P-TECH Health Science Academy

P-TECH Health Science Academy

2022-2023 Enrollment Application Form

Student Information

Student ID

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First Name*

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Middle Name

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Last Name*

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Student Cell Number*

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Student Email

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Grade*

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Street Address

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City

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Zip/Postal

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Student Cell Phone/Other:*

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Student Email Address:*

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Parent Information

Parent / Guardian 1 First Name*

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Parent / Guardian 1 Last Name*

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Parent / Guardian 1 Email*

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Parent / Guardian 1 Phone*

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Parent / Guardian 2 First Name

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Parent / Guardian 2 Last Name

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Parent / Guardian 2 Email

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Parent / Guardian 2 Phone

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Programs

Please rank the following programs of study in the order of your interest (1 being most interested)

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Programs

By enrolling into the P-TECH Health Science Academy, I understand that P-TECH classes include:

a rigorous health science classroom environment to prepare students for entrance into their desired program of study and future career goals. Therefore, I will give 100% to my academic coursework.
attendance at Freshman Camp program to introduce students to cohort and classroom expectations (this will occur for 1 week in June 2022 – attendance is highly recommended)
the requirement of at least 4 dual credit class by the end of my junior (11th grade) year
student support services as needed for academic coursework
work-based learning experience in each grade level

Student Signature*

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Date*

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As a parent, I understand that I serve as a partner in helping my student succeed in their P-TECH classes. Therefore, as a parent, I agree:

to encourage and support my student to complete all coursework in a timely manner
that attendance is extremely important and necessary for success in academic classes
to be present for any and all student/parent meetings, to include parent/teacher conferences, if needed.
that my student will attend Summer Bridge for 1 week in June 2022, as attendance is highly recommended.

Parent Signature*

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Date*

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Please fix the highlighted areas below before submitting.

P-TECH Health Science Academy 22-23 Enrollment Form

Student Information

Parent Information

Programs

Programs