Placentia-Yorba Linda Unified School District 1301 E. Orangethorpe Ave., Placentia, CA (714)

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1 1 INTERNATIONAL STUDENTS Welcome to the. This information is for international students who are seeking a one year public high school experience for Grades Esperanza High School ( Valencia High School ( and Yorba Linda High School ( have been authorized by the U.S. Government to issue I-20 forms. Please go to the high school websites to learn more about the many programs offered at each of these comprehensive high schools. You will need to fill out all the information listed on the application, gather all the needed documents, and contact the Student Services Department of the Placentia-Yorba Linda Unified School District for an appointment (714) The school year will begin on Monday, August 29, 2016, and end on Thursday June 15, You must be able to begin school on August 29th. The acceptance and enrollment process may take some time, so we urge you to start the enrollment process now. Getting the I-20 and then applying for the F-1 Student Visa at the Embassy can take a number of weeks or months. All international students must have a legal guardian with whom they reside. The guardian is usually the one who will work with the Student Services Department to complete the application process. The guardian may complete all the paper work, but the parents must sign the Guardianship Authorization Form and have it legally notarized. In order to maintain enrollment during the school year, the student must be living with an adult at all times, must maintain a minimum G.P.A. of 2.0, and must follow all school policies and procedures, including attendance and behavior expectations. The following websites may be helpful as you proceed: U.S. Immigration and Customs Enforcement: For the nearest U.S. Embassy: U.S. Department of State:

2 2 I-20 INSTRUCTIONS AND AGREEMENT New School Year Begins: August 29, 2016 Students who wish to attend a public high school in the Placentia-Yorba Linda Unified School District (PYLUSD) on an F-1 Student Visa will be required to receive an I-20 application form. In order to receive the I-20 form, students must fill out the application so that the District can determine if the student is able to fulfill the requirements for acceptance. The fee for attendance for one school year is $14,870. Once the school year begins, no refunds will be issued. Please follow the steps below to apply for a new I-20 or F-1 Transfer: STEP 1: Submit all of the following for consideration of acceptance: High School Transcript (must be evaluated by American Education Research Corp at Letter of Recommendation from current School Administrator (must have school stamp) International Student Application for Admission (Parent, Student, and Legal Guardian must sign application) For transfer student already in the country: Passport COPY (showing F1 Visa stamp, if student is transferring) Non-refundable application fee of $250 cashier s check (to be applied toward attendance fee) payable to: APPLICATIONS MAY BE SUBMITTED: In person to Student Services, Fax (714) Scanned and ed to the Student Services Department at STEP 2: Skype Interview with Student Services representative If approved, Student Services will issue a Letter of Acceptance STEP 3: Submit copy of Letter of Acceptance from PYLUSD Remaining payment of $14,620 shall be wired to PYLUSD. Business Services will provide support. Please call (714) for wiring instructions. STEP 4: District will issue I-20

3 3 STEP 5: For accepted students: Guardian is responsible for sending I-20 to parents. (An I-20 is the application to apply for the F-1 Student Visa at the American Embassy in the student s home country.) Pay the I-901 fee at before going to the Embassy. After F-1 Student Visa is received, please fax or deliver to Student Services immediately. Students may enter the U.S. 30 days prior to starting school with an I-20 to the U.S. STEP 6: After F-1 is received, all students must submit the following: F-1 Visa and Travel s fax or deliver F1 immediately; notify Student Services at PYLUSD of U.S. arrival (no more than 30 days prior to the start of school. Immunizations (COPY) it is school policy that all required immunizations are met prior to registration Guardianship Authorization Form completed and notarized by parent, (law offices worldwide are able to do this). It is a requirement that all students must live with an adult at all times. Completed Math and Language Assessment taken at District Office prior to enrolling at school site. TRANSFER STUDENTS TRANSFER students will receive an updated I-20 after all fees and documents are submitted and the previous school completes the transfer process. Withdrawal, Refund, and Enrollment Polices Notice of Withdrawal must be done in writing All fees are refundable (except the $250 application fee) if student decides not to use the I-20 for entry Students must meet with the Student Services Administrator/designee before starting school, maintain minimum of 2.0 G.P.A., and follow all school rules. CONCILIATION AGREEMENT: The parties agree to waive their right to file a lawsuit against one another in any civil court for any controversy or claim arising from this Agreement, except to enforce a legally binding arbitration decision. We have read and understand this document and agree to support this student regarding academic and behavior requirements. Parent Signature Guardian Signature

4 4 INTERNATIONAL STUDENT APPLICATION Receipt of this application by the does not automatically imply acceptance. Admission form must be completed in FULL to be processed. Mail or fax to: 1301 E. Orangethorpe Ave., Placentia, CA Attention: Student Services Administrator Fax Number: (714) Telephone Number: (714) Grade Applying for: NEW I-20 I-20 Transfer Application received: Determined by transcripts and verified by AERC PERSONAL INFORMATION: Student s Full Legal Name: Last Name First Name Middle Name of Birth: Age: Student s English Name: Student s Place of Birth (Country): Student s Passport Number: Ethnic Identity: African American Chinese Filipino Hispanic Japanese Korean Taiwanese White/Caucasian Other Expiration : Language(s) student speaks: PREVIOUS SCHOOL INFORMATION: Name of Previous School: Phone Number: Fax Number: School Address (number, street, city, state, zip, country):

5 5 PERSONAL STATEMENT 2016/2017 Student s Personal Statement Tell us about a personal quality, talent, accomplishment, contribution or experience that is important to you. What about this quality or accomplishment makes you proud and how does it relate to the person you are? Please list any academic or educational awards and honors you have received. Please use additional paper if necessary. I certify that this personal statement was written by me without assistance from another individual. Student s Name: Student s Signature: : Notary Seal Submit all required documents to:, Student Services Dept.

6 6 WE UNDERSTAND AND AGREE TO THE FOLLOWING CONDITIONS OF ENROLLMENT: A student may be withdrawn from the if there is: Lack of regular attendance Continued school failure after appropriate counseling Failure to comply with additional requirements for the student Continued actions contrary to the accepted practice of the school Failure to meet financial obligations Possession of firearms or weapons Theft, vandalism, possession or use of alcoholic beverages or narcotics on or off campus or at a school function Seriously endangering fellow students or the reputation of the school on or off campus Any action, by the student and/or parent, considered serious enough as determined by the Administration. THE INFORMATION ON THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF OUR KNOWLEDGE. UPON ACCEPTANCE OF OUR STUDENT, WE AGREE TO ABIDE BY ALL RULES AND REGULATIONS OF THE SCHOOL AND AUTHORIZE THE SCHOOL TO ADMINISTER SUCH DISCIPLINARY MEASURES AS MAY BE DEEMED NECESSARY AND PROPER BY THE ADMINISTRATION. Parent Signature Guardian Signature Student Signature All students must meet with the Student Service Administrator/designee within 48 hours of arriving in the United States. Please call (714) to set up an appointment. Once this meeting has taken place, the student must also register at the designated school and fill out all authorized registration materials in order to enroll in the school.

7 CAREGIVER S AUTHORIZATION AFFIDAVIT Use of this affidavit is authorized by Part 1.5 (commencing with Section 6550) of Division 11 of the California Family Code. Instructions: Completion of items 1 4 and the signing of the affidavit is sufficient to authorize enrollment of a minor in school and authorize school related medical care. Completion of items 5 8 is additionally required to authorize any other medical care. Print clearly. The minor named below lives in my home and I am 18 years of age or older. 1. Name of minor:. 2. Minor s birth date:. 3. My name (adult giving authorization):. 4. My home address:. 5. [ ] I am a grandparent, aunt, uncle, or other qualified relative of the minor (see back of this form for a definition of qualified relative ). 6. Check one or both (for example, if one parent was advised and the other cannot be located): [ ] I have advised the parent(s) or other person(s) having legal custody of the minor of my intent to authorize medical care, and have received no objection. [ ] I am unable to contact the parent(s) or other person(s) having legal custody of the minor at this time, to notify them of my intended authorization. 7. My date of birth:. 8. My California driver s license or identification card number:. 7 Warning: Do not sign this form if any of the statements above are incorrect, or you will be committing a crime punishable by a fine, imprisonment, or both. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. d: Signed: Notices:

8 8 State of California Immunizations A copy of a doctor s proof of the following immunization dates is required before meeting with the Student Services Administrator/designee. Listed below are the California school immunization requirements. All of these immunizations are available worldwide and are required before entering a classroom. Vaccines Polio DTaP (Diphtheria, Tetanus, Pertussis (whooping cough) Tdap (Tetanus, reduced Diphtheria, Pertussis (whooping cough) admission for Grades 7-12 MMR (Measles, Mumps, Rubella) Hepatitis B Varicella (chickenpox)

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