Duplin Early College High School

Duplin Early College High School

Application for 2015-16 School Year

The staff, families, and students at Duplin Early College High School all choose to be a part of the school because they believe in its vision. Being a part of this community is intentional. We produce college-ready students prepared for a globally competitive world. With the choice to become part of this exceptional community comes the responsibility to work hard every day. We commit to true partnerships that enable us to transform our vision statement into our daily reality. We purposely create a nurturing environment where excellence is the norm. We are committed to success greater than just our own. We understand that every action, positive and negative, ripples beyond us to influence our entire community. We offer our strengths as support to others. We believe that all students can be held to rigorous academic and community commitments while respecting individual differences. The diversity of our community enriches our learning. We believe that students who learn to use their minds effectively will make positive decisions for themselves.

Application/Acceptance Process:

●Applications must be handwritten and submitted on or before February 16, 2015. Incomplete applications may be rejected from consideration.

●All information provided in the application is confidential and will not be released to any outside agencies.

●Please note that some of the information requested is optional. This optional information, if provided, may enhance a candidate’s probability of selection based on the early college model.

●Parent/Guardian signatures must be included.

●Two recommendation forms (included) from staff members at your school must be in your completed application packet.

●A copy of your discipline profile will be requested from your current school.

●An attendance profile will be requested from your current school.

●Other pertinent information may be requested from your school, if necessary.

●Duplin Early College High School admissions committee will review all application materials and candidates will be contacted to schedule a personal interview.

●Following the application and interview process, students will be notified of their acceptance/non-acceptance into the program.

Please return this completed application, including two recommendation forms, to your school counselor by February 16, 2015.

Student Name: ______

Current School: ______

Parent/Guardian Section

Name of Student: ______Sex: ______Race: ______

Age: ______Dateof Birth: ______

Name(s) of Parent(s)/Legal Guardian(s): ______

Home Address: ______

(Street)

______

(City) (State) (Zip Code)

Mailing Address: ______

(Street)

______

(City) (State) (Zip Code)

Parent email address: ______

Home Phone: ______Work Phone: ______

Cell Phone: ______

Please check the highest level of education for parents of applicant. (Optional)

Father’s EducationMother’s Education

______Some High School______Some High School

______Completed High School______Completed High School

______Some College______Some College

______Completed Associate’s Degree______Completed Associate’s Degree

______Completed Bachelor’s Degree______Completed Bachelor’s Degree

______Master’s Degree or Higher______Master’s Degree or Higher

Please provide the total number of people currently living in your household. (Optional)

Total People: ______

Please check the level of your family’s total gross income (Include all types of income).

______Less than $10,000______$30,000 - $34,999

______$10,000 - $14,999______$35,000 - $39,999

______$15,000 - $19,999______$40,000 - $44,999

______$20,000 - $24,999______$45,000 - $49,999

______$25,000 - $29,999______$50,000 or more

Answer YES or NO to the following questions. (Circle your response)

3.Does your child have an IEP (Individualized Education Plan through the Exceptional Children Program)?

YESNO

Does your child have a 504 plan?

YESNO

Does your child receive services in the AIG (Academically Gifted) Program?

YESNO

Will your child need bus transportation?

YESNO

PLEASE READ CAREFULLY: By submitting this application, you understand the commitment of effort and time your child will undertake if accepted in the Duplin Early College High School. Students who enroll in Duplin Early College High School complete a five -year program of study designed to give them the opportunity of receiving a high school diploma and an associate’s degree, or up to two years of college credit. Students will be required to request school reassignment upon acceptance and at the end of each year for as long as your child is enrolled in Duplin Early College High School. If at the end of any high school semester your child is unwilling or unable to continue studies at Duplin Early College High School, he/she may be reassigned to the high school in his or her attendance area. Also, attendance and/or behavior problems may be sufficient cause to rescind any reassignment that may be granted. If your child is accepted and enrolls in Duplin Early College High School, you will be asked to become an active participant in their education. Your active support and accessibility will be vital in the success of your child. By signing below, you and your child acknowledge the expectations of the school and understand that failure to meet those expectations may result in dismissal. You understand that having a sibling attending Duplin Early College High School does not improve the applicant’s chances of acceptance. Also by signing, you assure that the information provided on the application is accurate and complete.

______

Parent/Guardian SignatureDate

______

Student SignatureDate

Please return this application to your child’s school counselor by February 16, 2015.

Student Section

Explain why you are interested in attending Duplin Early College High School.

______

Write a brief summary of your experience at school. Tell the things that make it positive and/or negative.

______-

Describe your greatest strengths.

______

What do you feel is an area you can improve upon? Explain your answer.

______

What are your goals in school and life? Explain your answer.

______

Essay Requirement: Write a handwritten essay of at least 100 words.

Topic: Please describe in your own words how attending Duplin Early College High School will help you accomplish your goals in life. Explain how receiving two years of free college credit while attending would benefit both you and your family, especially with regard to financial need and/or other special circumstances.

______

Use the back of this page if more space is needed.

Duplin Early College High School

Recommendation Form

Student: This form must be completed by school personnel at the school you currently attend. This form must be included with your application. You must include two completed recommendations for your application to be considered complete.

Student Name: ______Student #: ______

School Personnel: Please complete this form and return to the student in a sealed envelope with your name written across the back flap of the envelope after it has been sealed. Please try to complete this in a timely manner for the student above.

The student named above is applying for admission to Duplin Early College High School. The student will take a rigorous course selection and college classes during their five years at DECHS. Please rate the student according to the following statements as you have observed the student.

Statement / Rating Scale
N/O* / Below
Average / Average / Above
Average / Exceptional
Academic ambition
Academic potential
Attitude towards school work
Behavior/Self-Discipline
Communication skills
Confidence
Educational aspirations
Relationships with peers
Relationships with teachers
Responsibility
Self-direction
Social Skills
Study skills/habits
Potential for success in post-secondary education (this may or may not be reflected in their current grade)

*Not observed enough to rate

Based on my experience with the applicant, my recommendation to DECHS is as follows:

( ) Highly Recommend ( ) Recommend ( ) Recommend with reservation ( ) Do not recommend

Name (Please Print) ______Title:______

Signature: ______Date: ______

Please use the reverse side of this from to provide any additional information or comments about this student.

( ) Comments on reverse side

Duplin Early College High School

Recommendation Form

Student Name: ______Student #: ______

*Not observed enough to rate

Based on my experience with the applicant, my recommendation to DECHS is as follows:

( ) Highly Recommend ( ) Recommend ( ) Recommend with reservation ( ) Do not recommend

Name (Please Print) ______Title:______

Signature: ______Date: ______

Please use the reverse side of this from to provide any additional information or comments about this student.

( ) Comments on reverse side