SUMMER SCHOOL CREDIT RECOVERY APPLICATION 2015 Applications are Due by April 13, 2015 Student ID #:______________ Grade:____________ School of Residence:_________________________________________ Student Name:________________________________________________ Address:_________________________________________________ Age:____________ DOB:______/______/______ City:_________________________ Zip:____________ Parent/Guardian Name:____________________________________ Telephone: H__________________ C_________________ SUMMER SCHOOL DATES: JUNE 15 – JULY 10, 2015 (NO CLASSES JULY 03) Below are the schools that will host Summer School 2015. Please circle the school based on your SCHOOL OF RESIDENCE. SUMMER SCHOOL SITE HOURS SCHOOL OF RESIDENCE CASTLE PARK HIGH OLYMPIAN HIGH MONTGOMERY HIGH SWEETWATER HIGH 8:00 a.m. – 12:30 p.m. 8:00 a.m. – 12:30 p.m. 8:00 a.m. – 12:30 p.m. 8:00 a.m. – 12:30 p.m. CPH, CVH, HH, OSS BVH, ELH, OLH, ORH MVH, MOH, SYH, SOH GJH, SUH, OPEN TO ANY SITE COURSE SELECTION: ENGLISH 91136A – English 9-A 91136B – English 9-B 91129A – English 10-A 91129B – English 10-B 91140A – English 11-A 91140B – English 11-B 91459A – ELD 1 Hour 1-A 91459B – ELD 2 Hour 2-A 91463A – ELD 3 Hour 1-A 91463B – ELD 4 Hour 2-A 91467A – ELD 5 Hour 1-A 91467B – ELD 6 Hour 2-A 91471A – ELD 7 Hour 1-A 91471B – ELD 8 Hour 2-A 98728A – READ 180 Fundamentals A 98728B – READ 180 Fundamentals B MATH 92604A – Algebra A 92604B – Algebra B 98566A – Algebra Fundamentals 1-A 98566B – Algebra Fundamentals 1-B MATH (CONT) 98568A – Algebra Fundamentals 2-A 98568B – Algebra Fundamentals 2-B 92612A – Extended Algebra 1-A 92612B – Extended Algebra 1-B 92614A – Extended Algebra 2-A 92614B – Extended Algebra 2-B 92630A – Formal Geometry A 92630B – Formal Geometry B 92644A – Intermediate Algebra A 92644B – Intermediate Algebra B 92923A – Integrated Math I-A 92923B – Integrated Math I-B 92924A – Integrated Math II-A 92924B – Integrated Math II-B 92926A – Integrated Math III-A 92926B – Integrated Math III-B HISTORY/SOCIAL SCIENCE 94322A – World Geography A 94322B – World Geography B 94397A – World History and Cultures A 94397B – World History and Cultures B HISTORY/SOCIAL SCIENCE (CONT) 94074A – US History A 94074B – US History B SCIENCE 92105A – Biology A 92105B – Biology B 92111A – Chemistry A 92111B – Chemistry B FOREIGN LANGUAGE 91203A – French 1-A ***Bilingual 91203B – French 2-B Classes 91205A – French 3-A Available*** 91205B – French 4-B 91224A – Spanish 1-A 91224B – Spanish 2-B 91226A – Spanish 3-A 91226B – Spanish 4-B 91256A – Spanish for Spanish Spkrs 1-A 91256B – Spanish for Spanish Spkrs 2-B 91258A – Spanish for Spanish Spkrs 3-A 91258B – Spanish for Spanish Spkrs 4-B HEALTH 94010 – Comprehensive Health Please write the course number(s) of your choice in the spaces below. 1st: _____________________ 2nd: ___________________Alternative Choice: __________________ *When looking at COURSE SELECTION, an “A” is equal to Semester One and a “B” is equal to Semester Two. **First priority will be given to students who have received an “F”. SPACE IS LIMITED. I give approval for my son/daughter to attend classes during the summer session. I understand that my son/daughter will be required to complete a minimum of 22 hours of homework. Counselor’s Signature: __________________________________________________ Date:___________________ Parent/Guardian Signature: ______________________________________________ Date:__________________ Sweetwater Union High School District EMERGENCY AUTHORIZATION Student Name:____________________________________________ Address:_____________________________________________ Age:__________ DOB:______/______/______ City:_______________________ Zip:____________ Parent/Guardian Name: ________________________________ Telephone: H ________________ C ________________ If other than parents, please indicate who has custody of child and/or if any person other than yourself should pick up the child from school. (Must be 18 years of age or older) In case of an emergency, illness or accident, indicate a relative or friend who would be authorized to transport your child. Name:____________________________________Relationship:__________________ Telephone:___________________ Name:____________________________________Relationship:__________________ Telephone:___________________ Name:____________________________________Relationship:__________________ Telephone:___________________ PHYSICIAN TO CALL IN EMERGENCY:_________________________________________Telephone:___________________ Address:__________________________________________ City:__________________________ Zip:____________ Insurance:________________________________________ Medical Record Number:___________________________ In the event of an emergency, your child will be transported to the nearest hospital. Remarks (Physical conditions which may need special care):__________________________________________________ California State Law requires that the parent inform the school nurse if their child takes medication on a continuous basis for a non-episodic condition (Epilepsy, Diabetes, Hyperactivity, etc.) My permission ☐ is given ☐ is not given (check appropriate box) to allow my child to be photographed, videotaped and/or interviewed at school-related events for the media (TV, radio and newspapers) or for promotional material, including Sweetwater District newsletters, brochures and websites. My permission is given to share medical information with school staff in order to provide optimal health care for my student. Parent/Guardian Signature: __________________________________________________ Date:___________________
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