Enrollment Forms Packet (EFP)

Transcription

1 Enrollment Forms Packet (EFP) Based on your student(s) grade and applicable circumstances, complete one enrollment package and review the information below to determine what you should submit for each student seeking admission to the Insight School of Colorado (IS CO). You can fax, scan and , or mail the required paperwork. Important Note: Please send copies, do not mail the original documents Fax (preferred): Scan and Mail: Insight School of Colorado Enrollment Processing Center 2300 Corporate Park Drive Suite 200 Herndon, VA Insight School Colorado Enrollment Processing Center 2300 Corporate Park Drive Ste 200 Herndon, VA Ph Fx Required For? Item Description Provided by? Proof of Age Official Birth Certificate (not the hospital issued certificate) Required for all Students Required for student with an IEP or other Special Education needs Required for students that have a 504 plan Affidavit of State of Colorado Residency Health Records/Immunization Record Release of Student Records Student Performance Agreement Please complete this form and submit Current Health and Immunization Record. By filling out this form, you are giving our school permission to request your student s official records from their previous school after the approval process. If your child was Homeschooled please indicate it on the form, fill out the top portion and sign it. Please complete this form and submit. Provided in this packet Provided in this packet Provided in this packet Report Card Most Recent copy of your students report card Unofficial Transcripts IEP Evaluation Report 504 Accommodation Plan You will need to request an unofficial transcript from your student s current school, which will show your student s academic standing. This is required in order to place all enrolling students. Once your student is approved, we will request the official transcript. A copy of your student s current IEP (Individualized Education Plan). Because the IEP expires yearly, please submit the current IEP. The Evaluation Report is valid for 3 years. If you do not have a copy of your student s ER, you can request a copy from your student s current school. A copy of your student s current 504 Accommodation Plan. Because the 504 expires yearly, please submit the current 504. The Insight Schools is a program of K12 Inc. Insight Schools is a service mark of K12 Inc. version 1.1

2 STUDENT PERFORMANCE AGREEMENT Insight School of Colorado ( ISCO ) is an online, public high school in which students are able to access their courses 24/7 from any site where Internet in available. ISCO is committed to offering high quality, standards-based curriculum, highly qualified teachers, and various levels of support to assist students in realizing their goal of earning a certified high school diploma. Even though ISCO offers flexibility in its program structure, the demands and rigors of online learning require a high level of student commitment and engagement. ISCO students will need to work in each course every week in order to be successful. As a result, ISCO asks each student and a parent/guardian to acknowledge and commit to the following expectations of student performance. Student First Name Last Name Parent/Guardian (if student is not 18 years old) First Name Last Name Student Agreement: I agree to the following as a demonstration of my commitment to online learning at ISCO and understand that my failure to comply with the terms of this Performance Agreement may result in my being involuntarily withdrawn from ISCO: 1. I will engage as a full-time student in accordance with the following expectations of attendance and academic progress: a. Attend school on a regular and consistent basis by working online a minimum of 8 hours in each course every week b. Participate in all live Class Connect sessions in each course c. Progress in my school work on a regular and consistent basis by completing a minimum of 60% of all assignments due in each course every week 2. I will comply with the school s attendance policy and acknowledge that I will be locked out of my courses after 7 consecutive days of non-attendance and withdrawn from school after 14 consecutive days of non-attendance. 3. I will attend and take all required and applicable state assessments and exams, including the Transitional Colorado Assessment Program ( TCAP ) and Colorado ACT. 4. I will take the SCANTRON assessment as required from time to time during my enrollment at ISCO, which is currently scheduled for three times each year. 5. I will complete all ICAP (Individual Career and Academic Plan) activities throughout the year as required by ISCO.

3 6. I understand that I must earn a minimum of two credits during the school year to continue my enrollment at ISCO the following year. 7. I will check my Kmail account on a daily basis and maintain consistent communication with my teachers, Advisor, counselor and other school staff by asking questions as needed and returning phone messages or within 24 hours of receiving the communication(s). 8. I will communicate with the ISCO office or my Advisor if I am going to be absent from school for more than three consecutive days or any extended period of time. 9. I will use my school issued computer for educational purposes only. 10. I will immediately contact Technical Support at for any computer related programs and understand that tech issues will not be accepted as an excused absence or reason for not submitting assignments. Parent/Guardian Agreement: I agree to the following as a demonstration of my commitment to online learning and the success of my student at ISCO and understand that my student s failure to comply with the terms of ISCO s attendance and participation policies may result in him/her being involuntarily withdrawn from ISCO: 1. I will ensure that my student attends and takes all applicable state and school required assessments and exams, including the TCAP, Colorado ACT, SCANTRON and completes all ICAP activities. 2. I will monitor my student s progress on a regular basis by logging into the OLS at least weekly and reviewing periodic progress reports. 3. I understand that my student must earn a minimum of two credits during the school year to continue his or her enrollment at ISCO the following year. 4. I will regularly check and respond to Kmails, phone messages and other communications from ISCO teachers, Advisors and staff within 24 hours of receiving the communication(s). 5. I will maintain consistent internet connection and/or make arrangements for my student to complete his or her school work at another location in the event of a disruption in service. 6. I will contact the ISCO offices with any change in personal information such as address, phone number or address. Student Signature: Parent/Guardian Signature: (if student is not 18 years old) Date: Date: Please return this form to: Insight School of Colorado 8601 Turnpike Dr., Suite 100 Westminster, CO 80031

4 Proof of Residency AFFIDAVIT OF STATE OF COLORADO RESIDENCY Pursuant to 1CCR301-71, Rules for the Administration, Certification and Oversight of Colorado Online Programs, the Colorado State Board of Education must ensure that student residency is documented and verified, both upon initial enrollment and annually thereafter. Colorado residency is determined by the student and Parent or legal guardian currently residing within the State of Colorado boundaries, except for students of military families that maintain Colorado as their state of legal residence for tax and voter registration purposes. Reasonable evidence of residency within the State of Colorado boundaries can be established by a written statement of residency from the student s parent/guardian pursuant to Section : Instructions: The I swear statement on the next page, is an example of valid documentation for establishing proof of residency for an online student, per Rule 1CCR Section Rule 1CCR states that an Online Program must verify and document student residency in the State of Colorado upon enrollment and annually thereafter and retain a copy of the document or written statement offered as verification in the student s mandatory permanent record. The written statement of residency should follow Section (a) and (b) C.R.S. with regard to physical presence within the state and a purpose and intent to remain for an undetermined period. In addition for Colorado Online Programs, the student and Parent or legal guardian must be currently residing within the State of Colorado boundaries, except for students in military families pursuant to Section of the Rules. The I swear statement on the next page should be completed by the Parent or legal guardian of the student(s). All of the requested information must be completed and the statement signed and dated by the Parent or legal guardian. The form is not valid if dated after October 31 st of that applicable school year (October 31, 2012 for the school year). Note: Address cannot be post office box or general delivery at a post office. No vacant lot or business address shall be considered a residence. For the school year, if the I swear statement is signed and dated prior to July 1 st of the school year, this document may be subject to additional audit review procedures to verify that the student and Parent or legal guardian are currently residents of the State of Colorado during the school year. For the school year, a new form must be completed for each new school year and may be completed during the spring enrollment period, but not later than October 31 st of that applicable school year (such as October 31, 2013 for the school year).

5 Student s Name: Proof of Residency AFFIDAVIT OF STATE OF COLORADO RESIDENCY Pursuant to 1CCR301-71, Rules for the Administration, Certification and Oversight of Colorado Online Programs, the Colorado State Board of Education must ensure that student residency is documented and verified, both upon initial enrollment and annually thereafter. Colorado residency is determined by the student and Parent or legal guardian currently residing within the State of Colorado boundaries, except for students of military families that maintain Colorado as their state of legal residence for tax and voter registration purposes. Reasonable evidence of residency within the State of Colorado boundaries can be established by a written statement of residency from the student s parent/guardian pursuant to Section : Please complete the below affidavit as evidence of your residency status for the Colorado State Board of Education Affidavit by Parent or Legal Guardian: I,, do hereby swear and affirm, under (Print Parent/Guardian Name) penalty of perjury, that my child(ren) and me are currently and will continue to be residents of the State of Colorado for the 2012/2013 school year. Parent/Guardian Signature: Date: Name: Address: Street Apt. # City County State Zip Note: Address cannot be post office box or general delivery at a post office. No vacant lot or business address shall be considered a residence. Children Enrolled at: (online school name)

6 R e c o r d s R e l e a s e F o r m P A R E N T / G U A R D I A N I N S T R U C T I O N S : P a r e n t s / G u a r d i a n s o f s t u d e n t u n d e r 1 8 y e a r s o f a g e ( o r s t u d e n t s o v e r 1 8 y e a r s o f a g e o r e m a n c i p a t e d ) s h o u l d p r i n t a n d c o m p l e t e a l l f i e l d s. P l e a s e p r i n t l e g i b l y. C o m p l e t e d f o r m s h o u l d b e f a x e d t o ( ) S t u d e n t n a m e : L e g a l o r o t h e r n a m e, i f d i f f e r e n t f r o m a b o v e : _ D a t e o f b i r t h : D a t e o f r e q u e s t : _ L a s t S c h o o l a t t e n d e d i n y o u r d i s t r i c t : _ L a s t D i s t r i c t a t t e n d e d : _ D i s t r i c t / s c h o o l c o n t a c t p h o n e # P A R E N T R E L E A S E O F R E C O R D S ( if s t u d e n t i s u n d e r 1 8 y e a r s o f a g e ) I, _, p a r e n t / g u a r d i a n o f, g i v e p e r m i s s i o n f o r t h e r e l e a s e o f m y s t u d e n t s r e c o r d s t o I n s i g h t S c h o o l o f C o l o r a d o f o r t h e p u r p o s e o f r e v i e w. S T U D E N T R E L E A S E O F R E C O R D S ( if s t u d e n t i s o r i s o v e r 1 8 y e a r s o f a g e o r e m a n c i p a t e d ) I,, g i v e p e r m i s s i o n f o r t h e r e l e a s e o f m y r e c o r d s t o I n s i g h t S c h o o l o f C o l o r a d o f o r t h e p u r p o s e o f r e v i e w. P a r e n t / G u a r d i a n / S t u d e n t S i g n a t u r e : _ D a t e : _ S C H O O L / D I S T R I C T I N S T R U C T I O N S : F o r m a n d d o c u m e n t s s h o u l d b e a x e d t o ( ) I f a n y d o c u m e n t s n e e d t o b e m a i l e d o r t h e r e a r e a n y q u e s t i o n s, p l e a s e c o n t a c t t h e I n s i g h t S c h o o l o f C o l o r a d o R e g i s t r a r a t ( ) In order for a complete evaluation and/or educational program to be developed for this student, the agency/person listed above is permitted to exchange information that will be used in the planning process. Please refer to the Family Educational Rights and Privacy Act (FERPA) which allows disclosure without written parental consent to school officials with legitimate educational interests. These records may not be withheld for nonpayment of school fees or any other reason. Insight School of Colorado has a legitimate educational interest and needs to review these educational records in order to develop an educational program for the above named student. I N F O R M A T I O N R E Q U E S T E D ( P l e a s e p r o v i d e a l l t h a t a p p l y ) P e r m a n e n t r e c o r d / t r a n s c r i p t s ( p l e a s e i n c l u d e a l l e n r o l l m e n t d a t e s ) A c a d e m i c R e c o r d s : R T I, S t u d e n t L e a r n i n g P l a n s, L A P, C D S E d u c a t i o n a l E v a l u a t i o n s / T e s t S c o r e s S p e c i a l E d u c a t i o n r e c o r d s : l a t e s t I E P & s u m m a r y r e p o r t, D N Q R e p o r t e v a l u a t i o n D i s c i p l i n e o r b e h a v i o r r e c o r d s H e a l t h r e c o r d s / I m m u n i z a t i o n r e c o r d P l a n R e m e d i a l a c a d e m i c r e c o r d s : T i t l e, J O M S e r v i c e s, C h a p t e r P s y c h o l o g i c a l a n d c o u n s e l i n g r e c o r d s A t t e n d a n c e r e c o r d s, T i t l e I R e c o r d s, d a t e o f w i t h d r a w a l, w i t h d r a w a l g r a d e s & l a s t c l a s s s c h e d u l e