Global Academy Online Learning New Student Registration Information

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1 Global Academy Online Learning New Student Registration Information Dear Parents and Students, Welcome to the Global Academy! You are enrolling in a program that will allow flexibility and self-paced learning, but will also require motivation and self-discipline. The virtual classroom experience is unique and truly works as a benefit to some students. With the right supports and tools in place, online learning can lead to great success. In order to complete the registration process, please carefully read the information below: All portions of this registration packet must be completed and returned to Global Academy before student registration can take place. All of the forms can be filled out online and ed back to the Global Academy. Documentation items, such as birth certifications, driver s licenses, etc. can either be dropped off in person to the Global Academy Office or can be scanned and ed to Global Academy. Once your registration paperwork is complete, you will receive a phone call to finalize the registration process, which includes selecting courses. At the end of the registration process, you will receive an confirming enrollment in the classes that you have selected. This will provide course log-in instructions, as well as other important information. *State Testing Information - All full time Global Academy students are required to take District and State mandated test. Test dates cannot be changed. Students (9 th -12 th ) taking or completing the following courses are required to take the End of Course (EOC) state test in: English 1B, English 2B, English 3B Algebra 1B, Algebra IIB, Geometry B, 9 th grade student will also take the AIM Science and Stanford 10 test. s TBA. Students (7 th 8 th ) are required to take End of Course (EOC state tests in: Language Art 7 th and 8 th Math 7 th and 8th The end of course tests will be given during the following testing window. Specific date will be announced soon. Fall 2016 EOC Test Window Spring 2017 Test Window Summer EOC Computer-based Testing (CBT) October 24 - December 2 (writing must be completed by November 18) March 27 - May 4 (Writing must be completed by April 21) TBD Paper-based Testing (PBT) N/A March 27 April 7 (Writing must be completed by 3/28/17) TBD If you have completed or are currently enrolled in an online Math or English course during 1 st or 2nd semester of , please plan to attend AzMERIT testing on the dates listed. To learn more about AzMERIT, please go to: If you need additional information about testing, please us at: If you have further questions about any of the State testing information, please feel free to contact our office. Sincerely, Beth Nickel Global Academy Coordinator Please save this registration information on your computer, fill out the registration, attach it to an , and send to:

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3 Please save this registration information on your computer, fill out the registration, attach it to an , and send to: Thank you Gilbert Public Schools Student Enrollment Form Legal Name: Last Suffix (Jr./Sr./I/II) First Middle Female Male Nickname (if any) Former Name (if any) Grade Residential Address Number/Street Apt City State Zip Contact 2 Contact 1 Student Information Home Phone Birth: MM/DD/YY Birth Place: City/State/Country Entered US Alternate Address/Student Mailing Other Number/Street City State Zip Has the Student Previously Attended a GPS School? No Yes Prior School: Name District City State Country Student Address: In Accordance With Federal Mandates, the Following 2 Questions Must Be Answered: Ethnicity (Check only one) No, Not Hispanic/Latino Yes, Hispanic/Latino Race (Check all that apply) American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Emergency Contact Priority 1 2 Resides w/student Has Custody Send Mailings Send Report Cards Legal Name: Last Suffix First Middle Marital Status Married Div Sep Single Primary Phone: Secondary Phone: Additional Phone: Home Work Cell Pgr Home Work Cell Pgr Home Work Cell Pgr Mailing Address (if different from student) Employer Name/Occupation: Primary Address: Secondary Address: Emergency Contact Priority 1 2 Resides w/student Has Custody Send Mailings Send Report Cards Legal Name: Last Suffix First Middle Marital Status Married Div Sep Single Primary Phone: Secondary Phone: Additional Phone: Home Work Cell Pgr Home Work Cell Pgr Home Work Cell Pgr Mailing Address (if different from student) Employer Name/Occupation: Primary Address: Secondary Address:

4 Emergency Contact Priority 3 Legal Name: Last Suffix First Middle Relationship to Student Contact 3 Parent Relative Primary Phone: Secondary Phone: Additional Phone: Guardian Friend Home Work Cell Pgr Home Work Cell Pgr Home Work Cell Pgr Mailing Address (if different from student) Employer Name/Occupation: Primary Address: Secondary Address: Has the student been identified for any of the following Special Programs? Student s Academic History Special Education No Yes Category Placement 504 Student No Yes Speech Therapy No Yes English Language Learner (ELL) No Yes Reading Program No Yes Gifted (ALP) No Yes Math Program No Yes Has the student ever received a long term suspension or been expelled from school? No Yes If Yes, Administrator must approve enrollment: School: Grade: When: Retained? No Yes Is the student a child of Military Service Personnel? No Yes Is the student a recent immigrant? (In US less than 3 years) No Yes Does the student have refugee status? If Yes, please provide your documenta on with this form (I.E. I 94 card) Country of Origin: What is the language that the student first acquired? English Spanish Other: Languages What is the primary language used in the home? English Spanish Other: (regardless of the language spoken by the student) Please complete the State required Home Language Survey in your enrollment packet **Responses to these questions will determine whether the student is assessed for English Language Proficiency I HEREBY AFFIRM THAT THIS INFORMATION IS CORRECT. I also understand that legal updating of the information on this form is my responsibility and includes submitting proper documentation within 30 days. Signature Typing your name above acts as your signature and Indicates you have provided accurate information. Relationship to Student Student Signature (if 18 or older) Typing your name above acts as your signature and indicates that you have provided accurate information Please save this registration information on your computer, fill out the registration, attach it to an , and send to: Thank you

5 Gilbert Public Schools Global Academy Records Office Fax Cover Sheet 500 S. McQueen, Gilbert, AZ Office: (480) Fax: (480) Website: Request for Student Records: (This document is important! Complete all information below. At a minimum, we must have a phone number of the school the student last attended.) In accordance with the Family Educational Rights and Privacy Act and Arizona State Law, I hereby authorize the release of student information for: Student s Name Grade Birth Previous School Name Address Phone Number Fax Number City State Zip Code PLEASE FAX UNOFFICIAL RECORDS AND MAIL OFFICIAL TRANSCRIPT DO NOT SEND CUM FOLDERS Please include the following information: Official Transcript Please mail Unofficial Transcript Please fax ASAP Jr. High Transcript/Proof of Promotion Withdrawal Slip and Transfer Grades IEP/Psychological Records AIMS/Achievement Test Scores (9 12) Immunization Records Discipline and Attendance Records Legal Guardianship or Custody Paperwork Birth Certificate SELP Test Records Parent/Guardian Signature OR **Typing your name above acts as your signature and releases the above selected student records to Gilbert Global Academy Global Academy Records Official Signature Office Use Only: 1st Fax : 2nd Fax : 3rd Fax :

6 State of Arizona Department of Education Office of English Language Acquisition Services Primary Home Language Other Than English (PHLOTE) Home Language Survey (Effective April 4, 2011) These questions are in compliance with Arizona Administrative Code, R (B)(1), (2)(a c). Responses to these statements will be used to determine whether the student will be assessed for English Language Proficiency. 1. What is the primary language used in the home regardless of the language spoken by the student? 2. What is the language most often spoken by the student? 3. What is the language that the student first acquired? Student Name of Birth Parent/Guardian Signature Student ID SAIS ID **Typing your name above acts as your signature District or Charter School Please provide a copy of the Home Language Survey to the ELL Coordinator/Main Contact on site. In SAIS, please indicate the student s home or primary language West Jefferson Street, Phoenix, Arizona

7 Gilbert Public Schools Medical Emergency Card Student s Last Name First of Birth Grade ID# Address City Zip Home Phone # Father/Guardian Name Cell Phone # Company Name Business Phone Mother/Guardian Name Cell Phone # Company Name Business Phone Student Resides with: Mother and Father Mother Father Joint Custody Other IN CASE OF EMERGENCY: Names of persons who could assume temporary responsibility Local Friend or Relative Phone Local Friend or Relative Phone Local Doctor Phone Local Hospital Emergency Health Information 1. Does this student have any health problems? No Yes If Yes, please explain: 2. Asthma Bee Stings/Severe Allergy Seizures Diabetic Other: 3. Daily Medications: I, the undersigned parent/guardian, hereby give my consent for the above named child to be released to the friend/relative I have designated and/or to the nearest hospital in case of emergency Signature of Parent/Guardian **Typing your name above acts as your signature **Please note that treatment in the emergency room will require your presence

8 Office Use Only AzMERIT Testing Information : Signed: Student Name: AzMERIT testing is a mandatory requirement for 7-12 grade students. All full-time enrolled Global Academy students MUST attend AzMERIT state testing. *State Testing Information - All full time Global Academy students are required to take District and State mandated test. Test dates cannot be changed. Students (9 th -12 th ) taking or completing the following courses are required to take the End of Course (EOC) state test in: English 1B, English 2B, English 3B Algebra 1B, Algebra IIB, Geometry B, 9 th grade student will also take the AIM Science and Stanford 10 test. s TBA. Students (7 th 8 th ) are required to take End of Course (EOC state tests in: Language Art 7 th and 8 th Math 7 th and 8th The end of course tests will be given during the following testing window. Specific dates will be announced soon. Fall 2015 EOC Spring 2016 Summer 2016 EOC Computer-based Testing (CBT) October 26 - December 4 (writing must be completed by November 13) March 28 - May 6 (Writing must be completed by April 15) TBD Paper-based Testing (PBT) October 26 - November 6 March 28 - April 8 TBD If you have completed or are currently enrolled in an online Math or English course during 1 st or 2nd semester of , please plan to attend AzMERIT testing on the dates listed. To learn more about AzMERIT, please go to: If you need additional information about testing, please us at: By signing below you acknowledge the state of Arizona and Gilbert Public Schools requirement for high school graduation. You also understand your student is required to attend on these dates. Parent Signature: Student Signature: Testing Center Location: The testing center is located at 500 South McQueen Road, Gilbert, AZ We are on Mesquite High School s campus in the south parking lot. The test will be administered at 9:00am each day. Bring the following item with you on the date of your testing: Photo ID Please save this registration information on your computer, fill out the registration, attach it to an , and send to: Thank you

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11 Office Use Only : Signed: Student Name: AzMERIT testing is a mandatory requirement for 7-12 grade students. All full-time enrolled Global Academy students MUST attend AzMERIT state testing. *State Testing Information - All full time Global Academy students are required to take District and State mandated test. Test dates cannot be changed. Students (9 th -12 th ) taking or completing the following courses are required to take the End of Course (EOC) state test in: English 1B, English 2B, English 3B, Algebra 1B, Algebra IIB, Geometry B, 9 th grade student will also take the AIM Science s TBA. Students (7 th 8 th ) are required to take End of Course (EOC) state tests in: English 7 th and 8 th and Math 7 th and 8th The end of course tests will be given during the following testing window. Specific date will be announced soon. Fall 2016 EOC Spring 2017 Summer EOC Computer-based Testing (CBT) October 24 - December 2 (writing must be completed by November 18) March 27 - May 4 (Writing must be completed by April 21) TBD Paper-based Testing (PBT) N/A March 27 April 7 (Writing must be completed by 3/28/17) TBD If you have completed or are currently enrolled in an online Math or English course during 1 st or 2nd semester of , please plan to attend AzMERIT testing on the dates listed. To learn more about AzMERIT, please go to: If you need additional information about testing, please us at: By signing below you acknowledge the state of Arizona and Gilbert Public Schools requirement for high school graduation. You also understand your student is required to attend on these dates. Parent Signature: Student Signature: Testing Center Location: The testing center is located at 500 South McQueen Road, Gilbert, AZ We are on Mesquite High School s campus in the south parking lot. The test will be administered at 9:00am each day. Bring the following item with you on the date of your testing: Photo ID. Please save this registration information on your computer, fill out the registration, attach it to an , and send to: Thank you

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