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ACES: Academy for Computer Engineering Sciences

Student Academy Application

Enrollment Limited! Application Due: Friday, May 19, 2011

Student’s Full Name: _________________________

Student ID Number: ______________

Home Address: ______________________________________________________________

Name(s) of Parent(s)/Guardian: ________________________________________________

Home Phone: ____________ Cell Phone: ____________ Work Phone: _______________

Email address: ______________________________

Are you interested in participating in any of the following:

_____ Choir _____ Band _____ ROP _____ AP Classes

_____ Dance _____ Athletics _____ Debate Team _____ 0 Period Band (if offered)

What do you expect to gain from the Academy experience (continue on back if needed)?

How do you think you will benefit from the Academy program (continue on back if needed)?

Additional information you feel would be helpful in the selection process (continue on back if needed):

For the Parent/Guardian:

“I understand that the Academy is a unique learning environment that will require off-campus job shadowing and mentoring with a business person and business internships. I understand that my student and the Academy will require parental support in order to be successful. I agree to attend mandatory parent meetings. I grant permission for my son/daughter to enroll in the Academy Program.”

Parent Signature(s): __________________________________________________________

Student Signature: _________________________________________ Date: ___________

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