Admissions Application Parent ... - Jeffco Public Schools

[Pages:4]COLLEGIATE ACADEMY OF COLORADO

8420 S Sangre de Cristo Road Littleton, CO 80127

Admissions Application - Parent Information

Please read the following information carefully before signing this Admissions Application:

1. An approved Jeffco Choice Enrollment application shall be valid for attendance at the school for the remainder of the level that the school serves - elementary, middle, or high school. 2. Students who wish to return to their neighborhood school or to enroll in a different school must submit a Jeffco Choice Enrollment Form or Administrative Transfer Request following timelines for these applications. 3. All Jeffco Choice Enrolled high school students must comply with all CHSAA requirements and bylaws. A student who transfers from School A to School B without a bona fide family move will be eligible for varsity competition in the first 50 percent of the maximum regular season contests allowed in any sport in which the student was a participant in the last twelve months. Other factors may also influence athletic eligibility. 4. Transportation is not provided for Jeffco Choice Enrollment transfers. Please complete this application in full and click the "Submit" button.

*By submitting this application you acknowledge that you have read, understand, and agree to the conditions of admission to Collegiate

Academy of Colorado as defined in the school Pride Book and the Jefferson County Code of Conduct.

Parent/Guardian Name: _____________________________ Fem ale or Male Phone: ____________________

Address: ________________________________________ City: _____________ State: ___ Zip: _______

County of Residence: ________________ Email Address: ________________________________________

Parent/Guardian Name: ________________________________ Fem ale or Male Phone: _________________

Address: ________________________________________ City: _____________ State: ___ Zip: _______

County of Residence: ________________ Email Address: ________________________________________

Employee of CAC? Y es o r No

Siblings already enrolled at CAC? Y es or No

How did you hear about us? (ple ase ch o o se o n e) Jeffco " Choices " B r ochu re / Colu m bin e Cou rier / Jeffco Website / Daycare / Preschool / CAC Family Referral ______________________ / Other _______________________

Enrollment Semester of Interest: Fall o r Spr in g

Enrollment Year: 2017-2018 or 2018-2019

Child(ren) Applying: ______________________________________________________________________

Upon acceptance, Parent/Guardian agrees to support their student as they:

Strive to reflect each of our CORE Values both at school and at home Integrity, Perseverance, Quality, and Ownership Comply with the Collegiate Academy Pride Book (found at ) Comply with the Jefferson County Conduct Codes (found at ) Adhere to the Collegiate Academy Dress Code (found at )

Parent/Guardian agrees to:

Support their student and CAC staff in homework and behavior accountability Pay Annual School Fees and any Fines accrued. (Free and Reduced Lunch and Fee Application at .) Provide transportation to and from school every day and on time Check academic progress weekly on the Jeffco Campus Portal Participate with teachers in bi-annual student-led conferences Contribute 40 volunteer hours per family, donate the equivalent supplies, or pay cash and log contributions online

Physical donations may be to the classroom, school, or events and convert to hours at the rate of $10=1 hour Volunteer hours may be met in the classroom, at special events, assisting outside the classroom, or through participation on the Foun-

dation, School Improvement Team, or the Board of Directors and opportunities are posted in the FYI newsletter weekly, through classroom newsletters, and on the board in the Elementary lobby.

Parent/Guardian Signature: _______________________________________ Date: _______________

Parent/Guardian Signature: _______________________________________ Date: _______________

Phone: 303-972-7433 Fax: 303-932-0695 enrollment@

Update 1/6/2016

COLLEGIATE ACADEMY OF COLORADO

8420 S Sangre de Cristo Road Littleton, CO 80127

Admissions Application - Student Information

Student : __________________________________________________________________ Female or Male

Last

First

Middle

Birth Date: ______________________ Grade Applying For: _________ Fall or Spring of _____________

Last School Attended/Currently Attending: ____________________________________________________

Accommodations Required: (Ple ase ch oo se o n e ) ALP / IEP / 504 / Non e

If your child has been identified to receive one or more of these services, please fax the documentation to our school at 303-9320695 for review by the appropriate staff members. This will allow us to ensure that we can meet your child's needs prior to our meeting. Student Health Concerns/Allergies Please list any student health concerns (including allergies, asthma or breathing, bowel/bladder, diabetes, heart/cardiovascular, headaches, special dietary needs, hyperactivity, emotional/behavioral, mobility, seizures, or other needs). Please write "none" if your student has no health concerns. If your child is currently taking medication, please write the name of the medication, the dose, and the time even if given outside of school hours. _______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

Difficulties with peer relationships? (Examples: shyness, bullying) Yes No

If yes, explain. _____________________________________________________________________

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

Anxiety, depression, or other emotional problems needing support? Yes No

If yes, explain. _____________________________________________________________________

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

History of underachieving, lacking motivation, or otherwise struggling in the classroom? Yes No

If yes, explain. _____________________________________________________________________

________________________________________________________________________________ ________________________________________________________________________________

________________________________________________________________________________

Demonstrate signs of a possible undiagnosed learning disability? Yes No

If yes, explain. _____________________________________________________________________

________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________

Phone: 303-972-7433 Fax: 303-932-0695 enrollment@

COLLEGIATE ACADEMY OF COLORADO

8420 S Sangre de Cristo Road Littleton, CO 80127

Tested for special needs services? Yes No If yes, explain. ___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Been involved in any discipline problems at his/her last school? Yes No If yes, explain. ___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Ever been expelled or currently suspended? Yes No If yes, explain. ___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Ever been in trouble with the law? Yes No If yes, explain. ___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Ever been designated as "habitually disruptive"? Yes No If yes, explain. ___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Please attach an additional sheet of paper if you need more room to elaborate.

As a student of Collegiate Academy of Colorado I agree to abide by the following:

Strive to reflect each of our CORE Values both at school and at home Integrity, Perseverance, Quality, and Ownership Comply with the Collegiate Academy Pride Book (found at ) Comply with Jefferson County Conduct Codes (found at ) Adhere to the Collegiate Academy Dress Code (found at ) Maintain a positive attitude Take responsibility for academics and behaviors Complete all school assignments, including homework Commit to showing up every day and on time Come to class prepared every day

Parent/Guardian Signature: _______________________________________ Date: ______________ Parent/Guardian Signature: _______________________________________ Date: ______________ Student Signature: ______________________________________________ Date: _____________

Phone: 303-972-7433 Fax: 303-932-0695 enrollment@

Update 1/6/2016

COLLEGIATE ACADEMY OF COLORADO

8420 S Sangre de Cristo Road Littleton, CO 80127

REASONS FOR CHOOSING COLLEGIATE ACADEMY

The Administration would like to know why you have chosen Collegiate Academy of Colorado. What differences do you expect to find here over your neighborhood school? What led you to seek a choice school over your neighborhood school? How did you discover our school? This form should be completed by a parent for grades K-3. Older children should complete this form on their own in addition to one completed by the parent/guardian. Additional pages should be attached as needed. Name of Student ________________________________________________ Grade in 2018-19 ________ Parent/Guardian Name __________________________________________________________________ Parent/Guardian Name _____________________________________________________________

______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

Parent/Guardian Signature: ____________________________________________ Date: ______________ Parent/Guardian Signature: ____________________________________________ Date: ______________ Student Signature: ___________________________________________________ Date: ______________

Phone: 303-972-7433 Fax: 303-932-0695 enrollment@

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