APPLICATION FOR ENROLLMENT EARLY COLLEGE

Transcription

1 Admissions Office Virtual Learning Academy Charter School P.O. Box 1050, Exeter, NH T: F: APPLICATION FOR ENROLLMENT EARLY COLLEGE Instructions Please complete all sections of this application. If you need this application in another language, please contact Please the completed application to or print and mail the application to: LT College Admissions Virtual Learning Academy Charter School P.O. Box 1050 Exeter, NH Residency I am applying as a New Hampshire resident. New Hampshire residents can attend the Virtual Learning Academy Charter School without cost for middle or high school credit. New Hampshire residents will pay early college administrative fees. As per RSA 193:12, VLACS reserves the right to request proof of residency. I do not reside in New Hampshire. Please enclose a non refundable check for $30 to cover registration fees. Please make the check payable to: Virtual Learning Academy Charter School. Non resident students who are admitted to the school will be assessed a tuition fee of $460 per early college course. Additionally, non resident students will pay early college administrative fees. Early College Administrative Fees An administrative fee of $100 per course will be charged by Southern New Hampshire University for each early college course. Administrative fees are paid before beginning a course and are not refundable. Students who earn an associates degree will be required by Southern New Hampshire University to pay a fee of $150 at the time of graduation. Southern New Hampshire University may change the amount charged for administrative fees at any time. Enrollment requirements I have completed a freshman and sophomore level English course, or equivalent. I understand that additional high school English courses may be required before enrolling in certain college level courses. I have completed algebra I or equivalent. I understand that additional high school math courses may be required before enrolling in certain college level courses. I have completed a Transcript Request Form and sent it to my school. Note: Home schooled

2 students should contact the guidance office to learn how this requirement can be satisfied. I understand SNHU will not confer the degree until my high school submits transcripts and proof of graduation. If the student is home educated, they would need to prove high school graduation in a manner accepted by SNHU. Please Select Desired Program (you can change this as needed once admitted) Associates / 60 credit / 20 courses 1 year / 30 credits/ 10 courses Student Information Last Name First Middle Date of Birth / / Gender: Male Female Place of Birth: City State Legal Street Address: City State Zip Mailing Address: City State Zip Home Telephone Number ( ) Cell Phone E mail Address Parent/Legal Guardian Information Mother or Legal Guardian: Last Name First Legal Street Address: City State Zip Home Telephone Number Work/Cell Phone Address Legal Custody of Student Yes No Father or Legal Guardian: Last Name First

3 Legal Street Address: City State Zip Home Telephone Number Work/Cell Phone Address Legal Custody of Student Yes No Current School Information School Name School Address City State Zip School Telephone Number Fax Number Guidance Counselor Address Current Grade Level Years at present school Is the student currently attending this school? YES NO If NO, when did the student withdraw? Student Questions 1. Why would you like to enroll in the VLACS early college program?

4 2. Based on your knowledge about yourself as a student, what do you anticipate will be challenging about completing college level work? Parent Questions 1. Why would you like your child to enroll in the early college program? 2. What types of academic supports will your child need in order to be successful in this program? Signatures Student Signature Date Parent/Guardian Signature Date

5 Admissions Office Virtual Learning Academy Charter School P.O. Box 1050, Exeter, NH T: F: Transcript Release Form The following student is applying for admission to the Early College program at the Virtual Learning Academy Charter School. The Early College program is available to part time students and does not require that the student withdraw from their current school. The Virtual Learning Academy Charter School is required to obtain written consent from the parent or eligible student before personally identifiable information from a student's education records is disclosed to any party other than those who are permitted access by law. Consent is also required before personally identifiable information is used for any other purpose than to aid in the planning for and provision of appropriate educational services to the student. Parents/Guardian Name : Student Name: Address: Records to be disclosed: [ ] Official academic transcripts [ ] Individual Education Plan (IEP)(if applicable) [ ] 504 Plan (if applicable) Is the above named student currently expelled from school? YES NO Records to be disclosed by: School: Fax #: Address: PARENTS: Please indicate your response to this request by checking the box, which reflects your decision, and then sign the document in the space provided. A copy of the records to be released will be provided to you upon request. Thank you. [ ] I CONSENT to the disclosure of the information as described above within one year of date below. [ ] I DO NOT CONSENT to the disclosure of the information as described above. Parent/Guardian Signature: Date: Parent/Guardian Printed Name:

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