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Student ApplicationApplicant InformationLegal Last Name FORMTEXT ?????Legal First Name FORMTEXT ?????Middle Name FORMTEXT ?????Date FORMTEXT ?????Street Address FORMTEXT ?????Apartment/Unit # FORMTEXT ?????City FORMTEXT ?????State FORMTEXT ?????ZIP FORMTEXT ?????Home Phone Student Cell FORMTEXT ?????Parent E-mail Address Student E-Mail Address Current Middle School FORMTEXT ?????Current Grade Level FORMTEXT ?????Gender (Male or Female) FORMTEXT ?????Mother’s/Guardian’s Full Name FORMTEXT ?????Mother’s/Guardian’s Cell Telephone Number FORMTEXT ????? FORMTEXT ?????Father’s/Guardian’s Full Name FORMTEXT ?????Father’s/Guardian’s CellTelephone Number FORMTEXT ????? FORMTEXT ?????Applicant’s Native Language FORMTEXT ?????Applicant’s Zoned High School FORMTEXT ?????Academic Areas of InterestRank the following subjects according to your interest from 1 to 6 (1 is the highest, 6 is the lowest). Subjects may be ranked equally if you wish (more than one ranked as #1). FORMTEXT ????? Foreign Language FORMTEXT ????? Language Arts FORMTEXT ????? Computers FORMTEXT ????? Social Studies FORMTEXT ????? Environmental Science FORMTEXT ????? Art FORMTEXT ????? Psychology FORMTEXT ????? Theater FORMTEXT ????? Other Sciences FORMTEXT ????? Language Arts FORMTEXT ????? Mathematics FORMTEXT ????? MusicMajor Awards/Honors, if any (List Below). FORMTEXT ?????Extra-curricular Areas of Interest FORMTEXT ????? FORMTEXT ?????Admissions AgreementThe International Baccalaureate Diploma Program is a rigorous, comprehensive program designed for the academically motivated student with the potential to earn the International Baccalaureate Diploma. For a student to be successful in this program and be prepared for IB examinations, the student must be committed to a high quality education. Therefore, the International Baccalaureate Diploma Program requires the student and the family to make the following commitment:I (we) agree to the following terms and conditions for participation in IB:Follow the rules of Suffolk Public Schools as specified in the Student Handbook. A copy may be obtained from the Suffolk Public Schools website or by contacting the main office at King’s Fork High School.Meet the expectations of each class by participating in daily activities including completing homework, listening attentively, offering relevant comments, posing insightful questions, and taking notes.Work seriously to improve reading and writing skills.Submit high quality work at deadlines.Maintain a minimum GPA of 3.0 and abide by the Academic Review Process.Exemplify the highest degree of academic and personal integrity. Cheating and repeated class disruptions are grounds for dismissal from the program.Exert concerted effort to schedule recreational trips and all appointments (such as medical and dental) outside of the school day.Remain in the program unless released by the recommendation of the IB Coordinator and the Academic Review Committee. Motivation, attitude, and progress will determine continued involvement in the program.I understand that if I do not meet the standards of the IB Diploma program, either because of the quality of my work or because of my performance as a serious learner, I may be asked to withdrawal from the program to enroll in a course of study which better meets my level of performance. I also understand that if I leave the program, I may be requested to return to my zone school and, according to Virginia High School League rules, I would not be eligible to participate in VHSL activities for 365 days unless I am granted a waiver under rule 28-6-2 (14).I am aware that by applying for the program, I will become a King’s Fork High School student eligible for extra-curricular activities at the school and that I will earn my high school diploma from King’s Fork High School. I realize that if I reside outside of the King’s Fork High School attendance zone, I will not be eligible to participate in any extra-curricular activities at the home attendance zone high school while enrolled at King’s Fork High School._______________________________________________Student Signature*DateI understand that the selection committee will be looking at my child’s academic performance, confidential teacher recommendations, the writing sample, and the interview process to determine my child’s eligibility for selection. I grant permission for my son/daughter, if selected, to be enrolled in the International Baccalaureate Diploma Program at King’s Fork High School. I will also support my child’s academic growth and encourage development of independent study skills._______________________________________________Parent/Guardian Signature**Electronic signature confirms agreement.DateParent Recommendation FormStudent’s Name ___________________________ Middle School ______________________________________ Directions to Parent: Your child is completing an application for the IB Program. Please mark the box below that best represents your assessment of your child. Note: Current teachers will also be asked to complete this form confidentially. You do not need to take action. The IB Coordinator will secure this information.Almost AlwaysOftenOccasionallyRarelyNeverEase of Learning: Enjoys the challenge of problems, assignments, and issues. Learns quickly. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Adaptability: Approaches ideas and problems from a number of directions. Finds alternative means of solving problems. Thinks about ideas in new ways. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Initiative and Enthusiasm: Is a highly motivated, independent worker. Seeks additional tasks; is intellectually curious, and stays actively engaged in activities. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Persistence: Stays with tasks; relates progress on tasks to accomplishment of larger goals. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Reliability and Integrity: Is scrupulous and punctual in fulfilling obligations; readily accepts responsibility. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Reasoning: Uses logical, analytical reasoning and/or creative divergent thinking to consider ideas or solve problems. (Originality and elaboration of thinking). FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Communications: Communicates effectively. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Organization: Manages time, resources and materials; meets deadlines; divides tasks into subtasks. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Leadership Qualities: Shows respect and tolerance of others’ views. Is willing to accept the ideas of others and contributes to the group process. Influences others in a positive manner. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Success: Displays the ability to succeed in a challenging program. FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX FORMCHECKBOX Please provide any comments that might assist us in determining your child’s potential to succeed in a rigorous academic program.Additional Comments: __________________________________________________________________DateParent signature*Electronic signature acceptableThank you for completing this form. Your input is valued.Required Writing Samples Applicant’s Statement on MotivationDirections: The IB Program is designed for students who are highly-motivated academically. Please provide below in one paragraph an example of something that you do or have done, which demonstrates you are an academically highly-motivated student. Include a brief explanation. FORMTEXT ?????Applicant Formal Writing Sample SessionThe Writing Sample will be administered the third week of January at each middle school. Students will be allotted 1 ? hour to complete the writing sample. Be sure to return your permission slip to your guidance counselor.I N F O R M A T I O NThe student will be given a writing prompt and asked to write a composition of more than one paragraph on the topic covered. The purpose of the writing sample is to determine if the student possesses competent writing skills necessary for success in the program.The student should bring two pens. Paper will be provided.If a student submits an application for the IB program but does not complete the required writing sample, his or her application is considered to be incomplete and cannot be evaluated by the IB Admissions Committee.Please contact the IB Coordinator at carkennedy-dickens@ , if you have any questions or concerns.International Baccalaureate Formal Writing SessionInformation and Permission SheetDirections:Parents, please complete this form, print it and return it to your child’s guidance counselor by January 6th .Student’s Name_________________________________________________________Address________________________________________________________________Phone_______________________________School_____________________________Please Check:_____My child has permission to participate in the International Baccalaureate Formal Writing Session at my child’s middle school. I understand that the writing sample is a part of the application process.***Please Note: The participation of your child in the Writing Session for the International Baccalaureate application process should not be interpreted as an implied, presumed or actual admission into the program._____________________________ Parent’s SignatureIB Honor CodeThe IB Program offers a quality education that not only insures knowledge, but cultivates the virtues of honor, courtesy, and perseverance. Of these virtues, honor is of great importance, for it is personal integrity that will influence and finally determine many of our actions and beliefs. This Honor Code exists in order to uphold and reinforce values that are central to the IB tradition of excellence and to prevent violations of that tradition such as cheating or plagiarism. Students should consider this Honor Code to be enforced in all IB classes and all activities associated with King’s Fork High School.IB defines malpractice in the following way:Malpractice:behavior that results in, or may result in, the candidate or any other candidate gaining an unfair advantage in any assessment component. It may include:Collusion: when a candidate knowingly allows his or her work to be submitted for assessment by another candidate. Plagiarism: the submission for assessment of the unacknowledged work, thoughts or ideas of another person as the candidate's own.Duplication of Work: the presentation of the same work for different assessment component and/or diploma requirements.Any other behavior which gains an unfair advantage for a candidate or which affects the results of another candidate.The King’s Fork IB Honor Code, simply stated, is:Students shall be honor bound to refrain from cheating of every kind, including plagiarism. Students shall be honor bound to take actions to stop any and all violations of this Honor Code which they see. Inaction implies that one condones inappropriate behavior. Living in a manner that is consistent with this code will produce an atmosphere of trust, freedom, and integrity necessary to the success of each student in this program. Without maintaining a high standard of honesty and conduct, the reputation of the school and of IB are compromised and society is poorly served.Honor PledgeI hereby pledge to uphold the Honor Code of the International Baccalaureate Program at King’s Fork High School. I shall refrain from all forms of academic malpractice: cheating; plagiarism; or other deceitful means of obtaining good grades.If I have knowledge that a student has violated the honor code, I have an obligation to take action to prevent damage to the program and its participants. I understand that breaches of the honor code are punishable according to the King’s Fork handbook for student conduct and may result in my removal from The International Baccalaureate Program and from King’s Fork High School.Student Signature* ________________________ Date ___________________Parent Signature *________________________Date____________________*Electronic signatures are acceptable. ................
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