Student Application 2017 - 2018

This application is for enrollment as a full-time student at Rockdale Open Campus. Students must have completed at least two years of high school and have a minimum of five credits to be eligible for admission. Once the application has been completed by the student and signed by student and parent, return to home school counseling department, graduation coach or Open Campus. Incomplete applications will not be accepted.

1. Student Information (Please print) Student Name______Date of Birth______

RCPS Student ID Number ______Current School or Last School Attended ______

Counselor’s Name______Year in High School (circle one): 2nd 3rd 4th 5th or more

Guardian/Parent Name ______Home Phone ______

Home Address City______Zip ______

Parent’s Cell Phone______Parent’s E-mail______

Student’s Cell Phone ______Student’s E-mail ______

This application is for enrollment for the 1st semester of the 2017-2018 School Year.

Application deadline is April 12, 2017.

Important Reminders: *Applying does not guarantee admission. *Once enrolled, a student cannot return to their home school until the start of a semester at the home school. *Once a student is enrolled, they do not have to re-apply for attendance for sequential mini-semesters. However, any break in attendance to a sequential mini-semester or withdrawal from a mini-semester will constitute a need to re-apply. *All students are expected to comply with the discipline code of conduct and attendance policy. *Attendance policy- Obtaining more than 5 absences for any class period (excused and/or unexcused) per mini-semester will result in the student being withdrawn from that class for the remainder of the mini- semester. Students who are withdrawn from all classes must re-apply for admission.

1 3. STUDENT QUESTIONNAIRE: (ALL QUESTIONS MUST BE ANSWERED BY THE APPLICANT. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED)

How many credits have you earned in high school? ______(Minimum of 5 credits required to be eligible for enrollment)

How many credits are required for graduation? ______

Based on the number of credits you have earned thus far, indicate the month and year in which you expect to graduate. ______

Describe your plan for completing your remaining requirements for graduation.

How will attending Open Campus assist you in achieving this plan?

The Open Campus full-time student schedule is 8:20AM – 5:00 PM, Mon-Thurs, with extra help opportunities on Fridays, 8:20 – 10:30AM. Are you willing to commit to this schedule?______

How would you rate yourself in the following areas as a student? Use the following rating scale: 1 = poor 2 = fair 3 = good 4 = great

___respect towards faculty and staff ___attendance at school

___dress code ___following school and classroom rules

___being on-time to class ___respect towards other students

Describe what will you do differently at Open Campus in the area above not rated as “4”.

______

Student Signature Date

Parent Signature Date Once the application is received at Open Campus, the student will be contacted for an interview with Open Campus staff. Students currently enrolled in RCPS will be interviewed at their home school.

2 Incomplete applications will not be accepted.