AVID APPLICATION CHECKLIST Kahuku High and Intermediate School Year

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1 Name: Current Grade Level: AVID APPLICATION CHECKLIST Kahuku High and Intermediate School Year The following checklist must be completed before being considered for the Kahuku High and Intermediate AVID Program. Please make sure EVERY form is filled out COMPLETELY. 1. AVID APPLICATION Must be completed and signed by both student and parent. 2. AVID RESPONSE QUESTIONS Must be answered in complete sentences and in your own handwriting. 3. TERMS OF AGREEMENT Must be signed by both student and parent. 4. TEACHER RECOMMENDATION FORM Must be completed by one of your current teachers and returned in a sealed envelope w/ teacher signature on the back. 5. CURRENT REPORT CARD Submit a copy of your most current report card, including teacher comments if applicable. DUE DATE Friday 3/4/16 Items #1-5 must be completed and turned in to the Kahuku High and Intermediate Front Office or received by mail (see school address below) by the 3/4/16 Due Date. After the AVID staff reviews items #1-5, ELIGIBLE students will be notified by or called for an interview. Students who submit incomplete applications will NOT be considered. Please be sure your contact information on the application is current. If you have not been contacted within four weeks after the due date, you may call the AVID Selection Committee to inquire. Contact the Kahuku High & Intermediate AVID Selection # Mailing Address: Kahuku High & Intermediate School Attention: AVID Selection Committee Kamehameha Hwy. Kahuku, HI INTERVIEW Students who are eligible will be interviewed by a member of the Kahuku High & Intermediate Site Team. After the interview you will be notified by phone or if you are accepted into the AVID Program. * Please remove and keep this first page for your information.

2 Is AVID For You? What is AVID? AVID stands for Advancement Via Individual Determination and is a regularly scheduled elective class that prepares students in the middle, with academic potential, for success in advanced high school classes and in college. What are AVID student expectations? Maintain a C grade or better in ALL classes Commit at least 2 hours to studying and doing homework nightly Maintain an organized AVID Binder Use the Cornell Note-taking method in ALL classes Participate in weekly AVID tutorials Demonstrate appropriate behaviors in school, home, and community Take rigorous classes such as Advanced, Honors and AP Take the EXPLORE, PSAT, SAT, and ACT exams Complete Learning Logs and Grade Checks are required Be a well-rounded student (get involved in extra curricular and community activities) Apply to several four-year colleges What are AVID parent expectations? AVID parents are expected to encourage their students to achieve academically, to maintain regular contact with the AVID teacher and coordinator and to become involved in the activities of the AVID program. What happens in the AVID program? The AVID elective program is three-pronged: 1) Students receive academic instruction on writing, note-taking, studying, test-taking, and organizing. 2) Students receive academic support from college tutors through collaborative tutorial groups and peer counseling. 3) Students are motivated to pursue academic excellence through goal setting, rigorous classes, cultural and college field trips, classroom guest speakers, and AVID team building. How do you recognize an AVID student? The AVID student carries a 2, 3 ring binder, takes notes in all classes, is prepared for class, is a positive role model for others, and is on track for college. What are AVID results? Over 95% of students who have graduated from AVID programs have enrolled in four-year colleges and universities. Two years later, 89% are still enrolled.

3 Kahuku High & Intermediate School AVID APPLICATION Check ONLY if completed: 1. AVID Application 2. AVID Response Questions 3. Terms of Agreement 4. Teacher Recommendation Form 5. Current Report Card FOR AVID ADMINISTRATOR/OFFICE USE ONLY PRIORITY X INTERVIEW Yes No Date: Time: Place: Application RECEIVED (date and initials) I am interested in participating in the AVID college preparatory program at Kahuku High & Intermediate for the school year. STUDENT INFORMATION Current grade level 6 th 7 th 8 th 9 th Last Name: First Name: Other Name(s) Used, if any: Mailing Address: Phone #: Date of Birth: Age: male female Ethnicity: Primary Language Spoken at home: Cumulative GPA: Class Rank: Do you have a desire to go to college? Do you have a good attendance record? Do you receive free or reduced lunch? Please describe the core classes you have selected on your registration card for next school year: Check the appropriate box. Core Class Title General Math English Science Social Studies Advanced/ Honors GT AP Other

4 PARENT/GUARDIAN INFORMATION Single Parent Household YES NO # in Household Father/Guardian Phone no. Father s Highest Level of Education Completed: Some HS HS Graduate Some College Associate Degree/Trade School Bachelor s Degree Graduate/Professional Degree Mother/Guardian Phone no. Mother s Highest Level of Education Completed: Some HS HS Graduate Some College Associate Degree/Trade School Bachelor s Degree Graduate/Professional Degree What do you see as your child s greatest strengths? In what areas do you see your child needing support? How do you see your child benefiting from the AVID program? How do you see yourself supporting your child in the AVID program? CERTIFICATION/RELEASE OF RECORDS I hereby certify that the information is complete and correct to the best of my knowledge. I also understand that any misrepresentation or false information may result in revocation or denial of my admission and subject me to any disciplinary measures in accordance with KHIS policies. Student Signature: Date: Parent Signature: Date: Please submit completed application packet to the Kahuku High & Intermediate Front Office and be sure that it is date stamped and initialed when received.

5 Name: Date: Current Grade Level: AVID RESPONSE QUESTIONS Please answer the following questions in complete sentences and in your own handwriting. 1. What do you already know about AVID? 2. What do you think will be expected of you if you join AVID? 3. What are some specific things that you want to get out of the AVID class? 4. What have you done in and/or outside of school that has made you most proud? (include awards, recognition, community service, etc.) 5. Give an example of a time you showed great commitment.

6 6. What is individual determination, and how do you demonstrate determination? 7. Have you decided on a career goal? If so, what is it? If not, what might be some careers that match your talents and your interests? 8. List two academic goals you set for yourself this school year. 9. Did you meet the goals in question #8? Why or why not? 10. What skills and/or characteristics will you bring to the AVID class to make it successful? (The AVID elective class is not a program that just gives to students. It is only as successful as the AVID students make it.)

7 Name: Current Grade Level: TERMS of AGREEMENT for ENROLLMENT in AVID Please read and sign the Terms of Agreement for enrollment in AVID and submit with your application. I agree to enroll in the AVID class for the entire academic year. I agree to take notes in my classes as required in AVID. I agree to keep my binder organized as required by AVID. I agree to maintain good attendance and be punctual for all my classes. I agree to participate fully in tutorials as required by AVID. I agree to participate in field trips, college visitation and other AVID activities. I agree to keep my parents fully informed of AVID program activities. I agree to complete all my assignments in all classes including AVID. I agree to ask for help, talk to my AVID teacher or counselor if necessary. I agree to keep a positive attitude and be enthusiastic about preparing for college. Student Signature Parent/Guardian Signature Date

8 Kahuku High & Intermediate Advancement Via Individual Determination Program T e a c h e r R e c o m m e n d a t i o n F o r m Applicant s Name current grade level Teacher s Name Subject What AVID is for students with college potential for students with middle to high test scores for students who are already motivated to succeed What AVID is NOT an at-risk program for unmotivated students a quick fix for student problems a study hall class easy Please answer the following questions by checking the appropriate column. Yes Sometimes No 1. Does this student have average to above average skills in general? 2. Does this student appear to need assistance with reading strategies to improve comprehension? 3. Do you believe this student is working up to his/her potential? 4. Does this student display good classroom work habits? 5. Does this student abide by school and classroom rules and demonstrate courtesy to others? 6. Does this student have an acceptable attendance record? 7. Does this student seem to have college potential, if given support? 8. Does this student produce quality homework and classwork? 9. Do you feel this student would be successful in honors and AP courses if given appropriate support? Please check the appropriate box below. YES, I recommend this student for placement in the Kahuku AVID Program. NO, I do not recommend this student for AVID. Briefly explain your recommendation. Please comment on the student s level of motivation and any special circumstances that you may know of that the selection committee should be aware (i.e. low income, first to attend college, single-parent, etc.) Teacher Signature Date Please return this form in a sealed envelope to the applicant. Include the applicant s name and current grade level on the front and the teacher s signature on the back of the envelope. Students will not be considered for AVID without a teacher recommendation.