APPLICATION SUFFIELD REGIONAL AGRISCIENCE CENTER @ Suffield High School Animal SciencE Plant Science Natural Resources Agricultural Mechanics Application due no later than the second week in January
APPLICATION FOR ADMISSION SUFFIELD REGIONAL AGRISCIENCE CENTER @ SUFFIELD HIGH SCHOOL 1060 Sheldon Street, West Suffield, CT 06093 TELEPHONE: (860)668 3817 FAX: (860)668 8178 WEBSITE: http://shs.suffield.org The Suffield Regional Agriscience Center at Suffield High School welcomes all interested 8 th grade students to apply to this exciting and educational Connecticut Public School Choice program. The Suffield Regional Agriscience Center is one of nineteen state sponsored centers specializing in agricultural science education. It strives for the highest possible achievement level in a creative and flexible environment. It values each student s unique abilities, talents, interests, learning styles and backgrounds. The Suffield Regional Agriscience Center established in 1964, is an integral part of Suffield High School. Students schedule their agricultural science program courses in conjunction with their required high school courses leading to a high school diploma and agricultural science certificate. Students later seek further college education and/or direct job employment. The programs and policies of this Center are consistent with pertinent Federal and State laws and regulations on non discrimination regarding race, color, national origin, sex and disability. The following is a list of required information that must be completed by you to determine your acceptance. PART I - STUDENT INFORMATION is to be filled out by the student and his/her parent(s)/guardian(s). The signature of the parent(s)/guardian(s) is required in two places Parent approval to apply to the program and Release of Information. PART II - STUDENT ESSAY Student should write a paragraph explaining why he/she would like to be accepted into the Agriscience Program (include interests, hobbies and applicable experiences). PART III - TWO LETTERS OF RECOMMENDATION 1. From a teacher or guidance counselor in the school you are now attending. 2. From someone (other than parents/guardians) who knows of your interest in agricultural science and technology. PART IV - STUDENT RECORDS (To be completed by your present school) Transcript, most recent 8 th grade report card, discipline report, attendance report, CMT scores, special service records, (if applicable). When the application has been completed, please forward to the Suffield Regional Agriscience Center, 1060 Sheldon Street, West Suffield, CT 06093 (In most cases the student s present school will forward the application after a final review.) After the application has been received a personal interview with the student will be required. A committee reviews each candidate s application.
PART I STUDENT INFORMATION (To be filled out by the student applicant please print or type.) Applicant s Name (Last) (First) (Middle) Male Female Date of Birth Age Street Address Town State Zip Code Home Telephone Number email Address Name of Middle School presently attending Guidance Counselor s Name List the names and addresses of the TWO individuals from whom you will obtain letters of recommendation. Recommendation #1 Teacher or Guidance Counselor (Name) (Mailing Address) (Telephone Number) Recommendation #2 Individual that knows of your interest in agriculture (Name) (Mailing Address) (Telephone Number)
PART I STUDENT INFORMATION (Continued) (To be filled out by the Parents / Guardian of the applicant please print or type.) Father or Guardian Name email Address Home Telephone Cell Telephone Work Telephone Mother or Guardian Name email Address Home Telephone Cell Telephone Work Telephone Parent/Guardian Approval for Enrollment I (parent/guardian) agree to have my son/daughter,, considered for enrollment in the Suffield Agriscience Program at Suffield High School. I understand that because of the applied vocational nature of the program that field trips are taken. I realize that special clothing may be needed for outside and laboratory work if required by the instructor. I further understand that the student is required to acquire 150 hours of practical agricultural experience outside of school either in the form of a production project, research project, or work experience project. Signature of Parent / Guardian Date Release Information I (parent/guardian) hereby request the School Guidance Department to release the records of my son/daughter,, to the Suffield Regional Agriscience Center and Suffield High School to accompany the application for acceptance into the Agriscience program. Records are to include: transcript of 8 th grade courses completed with final grades and credits earned, standardized test scores (CMT), most recent 8 th grade Report Card with teacher comments, discipline records, attendance records, and special education records (IEP and others as needed), if so identified. Signature of Parent / Guardian Date
PART II STUDENT AGRICULTURAL INTEREST ESSAY (To be completed by the Student Applicant.) (Your Name) Please write a short essay on why you want to enroll in the Suffield Regional Agriscience Program at Suffield High School. (If necessary, you may attach additional paper and/or use a computer word processor.) Include agricultural interest areas (Animal Science, Plant Science, Natural Resources Management and/or Agricultural Mechanics. Other topics could include: your practical agricultural experience, your agricultural background (if any), your participation in agriculturally related clubs and organizations, your agricultural career objectives (if known), and any other information which might explain your interest in the Agriscience program. Signature of Student Applicant Date
PART III STUDENT RECOMMENDATION FORM #1 (To be completed by a Teacher or Guidance Counselor.) STUDENT APPLICANT NAME GRADE Your thoughtful consideration is requested in completing the personal data information listed below to ensure that the applicant is given our most careful consideration for admission to The Suffield Regional Agriscience Center at Suffield High School. NAME OF SENDING SCHOOL TOWN NAME OF TEACHER or GUIDANCE COUNSELOR 1. To what extent do YOU judge this individual s seriousness of intent in the pursuance of his / her expressed interest in the Agriscience program? 2. What characteristics do you identify as being this student s strong and weak points as you have observed in your school setting? 3. Please describe this student s general behavioral pattern within your school (i.e. attitude, disposition, cooperation with teachers, administrators, fellow students). Please be as specific as possible. 4. Please describe this student s attendance pattern. If attendance is poor, indicate whether it is due to personal, parental, school, or other issues. Signature of Teacher or Guidance Counselor Date
PART III STUDENT RECOMMENDATION FORM #2 (To be completed by an individual that knows of your interest in agriculture.) (Name of individual completing this recommendation.)(not a parent/guardian) of (Student s Name) (Town) is applying to the Suffield Regional Agriscience Center at Suffield High School. Please write a letter of recommendation for this student. (If necessary, you may attach additional paper and/or use a computer word processor.) Please forward your letter to the child s guidance counselor or return to: Suffield Regional Agriscience Center 1060 Sheldon Street West Suffield, CT 06093 TELEPHONE: (860)668-3817 FAX: (860)668 8178 Attention: Agriscience Director Signature of individual that knows of your interest in agriculture. Date
PART IV STUDENT RECORDS (It is requested that transcripts of grades, test results, discipline and attendance records and other pertinent information regarding the applicant be forwarded to the Suffield Regional Agriscience Center with this form.) Please check off included items: Transcripts Most Recent 8 th grade Report Card Discipline Record Attendance Record Standardized Testing Scores (Must include Connecticut Mastery Test Scores) Is this student receiving special services? YES NO IF YES, please include all special services records I.E.P., P.P.T. and minutes from recent Annual and/or Triennial Evaluations. NOTE: Parental permission for release of information must accompany the documents. Suffield Regional Agriscience Center 1060 Sheldon Street West Suffield, CT 06093 TELEPHONE: (860)668-3817 FAX: (860)668 8178 Attention: Agriscience Director A special Thank you to Guidance Counselors and Parents / Guardians for their time and effort encouraging students and assisting them in the preparation of their application to the Suffield Regional Agriscience Center.