DELAWARE CITY SCHOOLS - dcs.k12.oh.us



DELAWARE CITY SCHOOLS

2015 SUMMER SCHOOL ENROLLMENT APPLICATION

For Upcoming Grades 9-12

Rutherford B. Hayes High School

(740) 833-1010 FAX: (740) 833-1099

I am requesting that my child be enrolled in the Delaware City Schools’ summer school program. Seating is limited and priority will be given to those upperclassmen students who need to make-up failed courses. Summer School courses are not approved for NCAA Athletic Eligibility. I understand that transportation is not provided and summer school sessions will be held during the following dates, times, and locations:

APEX Six-Week Online Session (For English, Math, Science, and Social Studies Credits): June 8-July 16, 2015*

Location: Hayes High School LMC* Optional Lab Times: Mon - Thurs 9 AM – 12 Noon (See calendar)

*All APEX students are required to attend an Info/Training Session to participate. Last names A-L on June 8, 2015 and M-Z on June 9, 2015 from 9:00 am -12:00 noon. APEX students may work at home or attend lab times as needed. Please see attached calendar for lab times. Communication via e-mail with the instructor will be required if working from home. Parents please include your email address on this form to receive weekly progress reports.

APEX Three-Week Online Session (For Elective Credits): 1st Session: June 8-June 25, 2nd Session: June 29-July 16, 2015*

Location: Hayes High School LMC* Optional Lab Times: Mon - Thurs 9 AM – 12 Noon (See calendar)

*All APEX students are required to attend an Info/Training Session to participate. June 9, 2015 for 1st session and June 29, 2015 for 2nd session from 9:00 am -12:00 noon. APEX students may work at home or attend lab times as needed. Please see attached calendar for lab times. Communication via e-mail with the instructor will be required if working from home. Parents please include your email address on this form to receive weekly progress reports.

PE will not be offered through Hayes High School this summer. Students may choose to take PE online through

TRECA Summer School. Cost is $85 for 0.5 credit of PE. Visit for more details.

Student Name: ________________________________________DOB:____________________________

Student Gender: ( M ( F Home Phone #:__________________ Cell / Day Phone #:______________

School Last Attended: __________________ Grade Level for Current School Year: ________________

(Grade level just completed)

Parent/Guardian Name: _________________________________________________________

Address: _____________________________________________________ Email: _________________________________________

Please indicate the course in which you are enrolling your child and attach appropriate payment. Students may sign up for only one course unless prior approval is granted.

All students are required to pay a $75.00 non-refundable deposit due upon registration. No new registrations will be taken after June 9th; no additional time will be allotted for late registrations. Deposit will apply to tuition cost.

Cost for Delaware City Students (Grades 9-12): APEX: $150.00

APEX: Course request: ______________________________________________________ New: ____ Make-up: ____

*Please indicate 1st or 2nd session for 3-week elective courses

Courses available

|English |Math- Make Up Only |Science- Make Up Only |Social Studies |Electives- 3-Week Session |

|English 9 |Algebra 1 |Physical Science |World Studies |Health (.5) |

|English 10 |Algebra 2 |Biology |United States Studies |Music Appreciation (1.0) |

|English 11 |Geometry |Earth Science |Government (.5) |Art Appreciation (.5) |

|English 12 | | |Economics (.5) |Sociology (.5) |

| | | | |Psychology (.5) |

Application and Deposit to be returned to Hayes by June 1, 2015

Your School Counselor MUST approve and sign your application prior to enrollment

Full payment must be received by last day of class to receive credit. Checks should be made payable to the Delaware City Schools.

Counselor Approval: ______________________________________________________________________________

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Date Received

Admission Date

DIS Code

Building IRN

Payment Type/Amt.

Office Use Only

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