AVID APPLICATION
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1 AVID APPLICATION APPLICANT INFORMATION Name: Date of birth: Student ID Number: Phone: Current address: City: State: ZIP Code: What school do you currently attend: Current Grade: How did you hear about the AVID program? FAMILY INFORMATION Parent/Guardian Name: Parent/Guardian Address: Cell # Work# Parent/Guardian Name: Parent/Guardian Address: Cell# Who does the student live with? Are you interested in being a part of our parent council? Yes No Relation: When are you available? Please specify dates/ times. Work# Please list the best way to contact you: DEMOGRAPHIC INFORMATION (IF YOU DON T KNOW THE RESPONSE, YOU MAY LEAVE IT BLANK) 2014 FCAT Scores: Reading Score: Math Score: Science Score: (5 th grade only) Gender: Male Female How many absences have you had this school year ( )? Do you have a large family? (4 or more siblings) Will you be the first in your family to graduate from college? Do you live in a single parent family? How many referrals have you had this year? What level where they? Ethnicity: Do your parents have a college degree? Are you currently an ESOL student? Degree Type (mark all that apply) AA: AS: BA: BS: AVID FAMILY INFORMATION Do you have any siblings who are currently, or were at one time an AVID Student at Jackson Middle School? Yes No Do you have any siblings who was/is an AVID student at another school? Yes No (If you answered yes to either of the questions above please complete the information below with the sibling s information) Name: Current Grade: School: Name: Current Grade: School: Name: Current Grade: School: SIGNATURES Student Signature: Guardian Signature: Address you will like your acceptance/denial letter sent to: Date: Date: Alternative:
2 Student Name AVID applicant, complete the following essay and return AVID Essay 1. Why do you want to be part of the AVID program at Jackson Middle School? (3 sentences minimum) 2. Describe your strengths. What are your characters or traits that demonstrate your individual determination to succeed? (3 sentences minimum) 3. What goals do you have for yourself regarding high school and college?
3 Name Current School: AVID applicant, please leave this page blank and attached to your application. This page will be completed by the person who interviews you AVID Interview Student s Oral Responses to Interview Questions: Homework: Studying: Interviewer Feedback: Please wait until student is no longer present to respond. Based on this interview, would you recommend this student for AVID? Yes / No Why or why not? Additional Comments: Interviewer Name (Please print):
4 AVID applicant, give this form to your current Language Arts, Science, Social Studies, or Reading teacher. Teacher Recommendation Form for AVID Please Print In Ink. Teachers, return this form to Mrs. DeMars in the Media Center. Do not return to student. 5th grade teachers return this form to your school counselor. Teacher s Name: Student s Name: The student named above has been recommended for placement in the AVID program. This is a course designed primarily for students who have college potential. AVID students are expected to earn a GPA of at least a 2.0, pass all of their academic classes with a C or higher, maintain good conduct, and show individual determination to be successful. As this student s teacher, your feedback will be highly valued and much appreciated. Please take a few moments to answer the following questions so that the AVID team may determine an appropriate placement for this student. Thank you. Please check the appropriate box: Rarely Sometimes Always Do you believe this student needs the support of the AVID class? Does this student seem to have college potential? Does this student display good classroom work habits? Does this student display good classroom behavior habits? Does this student complete their homework? Does this student practice good citizenship? Does this student have an acceptable attendance record? Please write a brief description of why you feel this student would be a good candidate for the AVID program. Also, do you have any recommendations to ensure this student is academically successful? Teacher Signature:
5 AVID applicant, write your name on this form and give this form to your current Math teacher. Math Teacher Recommendation Form for AVID Please Print In Ink. Teachers, return this form to Mrs. DeMars in the Media Center. Do not return to student. 5 th grade teachers return this form to your school counselor. Teacher s Name: Student s Name: The student named above has been recommended for placement in the AVID program. This is a course designed primarily for students who have college potential. AVID students are expected to earn a GPA of at least a 2.0, pass all of their academic classes with a C or higher, maintain good conduct, and show individual determination to be successful. As this student s math teacher, your feedback will be highly valued and much appreciated. Please take a few moments to answer the following questions so that the AVID team may determine an appropriate placement for this student. Thank you. Please check the appropriate box: Rarely Sometimes Always Do you believe this student needs the support of the AVID class? Does this student display good classroom work habits? Does this student display good classroom behavior habits? Does this student complete their homework? If the student is currently a 6 th grader, can you recommend them for Pre-Algebra next year as a 7 th grader? If the student is currently a 7 th grader, can you recommend them for Algebra 1 or Algebra 2 next year as an 8 th grader? Please write a brief description of why you feel this student would be a good candidate for the AVID program. Also, do you have any recommendations to ensure this student is academically successful? Teacher Signature:
6 IMPORTANT DATES TO REMEMBER Please detach this page for your records **Applications are due by May 16 th to Mrs. DeMars at Jackson Middle School** **AVID Interview Night- Wednesday, May 21 5pm** Please plan on attending AVID Interview Night at the Jackson Middle School Cafeteria. ALL APPLICANTS MUST BE INTERVIEWED! Questions or concerns, please contact Mrs. DeMars at Ext or Vanessa.DeMars@ocps.net
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