COLORADO WEST CHRISTIAN SCHOOL
2705 Sunnyside Road
Montrose, CO 81401
Phone: (970)-249-1094
Fax: (970)-249-7988
E-Mail:
STUDENT APPLICATION
Date ______
Name of Student ______
First Middle Last
Sex ______Date of Birth ______
Grade Entering (circle one) K-4 K-5 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
Parent (Guardian) Names ______/______
Please list last school attended and/or presently attended by student:
School Name School Address
______/ ______
Colorado West Christian School is not staffed to educate students with severe learning disabilities or those who have severe behavioral issues. For your child’s best interest, please be candid when you answer the following questions. Further elaboration of your answers may take place during your interview.
A. Has the student ever been referred for testing or placed in a special program? ______
B. Has the student received any other special modifications, help, or tutoring? ______
C. Has the student ever repeated a grade for any reason? ______
D. Has the student ever been suspended, expelled, or received repeated discipline by a previous
school? ______
If so, please briefly explain: ______
______
______
COMPLETE REVERSE SIDE
E. Has the student ever seen a counselor/doctor/psychiatrist for any type of social, behavioral, or
mental problems? ______If so, briefly state the nature of the problem: ______
______
______
F. Has the student ever been examined or treated by a counselor/doctor/psychiatrist for hyperactivity
or attention deficit disorder (ADD or ADHA)? ______
G. Do you either suspect or have you been told that you child might have dyslexia? ______
H. Has the student ever been involved in legal problems or been arrested? ______
Both Parents and/or Guardians Should Sign:
Parent or Guardian Signature ______Date ______
Parent or Guardian Signature ______Date ______
COLORADO WEST CHRISTIAN SCHOOL
Technology and Internet Acceptable Student Use Agreement
Colorado West Christian School is fortunate to have multiple computers and Internet stations available to students. Our School Board considers computers and computer networks to be valuable learning tools when used as educational resources to support our curriculum. All students have the responsibility to use this technology in an appropriate manner.
Students will:
- Use school facilities and equipment only for school related educational activities
- Use the Internet only for activities related to curriculum expectations
- Adhere to copyright laws
- Transmit material that is in compliance of local, state or federal laws, or CWCS regulations
- Use only personal user IDs or passwords, refrain from sharing those or using another students ID or password
- Access only files, computers and settings to which they have been granted access by an authorized staff member
- Use external storage devices only with staff approval
- Store or use files or applications that are school related only (no personal music, browsers, images, games, etc.)
- Use only school approved software in compliance with licensing agreements
- Avoid monopolizing systems, overloading networks and printing excessive materials
- Adhere to class specific guidelines as outlined by individual teachers
- Not access the school network with a personal computer or other device
The use of the information system is a privilege, not a right, and inappropriate use will result in cancellation of those privileges.
The use of my assigned account must be in support of education and educational goals and objectives of the Colorado West Christian School. I am personally responsible for this provision at all times when using the electronic information service.
I understand and will abide by the provision and conditions of this contract. I Understand that any violations of the above provisions may result in disciplinary action, the revoking of my user account and appropriate legal action.
By signing this contract, I agree that I have read, understood and agreed to abide by all the rules.
Student Signature ______Date: ______
Parent or Guardian Signature ______Date: ______
COMPLETE REVERSE SIDE
Student Use of the Internet and Electronic Communications
(Annual Acceptable Use Agreement)
I have read, understand and will abide by the CWCS policy on Student Use of the Internet and Electronic communications. Should I commit any violation or in any way misuse my access to the school’s computers or computer system, including use of the Internet and Electronic Communications, I understand and agree that my access privileges may be revoked and disciplinary
and/or legal action may be taken.
If I am 18 years or older, I hereby release CWCS from all costs, claims, damages or losses resulting from my use of CWCS computers and computer systems, including use of the Internet and Electronic Communications, including but not limited to any user fees or charges incurred through the purchase of goods or services.
Your signature on this Acceptable Use Agreement is binding and indicates you have read the school’s policy on Student Use of the Internet and Electronic Communications and understand its significance.
______
Student’s Name (Printed) Date of Birth (Day/Month/Year)
______
Student’s Signature Date
*If the user is under 18 years of age, a parent or guardian must also sign this Agreement*
As the parent or guardian of this student, I have read the school’s policy on Student Use of the Internet and Electronic Communications. I understand that access to the Internet and Electronic Communications is designed for educational purposes and that the school has taken reasonable steps to block or filter material and information that is obscene, child pornography or otherwise harmful to minors, as defined by the Board. I also recognize, however, that it is impossible for the school to prevent access to all materials or information I might find harmful or controversial, and I agree not to hold the school responsible for any such materials and information accessed by my child. Further, I accept full responsibility for supervision if and when my child’s Internet or Electronic Communication use is not in a school setting.
I hereby release the school from all costs, claims, damages or losses resulting from my child’s use of school computers and computer systems, including us of the Internet and Electronic Communications, including but not limited to any user fees or charges incurred through the purchase of goods or service.
I hereby give permission to issue an Internet and Electronic Communications Account for my child and certify that the information contained on this for is true and correct.
Your signature on this Acceptable Use Agreement is binding and indicates that you have read the school’s policy on Student Use of the Internet and Electronic communications carefully and understand its significance.
______
*Parent or Guardian Name (Printed)
______
*Parent or Guardian Signature Date