Crossroads Arts and Science Early College

Crossroads Arts and Science Early College

476 North Center St, Statesville, NC 29677

Phone (704) 978-0034, fax (704) 978-0035

Crossroads VIP Pass Application (grades 11th through 13th only)

***VIP pass status is a privilege; therefore, it can be revoked at any time by the principal or a parent!

Student name: ______Grade ______

Student cell phone: ______

Student Crossroads email: ______

Student Mitchell email: ______

Parent Permission:

My child has permission to be off campus when NOT enrolled in a Crossroads, SHS, or MCC class. VIP Passes do not grant authority to sign yourself out during high school or college classes. Written parent permission is still required for absences or dismissing early. I understand that any violation of the policy will result in loss of this privilege. In addition, I understand that grades, attendance, and discipline will be reviewed each quarter to determine if their status has changed. Students that demonstrate a drop in grades or attendance at progress reports or report cards will have their status changed to incorporate weekly lab time on Crossroads campus.

Parent signature: ______

Parent contact number: ______

Office Permission:

Attendance: Student has no more than 6 absences in all high school classes from the previous semester.

Approved ______Not Approved ____, ____ # of prior semester absences

Discipline: Student has no discipline referrals from previous semester.

Approved ______Not Approved ______

Academic Achievement: Student has no grades below a D for high school or college (no F or WF from MCC) classes from the previous semester.

Approved ______Not Approved ______

Return form to Mrs. Whitener.

______Approved

______Not Approved for these reasons:______

______

Mrs. Whitener’s signature: ______