.

Aviator Badge Awards Advisor:
Stacy Rickels (main office)

Each quarter, teachers will nominate three students from each upper grade class to earn their Aviator Badge during our quarterly awards ceremony. These are students who have demonstrated exemplary behavior, effort to reach personal goals, and/or a growth mindset. Students who earn their Aviator Badge also earn 1 point per year.

_________________________________ *Teacher’s Signature

Drama Drama Advisor:
Katie Chavez (Room 25) Starts: TBA

Drama is available for all students in grades 4-6. Students may receive credit by actively participating in all practices and attendance at Young’s annual Drama Production. Equal credit of 1 point per production is given to students who are drama chorus members, actors/actresses, or stage crew in the production. Young’s Drama Production takes place in the spring of each school year, or as selected by the director. Your child’s classroom teacher will advise students on the Drama schedule in early spring.

_________________________________ *Drama Director’s Signature

SPIRIT (cont.) | DETAILS | SIGNATURE REQUIRED
School-Sponsored Service Club/Activities | Includes any of the offered clubs/activities: | *Signature from each Club/Activity Advisor/Coach

Pilot Buddies Advisor: Hannah Shevenell (room 21) Starts: TBA; Last Friday of every month

Flight Club Advisor: Mary Kate Garcia (speech)
Caitlyn Hemman (room 9) Starts: October; on Fridays during 5^th and 6^th grade lunch recess

1 point per completed club/activity can be earned

 	Pilot Buddies
 	Flight Club (Garcia & Hemman)
 	Lunch helper (must serve 2 weeks)
 	1 point for attending all 4 Multicultural Family Nights
 	Other _________________________

_________________________________ _________________________________ _________________________________

Bonus Point

Students may earn 1 bonus point for participation in an activity, class, or organization not sponsored by the school. Activities such as scouting, community sponsored clubs, instructional classes in fine arts or other genuine community sponsored activities promoting the involvement of children in worthwhile learning activities qualify under this category.

In order to obtain these points the student MUST submit to his/her teacher a school form filled out and signed by the sponsor or leader of the non-school sport, activity, or class. This form will verify the student's involvement in the sport, activity, or class and certify that the student's participation meets the requirement for this bonus point.

*Only 1 point per year can be earned in this category and used toward the Total Spirit Points:

 	Scouts
 	Youth Group
 	Community Service
 	Other _________________________

*For any off-campus activities, please complete the attached Off-Campus Bonus Point Verification Form.

BLOCK Y AWARD OFF-CAMPUS BONUS POINT VERIFICATION FORM

Name: ______________________________________________ Grade: ________ Teacher: _____________________

PLEASE MARK WHICH CATEGORY YOU ARE APPLYING FOR A BONUS POINT
*A separate Off-Campus Bonus Point Verification Form must be completed for each category.

MIND

Off-Campus Academic Tutoring
 	Off-Campus Music Class/Lessons
 	Other: ______________________

BODY

Off-Campus Sports Team
 	Off-Campus Dance/Gymnastics Class/Team
 	Other: ______________________

SPIRIT

Scouts
 	Youth Group
 	Community Service
 	Other _______________________

Sponsor or Leader of Off-Campus Activity - Please complete the following section:

First and Last Name: _______________________________________________________________________________________

Name of Group/Organization: _____________________________________________________________________________

Phone Number: _______________________________ / Email Address: ____________________________________________

Description of Activity:

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Did the student attend practices/meetings regularly and required events?                           Yes                 No Did the student participate and put forth their best effort as you expected?                         Yes                 No

Sponsor/Leader’s Signature of Verification __________________________________________________________________

BLOCK Y AWARD OFF-CAMPUS BONUS POINT VERIFICATION FORM

Name: ______________________________________________ Grade: ________ Teacher: _____________________

PLEASE MARK WHICH CATEGORY YOU ARE APPLYING FOR A BONUS POINT
*A separate Off-Campus Bonus Point Verification Form must be completed for each category.

MIND

Off-Campus Academic Tutoring
 	Off-Campus Music Class/Lessons
 	Other: ______________________

BODY

Off-Campus Sports Team
 	Off-Campus Dance/Gymnastics Class/Team
 	Other: ______________________

SPIRIT

Scouts
 	Youth Group
 	Community Service
 	Other _______________________

Sponsor or Leader of Off-Campus Activity - Please complete the following section:

First and Last Name: _______________________________________________________________________________________

Name of Group/Organization: _____________________________________________________________________________

Phone Number: _______________________________ / Email Address: ____________________________________________

Description of Activity:

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Did the student attend practices/meetings regularly and required events?                           Yes                 No Did the student participate and put forth their best effort as you expected?                         Yes                 No

Sponsor/Leader’s Signature of Verification __________________________________________________________________

BLOCK Y AWARD OFF-CAMPUS BONUS POINT VERIFICATION FORM

Name: ______________________________________________ Grade: ________ Teacher: _____________________

PLEASE MARK WHICH CATEGORY YOU ARE APPLYING FOR A BONUS POINT
*A separate Off-Campus Bonus Point Verification Form must be completed for each category.

MIND

Off-Campus Academic Tutoring
 	Off-Campus Music Class/Lessons
 	Other: ______________________

BODY

Off-Campus Sports Team
 	Off-Campus Dance/Gymnastics Class/Team
 	Other: ______________________

SPIRIT

Scouts
 	Youth Group
 	Community Service
 	Other _______________________

Sponsor or Leader of Off-Campus Activity - Please complete the following section:

First and Last Name: _______________________________________________________________________________________

Name of Group/Organization: _____________________________________________________________________________

Phone Number: _______________________________ / Email Address: ____________________________________________

Description of Activity:

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Did the student attend practices/meetings regularly and required events?                           Yes                 No Did the student participate and put forth their best effort as you expected?                         Yes                 No

Sponsor/Leader’s Signature of Verification __________________________________________________________________