Interview Contact Information Please complete the following to be used to contact you to schedule your child s interview.
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1 Cabarrus\Kannapolis Early College High School Interview Contact Information Please complete the following to be used to contact you to schedule your child s interview. Student Name Student Number Middle School Parent\Guardian Name Phone Numbers to Call or Address Language spoken at home: School Use Only (Please do not write in the space below) 1 st Contact 2 nd Contact 3 rd Contact Date Outcome Interview Date Date Time Interpreter Needed Yes No 1
2 Cabarrus\Kannapolis Early College High School Student Application Packet for Student Name: Cabarrus County Kannapolis City The goal of the Cabarrus-Kannapolis Early College High School (C-KECHS) admissions process is to select and admit a diverse group of academically capable students who have a genuine interest in pursuing this unique and rigorous program focused on Associate in Arts and Associate in Science degrees. Applications and accompanying documentation of prospective applicants will be reviewed by the Admissions Team. All students will be evaluated based on specific admissions elements outlined and approved by the local school districts, the Department of Public Instruction and the New Schools Project of North Carolina. Elements considered for admissions include: Academic Potential to Succeed: Test Scores, Grades, Standardized Tests, Aptitude Tests or other inventories References: One from a current teacher or guidance counselor who can evaluate your potential Application: Well-written, thoughtful responses provided by the student and parents/guardians Interview: Team will interview those selected from initial application. Diversity: The class selected will reflect the diversity of Cabarrus County and Kannapolis City School systems, including academic, ethnic, geographic and socio-economic diversity. Characteristics: Intellectual curiosity, self-motivated, mature, self-disciplined, interested in science, need for non-traditional high school setting. Due Date: January 30, 2015 by the end of school. Late applications will not be accepted. Turn in Completed Application to your 8 th grade guidance counselor. All applications will be evaluated. The admissions team will consider diversity. Applicants will be informed of interview schedule between February 5 th 21 st. Class members will be selected and notified after interviews. An Educational Partnership 2
3 Helpful tips and Instruction for Completing the Application We re so excited that you are interested in Cabarrus/Kannapolis Early College! Completion of the application is the first step to participating in this exciting, new high school experience. The following checklist will help guide you through this process. Read the entire application before completing any information. Complete the application in either blue or black ink. o One recommendation from a current teacher or guidance counselor is needed as part of your application packet. This form must be returned to you in a sealed envelope with the signature of the person completing the recommendation written across the seal. Write a draft of your Section C Student Written Reponses on a separate sheet of paper and proofread it carefully before writing your final copy on the application. Ask your Parent or Legal Guardian to complete Section B Parent Information. It is okay if they want to write a draft and then write their final copy on the application. Remember to sign your part of the application. Make certain that your Parent or Legal Guardian signs in the parent section of the application. When all pages of your application are completed, and you have received the recommendation form back, return your complete application packet to your School Counselor no later than the end of school on January 31, Your counselor will then complete the back page of the application. Late or Incomplete applications will not be reviewed for admission to Cabarrus/Kannapolis Early College. Please do not wait until the last minute to complete your application. Once your counselor has received your application, (s)he will submit your application packet to Vance Fishback, Principal of the Early College. After all applications are received and reviewed, eligible students will be notified of the time and date of parent and student interviews. Students and parents\guardians must interview to be eligible for Early College. After interviews, all applicants will receive a letter stating your application status and instructions if you have been accepted. If you have any questions, please feel free to contact the counselor or principal at your school. Cabarrus-Kannapolis Early College 3
4 Part A: Personal Information High School Students Application Handwritten by Student Student Name: Last First Middle Gender: M F Date of Birth: Student Id #: Home Phone: Street Address: Mail Address (if different): City/State/Zip: County of Residence: Current School: Home High School: List All Schools attended and Grade Level at Each (K-8) (may use back of sheet): Student Ethnicity Data: African American American Indian/Alaska Native Hispanic Asian/Pacific Islander White (not Hispanic) Multi-racial Student s 1 st Language: Country of Birth: Parent s Language: Language Spoken at Home: Number of People Living in Home: Check: Father Mother Brothers Sisters Others living in Home: Siblings that attend ECHS: Family Income: Indicate your family s total yearly income level by checking the appropriate box Less than $20,200 $34,301- $41,350 $55,501 - $62,500 $20,201 - $27,200 $41,351 - $48,400 $62,501 - $69,500 $27,201 - $34,300 $48,401 - $55,500 more than $69,501 If you are also applying to Concord s IB or Central Cabarrus s STEM Academy, you must list the order of all your preferences in case you are accepted in multiple programs. Order Schools/Programs 4
5 Part B: Parent Information To be completed in ink by parent or guardian Student Name: Father or Male Guardian: Name: Street Address: City: State: Zip: Home Phone: Cell Phone: Address Marital Status: M S Occupation: Place of Employment: Work Phone: Mother or Female Guardian: Name: Street Address: City: State: Zip: Home Phone: Cell Phone: Address Marital Status: M S Occupation: Place of Employment: Work Phone: Parent/Guardian Education Level: Check the highest level completed by each. Father/ Mother/ Guardian Guardian School Name Less than High School Diploma High School Diploma Some College 2 year Associates Degree (Completed) 4 year Bachelors degree (Completed) Graduate Degree If you received a degree, please list the type of degree below: Mother: Father: 5
6 Part B: Parent Information continued. Evaluate your child on following characteristics by checking the appropriate box. Often Occasionally Rarely Cannot Evaluate Accepts Academic Challenge Accepts Personal Responsibility Accepts Responsibility for Learning Communicates ideas effectively Completes Tasks Has interests beyond the classroom Makes decisions independent of peers Shows respect for authority Works independently Works well with peers Social /Emotional Characteristics: Please evaluate your child on the following by checking the appropriate box. Excellent Average Below Cannot Evaluate Average Enthusiasm Integrity/Honesty Judgment/Common Sense Kindness Leadership Maturity Motivation Patience with Others Social Skills Parent Please answer the following questions: 1. Describe a specific positive or negative experience you had as a student and how it has influenced your dreams for your child. 6
7 Part B: Parent Information continued. 2. How much homework does your child have a night at his/her current school? Since C-KECHS is a school where students are challenged academically through honors high school courses and college courses, how do you think it will change in the amount of homework they do? How will you support them? 3. If accepted to C-KECHS, your child will not be attending the same school as their current friends. How will this affect your child? How will you support your child with this change? 4. Tell about a time that your child made you proud. Sign below if you AGREE to the following: 1. My child is able to complete the College Preparatory Course of Study at an Honors Level. 2. He/She will maintain high academic and behavior standards. 3. I understand that my child must devote a minimum of (2) hours each evening to homework and studying and that those hours will increase as my college coursework increases. 4. I understand that there are NO athletic, band, or ROTC programs at ECHS and students will not be allowed to participate at another Cabarrus County high school. Students are encouraged to participate in clubs and activities at ECHS and Rowan Cabarrus Community College. 5. I understand that ECHS will operate on a school calendar that is different from Cabarrus County and Kannapolis City school systems. 6. I understand that he/she will be afforded an opportunity to complete the Early College and Rowan- Cabarrus Community College requirements, earning both a high school diploma and a two-year associate s degree or transferable credit. 7. I understand that he/she must comply with Cabarrus Kannapolis Early College and Rowan- Cabarrus Community College regulations at all times. 8. I understand that if my child does not make adequate academic progress or has poor behavior, he/she will be removed from ECHS and sent to their traditional school. 9. I understand that requests for a transfer to another high school within Cabarrus County or Kannapolis City Schools will only be accepted at the end of each school year. I have read the above statements and agree to follow them as well as all rules and policies of the Cabarrus/Kannapolis Early College High School. Parent/Guardian Signatures: 7 Date: Date:
8 Part C: Student Written Response Form (To be handwritten in ink by student) Student Name: We are interested in learning more about you. The questions below are an important part of the selection process. In your own handwriting and words, respond to these questions. You must answer all of the questions. 1. Describe the last three years of your life. Include positive and negative experiences. 2. What makes you unique from everyone else? 3. What are your career goals? How will you achieve them? 4. Describe a situation when you worked as a part of a team. Describe your role on the team. 5. Describe a time when you took a big risk. Tell why it was risky and what you learned about yourself. 6. What is your ideal high school experience? 8
9 7. How do you use technology for school at your current school? 8. C-KECHS is a school where students are challenged academically through honors high school courses and college courses. We are also in a small school setting where relationships are important. Explain the qualities that you have that will make you successful at this school. 9. Check Characteristics that BEST describe you: Creative Team player Good with time management Shy Misunderstood Disconnected from School Friendly Independent Thinker Need Attention Flexible Strong Leader Loner Needs Help with Organizing Readily Accepts Authority Able to Walk Away from Conflict Sign below if you AGREE to the following: 1. I am able to complete the College Preparatory Course of Study at an Honors Level. 2. I will maintain high academic and behavior standards. 3. I understand that I must devote a minimum of (2) hours each evening to homework and studying and that those hours will increase as my college coursework increases. 4. I understand that there are NO athletic, band, or ROTC programs at ECHS and that students will not be allowed to participate at another Cabarrus County high school. Students are encouraged to participate in clubs and activities at ECHS and Rowan Cabarrus Community College. 5. I understand that ECHS will operate on a calendar similar to Rowan-Cabarrus Community College, not the regular school system calendar. 6. I understand that I will be afforded an opportunity to complete the Early College and Rowan-Cabarrus Community College requirements, earning both a high school diploma and a two-year associate s degree or transferable credit. 7. I understand that I must comply with Cabarrus-/Kannapolis Early College and Rowan-Cabarrus Community College regulations at all times. 8. I understand that if I do not make adequate academic progress or have poor behavior, I will be removed from ECHS and sent to my traditional school. 9. I understand that requests for a transfer to another high school within Cabarrus County will only be accepted at the end of each school year. I have read the above statements and agree to abide by them as well as all rules and policies of the Cabarrus/Kannapolis Early College High School. Student Signature: Date: 9
10 Part D: Academic and Administrative Information (To be completed by school counselor only) Student Name: Student Number: Middle School: 1. Exceptional Children / Section 504 Information (Check all that apply) Not Identified ( No EC / Section 504 plans /ESL, services or modifications) Identified as EC Classification Area Specific Modifications EC Consultative Services only Section 504 Plan Accommodations ESL Accommodations ESL Consultative Services only 2. Please describe any special circumstances or any additional information you would like for us to have regarding this student applicant: I have verified with the ECAT chair/esl Coordinator that this information is correct to the best of my knowledge. Counselor Name (Print) Counselor Signature: Date: Please attach the following: For Homeschool or Private School Final report cards for 6 th and 7 th grades Mid-term 8 th grade report card Last two years of National Standardized Test Results Discipline Summary Attendance Summary 10
11 Student Applicant: Current School: To be completed by a current teacher or counselor How long have you known this applicant? How well do you know this applicant? Please evaluate the applicant on the following characteristics: ACADEMIC CHARACTERISTICS Often Occasionally Rarely Cannot Evaluate Accepts Academic Challenge Accepts Personal Responsibility Accepts Responsibility for Learning Communicates ideas effectively Completes Tasks Has interests beyond the classroom Makes decisions independent of peers Shows respect for authority Works independently Works well with peers Social/Emotional Characteristics Excellent Average Below Average Cannot Evaluate Enthusiasm Integrity/Honesty Judgment/Common Sense Kindness Leadership Maturity Motivation Patience with Others Social Skills Highly Recommend Recommend Recommend with reservation Cannot Recommend Name: (print) Signature: Date: 11
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