Springtown High School 2015 Summer School Registration Form

1four week session: June 4th – 5th (Thurs – Fri the first week)

*8:00 - 12:00 June8th- 25th (Mon – Thurs next 3 weeks)

Student Name ______Current Grade Level ______Age ______

(Printed Name)

Name and Address of High School currently attending: ______

______

Parent/Guardian’s Name ______Address ______

(Printed Name) (Printed Address)

Phone: (home) ______(work) ______(cell) ______

Medical Information (medications, allergies, existing conditions, etc.) ______

______

Computer-based courses offered for Credit Recovery only – 1st or 2nd semesters:

English I, II, III, IVAlgebra IBiologyWorld Geography

GeometryIPCWorld History

Communication-Algebra 2ChemistryUS History

ApplicationsAlgebra 3PhysicsGovernment

Pre-CalculusEnviron. SystemsEconomics

Math Models

Students with internet access outside of school may be permitted to enroll in one full year course or two different semester courses. Students who do not have the opportunity to continue online coursework outside of the classroom will be restricted to enrollment in only one semesterof instruction.

Cost: In-District…………………..….. $50per semester course(no refunds for any reason)

*Out-of-District………………………$150 per semester course (no refunds for any reason)

*Enrollment of “Out of District” students will only be permitted if space is available

Course(s) Needed for Recovery: ______/______/______

Course Semester Course Semester

Attendance and Tardies: Four hours of attendance will be required each day.Four tardies will count as an absence.Studentsmissingmore than 30 minutes of class time (whether arriving late or leaving early) will be counted absent. STUDENTS MAY BE REMOVED FROM THE PROGRAM AFTER A SECOND ABSENCE. Students completingall required coursework before the four week session is over will not be required tocontinue attending.

Registration deadline is Wednesday, June3rd.

ContactBrent Haugen, Assistant Principal at SHS

817-220-3888 or

For School Use Only: Amount Received ______Date: ______

□ Cash □ Check # ______