Northern P-Tech Academy

ENROLLMENT PACKET

Pathways to Advanced Career Exploration –

PACE welcomes your application to the 2016-2017 ninth-grade class.

REQUIREMENTS FOR ENROLLMENT IN PACE PROGRAM

Students must:

• Currently be enrolled in school and pass the eighth grade
• Students must be working toward a New York State Regents diploma
• Complete the application form and submit the completed form to their school counselor no later than May 5, 2016

Parents must:

• Complete the parent statement portion of the application form to be submitted by the student to their school counselor no later than May 5, 2016

IMPORTANT DATES

May 5, 2016 – Application Submission

A completed and signed application must be submitted to the school guidance counselor in the student’s district of residence.

May9 – 11, 2016 – Student Conversations

Have more of your questions answered. Share more information about yourself that will help us plan your educational and extra-curricular experience.

May 19, 2016 – Career Jam

Career Jam is a one day hands-on career exploration event for eighth & ninth grade students. This event is designed to highlight local career possibilities in the 16 career clusters. This hands-on event is designed to engage students & encourage them to look at careers that are relevant to where we live. (Jefferson County Fairgrounds)

July 19 – 21, 2016 – PACE Summer Session (Dates will be confirmed prior to end of school)

Day 1: Adventure Activity

Day 2: Project Based Activities with PACE Teachers

Day 3: Technology and Social Media – Students will vote on school logo, colors, and other fun social media communications

STUDENT APPLICATION

Home School District: ______

Student’s Full Name: ______

Student’s Address: ______

City: ______State: ______Zip Code: ______

Gender: ___ Male Female Date of Birth: ______Current Grade: _____

Student’s Email Address: ______

Parent/Guardian Name: ______

Parent/Guardian Email: ______

Parent/Guardian Phone Number: ______Alternate #: ______

Teacher Recommendation Filled out by: ______

What careers interest you?

______

Personal Statement: If you could change one thing in your life, what would it be? Why? (250 word limit)

______

Student Signature: ______Date: ______

Parent / Guardian Form

TO BE FILLED OUT BY APPLICANT’S PARENT(S) OR GUARDIAN

Please answer all questions.

You may attach additional paper as necessary.

Student’s Full Name: ______

What are your dreams and aspirations for your child? ______

Please share any information that you feel is important for us to know about your child as a learner. ______

Please indicate your child’s top two strengths and top two challenges. ______

I agree that my child may enroll in PACE. I realize that students participating in the program will have the opportunity as a junior in high school to become a non-matriculated student at North Country Community College / SUNY Canton and that his / her grades in the college level classes will become part of his / her college transcript. I also understand the academic calendar for PACEstudents may be different from their home school, and may require summer coursework.

Parent/Guardian Signature: ______

Date: ______

Teacher Recommendation

TO BE FILLED OUT BY A TEACHER IN

THE APPLICANT’S HOME DISTRICT

Student’s Full Name: ______

Date: ______

Teacher Name: ______

Position: ______

How do you know the applicant? ______

How long have you known this individual? ______

Please rate using the following scale:

1= Unacceptable 2=Below Average 3=Average 4=Above Average 5=Outstanding

Please comment on the applicant’s strengths. (Use additional paper as necessary)

______

Please comment on the applicant’s challenges. (Use additional paper as necessary)

______

Teacher Signature: ______

School Counselor Recommendation

TO BE FILLED OUT BY APPLICANT’S SCHOOL COUNSELOR

Student’s Full Name: ______

Date: ______

Counselor Name: ______

Counselor Email: ______

Counselor Phone: ______Counselor Fax______

Administrator’s Name: ______Email: ______

Attendance in 2015-2016 School Year: ______Days Tardy ______Days Absent

IEP/504? _____ Yes _____ No (Please submit a copy of the IEP/504 plan with the application.)

Please comment on the applicant’s strengths and challenges. (Use additional paper as necessary)

______

What about this student makes them an ideal candidate for the PACE program? (Use additional paper as necessary)

______

Counselor Signature: ______

Principal Signature: ______

** Please include a copy of the student applicant’s report card and discipline history for grades 7 and 8 in the application packet. **