ENROLLMENT APPLICATION. If a minor (Parent/Guardian- print) Relationship. Address/City/State/Zip

Transcription

1 Goliath Academy s Project New-Direction 617 Eddie Robinson Sr. Dr.,Baton Rouge, Louisiana Ph: (225) or (225) ascreations4855@hotmail.com ENROLLMENT APPLICATION STUDENT DATE ] If a minor (Parent/Guardian- print) Relationship Address/City/State/Zip Male /Female Age Date of Birth: Mo Day Year Home Phone:( ) Cell:( ) Social Security #: Last School Attended: City State From: year To: year Circle last grade completed: 7 th, 8 th, 9 th, 10 th, 11 th, 12 th. STUDENT STATING TO HAVE CREDITS FROM PRIOR HIGH SCHOOL, AND NEEDS CREDITS TO MEET THE 24 CREDIT REQUIREMENT. TRANSCRIPT RECEIVED: Yes or No TUITION Tuition cost is determined on the amount of earned credits the student is starting the program with. The Transcript from the prior high school is mandatory! A minimum of four (4) credit courses in the Core- Subjects is required to receive a diploma from Goliath Academy, when you are an incoming, transfer student. An (academic year) is 180 days or 10 months of school and 12 months if extenuating circumstances exist.. If a student exceeds the allotted amount of time to complete their academic school year, but has more than threequarters of the work completed; he or she may complete the school year with a charge of $50.00 fee bi-weekly too keep the teachers assigned to him or her. If the student has not completed three-quarters of the school work for the academic year; he or she will be required to pay another academic year of tuition. Credit Recovery or Transfer Students: Goliath Academy uses a SACS approved curriculum which is college-preparatory and reciprocal to public schools accrediting body. However, selecting one or more Goliath Academy courses to be used for credit in another public or private high school must have prior written approval from both school officials, the issuing and receiving school. The written approval and a list of the approved courses and grade levels must accompany this enrollment agreement. Additionally, a Carnegie Credit has to abide by the traditional school standards of 180 clock hours for courses with lab and 135 to 150 clock hours for courses without lab. It is the responsibility of the student/parent or guardian, to choose the program which best suits your goals and plans. The Traditional Classroom Setting Program is for college and military bound students. The Distance Education Program varies in acceptance by the receiving institution and the Adult Education High School Completion Program is for work and technical/vocational schools. Please check to make sure the receiving institution of your chose receives the program option. PRINT NAME SIGN: DATE:

2 ADULT-EDUCATION HIGH SCHOOL PROGRAM COST: $ for students who completed the 10 th grade or have 12 or more credits. Also, for adults 21 and older. Students under 21 years of age with less than 12 credits, tuition is pro-rated to $60.00 per credit needed to graduate. Please pick a payment plan of weekly or bi-weekly payments! Enrollment Date: Weekly or Bi-weekly Payments. Program Cost $ Registration Fee: $ = New Balance $ Payment start-date is one or two weeks from the enrollment date! Date: Payment $ / NEW BAL. Date: Payment$ /NEW BAL.. Date: Payment $ / NEW BAL. Date: Payment$ /NEW BAL.. Date: Payment $ / NEW BAL. Date: Payment$ /NEW BAL.. Date: Payment $ / NEW BAL. Date: Payment$ /NEW BAL. Date: Payment $ / NEW BAL. Date: Payment$ /NEW BAL.. Date: Payment $ / NEW BAL. Date: Payment$ /NEW BAL.. This program is for students who have not completed their High School Diploma or the equivalent General Educational Development (GED) in the United States and whose educational level functions is at an eighth grade level or below. It is also for students who failed the state exit exams, the GEE or FCAT and whose native language is other than English. This program is also for adults who need an educational career pathway to enter post-secondary education and college. To graduate, students are required to earn 24 credits the Sunshine State Standards apply with 24 credits and a grade-point-average of 2.0 or above is required. There are no interest or finance charges on the above tuition payment plans. Annual percentage interest is 0%. CHECK A METHOD OF PAYMENT Your down payment or registration fee must be included with this agreement in order for your enrollment to be processed. Tuition includes all educational materials and personalized exam grading by qualified teachers. Shipping/handling fees of $10 may apply depending on the student situation. PAYMENT: CHECK, CASH, MONEY ORDER, VISA, MASTERCARD. STUDENT NAME: CREDIT CARD OWNER: CREDIT CARD NUMBER: ( )-( )-( )-( ) CREDIT CARD EXPIRATION DATE: MONTH YEAR. THREE-DIGIT CODE. BANK CARD NAME: SIGN: DATE:

3 Goliath Academy s Satellite : Project New Direction Tuition Protection Agreement Goliath Academy, a Christian high school, is confident you will be happy with your program. In the unlikely event you should wish to discontinue the program at the satellite center: Project New Direction, 617 Eddie Robinson Sr. Drive, Baton Rouge, Louisiana 70802, following procedures apply. Project New Direction, will refund your tuition according to the following refund policy which meets the refund policy published by Goliath Academy High School. You must request cancellation in writing. You may notify the school of your intent to cancel by mail, addressed to: Project New Direction, Attn: Pastor G. Spurlock, Sr. 617 Eddie Robinson Sr. Drive, Baton Rouge, Louisiana If enrollment cancellation is requested within three (3) days from midnight of the day on which the enrollment agreement is signed, the school will issue a refund in full; provided all material is returned in the same condition it was issued. 2 If enrollment cancellation is requested after three (3) days from midnight of the day on which the enrollment agreement is signed, and before the school receives the first lesson assignment submitted for grading, Goliath Academy Project New Direction is entitled to a fee of 20% of the total tuition or $ If the school is notified of cancellation after three (3) days from midnight of the day on which the enrollment agreement is signed, and after one or more lesson assignments have been submitted to the school for grading, a cover charge shall be entitled to a fee of 40% of the total tuition or $ If cancellation notification is requested and: (a) Completion of the first 10% of the program, the student will be obligated to PND for 10% of the tuition minus the amount of the registration fee of $ (b) When cancelled after completion of more than 10% and up to and including 25% of the program, the student will be obligated to PND for 25% of the tuition minus the amount of the registration fee of $ (c) When cancelled after completion of more than 25% and up to and including 50% of the program, the student will be obligated to PND for 50% of the tuition minus the amount of the registration fee $ (d) When cancelled after completion of more than 50% of the program, the student will be obligated to PND for the full Tuition cost of the program. 5 A student enrolled in the high school diploma program has three (3) years from the original date of acceptance to complete his or her program. This contract will cease to be in effect after three years from the original date of acceptance. No requests for refunds will be considered thereafter. 6 A student enrolled in the individual course program has one (1) year from the original date of acceptance to complete courses taken individually. This contract will cease to be in effect after one year from the original date of acceptance. No requests for refunds will be considered thereafter. 7 This enrollment cancellation policy is based upon the total tuition cost of the program. The percent of the program completed shall be the coursework received by the student as compared to the total coursework to be sent to Project New Directions High School Completion Program.

4 ADULT-EDUCATION HIGH SCHOOL COMPLETION PROGRAM INSTRUCTIONS : FOR COMPLETING YOUR HIGH SCHOOL PROGRAM 1 Just as soon as you enroll or we receive this enrollment agreement and the down payment, we will immediately issue you or send out your first course materials, including special instructions as to how the student can get the most from his or her studies. 2 After enrollment acceptance and the evaluation by Goliath Academy of official grade transcripts, if any, from previous high schools, the student will be notified in person or writing of the required coursework he or she must complete for a Goliath Academy High School Diploma. The student/parent or guardian is responsible for the payment of any transcript request fees to the previous school(s). 3 Upon successful completion of the Goliath Academy diploma program and payment in full of all financial obligations to the school, the student will be awarded an accredited high school diploma. 4 If the student is unable to complete his or her program within the allotted type pertaining to the students individual program, additional time to finish the program may be arranged for a nominal fee if the extension request and fee are received before the program expiration date. 5 If a bi-weekly tuition payment plan is selected, your first payment will be due 15 days after enrollment acceptance. All payments must be made when due regardless of the student's academic progress. Late installments not paid in full to the school 15 days after their due date shall be subject to a late payment charge. 6 If an examination is returned to the student with an incomplete or failing grade, the student is given the opportunity to retake the exam with an $8.00 fee for each exam that must be resubmitted 7 A virtual school student must pay a shipping and handling fee of $10.00 per course, which is charged to the student's account at the time the course is electronically sent to the student.. Airmail (overseas), overnight, or any special delivery fees are additional and must be prepaid prior to course shipment. 8 To assure confidentiality of a student's educational records in accordance with state statutes and the Family Rights and Privacy Act of 1974, as amended, Goliath Academy / Satellite: Project New Direction will not release information concerning a student's records, grades, or status over the telephone.

5 GOLIATH ACADEMY S PROJECT NEW-DIRECTION SCHOLASTIC HONESTY CODE ACKNOWLEDGEMENT FORM PLEASE SIGN AND RETURN WITH ENROLLMENT APPLICATION Scholastic Honor Code Advisory and Acknowledgement All Students enrolling at Goliath Academy are required to read, sign and return the Scholastic Honesty Code Acknowledgement Form. This form dictates how a student should view and conduct themselves, as it pertains to Education. Any student who does not read this document and is not in agreement with the particulars cannot participate in our Traditional Day Classes or Distance Education Program. I. The verbiage of this code deals specifically with cheating, attempted cheating, plagiarism, lying, and stealing. Instances of cheating, attempted cheating, plagiarism, lying and/or theft perpetrated by a student will constitute a violation of the Honesty Code and can subject the student to immediate termination from his/her academic program and the forfeiture of all tuition funds. A. Cheating encompasses the following: 1. The willful giving or receiving of an unauthorized, unfair, dishonest, or unscrupulous advantage in academic work over other students. 2. The above may be accomplished by any means whatsoever, including but not limited to the following: fraud; duress; deception; theft; trick; talking; signs; gestures; copying from another student; unauthorized use of study aids, memoranda, books, data, or other information; and the unauthorized access of computer-based information. 3. Attempted cheating. B. Plagiarism encompasses the following: 1. Presenting as one's own the words, the work, or the opinions of someone else without proper acknowledgment. 2. Borrowing the sequence of ideas, the arrangement of material, or the pattern of thought of someone else without proper acknowledgment. C. Lying encompasses the following: The willful and knowledgeable telling of an untruth, as well as any form of deceit, attempted deceit, or fraud in an oral or written statement relating to academic work or institutional form. This includes but is not limited to the following: 1. Lying to administration and faculty members. 2. Falsifying any institutional document by mutilation, addition, or deletion. D. Stealing encompasses the following: Taking or appropriating without the permission to do so, and with the intent to keep or to make use of wrongfully, property belonging to the institution, including the acquiring of unjustified program or graduation materials by means of deception. II. Students are responsible for understanding the provisions of and abiding by the Honesty Code. As part of program indoctrination prior to beginning his/her initial course of study, each student will sign an affirmation of the Code stating that they have read, have understood and indeed undertake to abide by the Honesty Code. III. The provisions of the Honesty Code shall be applied to the ongoing relationship between the student/graduate and the institution in perpetuity. Should it be discovered (even after graduation) that a program participant violated the provisions of the Scholastic Honor code during his/her program tenure or has committed a violation after his/her graduation (such as falsification of institutional records and documents, which are then published as genuine to a third party), the institution shall reserve the right to revoke and render void any and all credentials (including the high school diploma and transcripts) issued to that individual.

6 IV. It will be the responsibility of the office of the Principal to investigate and render a decision in all cases of suspected violations of the Honesty Code. Violators will face only one possible penalty: immediate expulsion from all academic programs / immediate revocation of any and all issued credentials and the forfeiture of all tuition fees. V. Students expelled /Graduates with credentials revoked for violation of the Honesty Code will be notified of the Principal s decision in writing via certified U.S. Mail. VI. Students expelled /Graduates with credentials revoked for violation of the Honesty Code will be entitled to a single appeal. Such appeals will be addressed in writing to the President, Goliath Academy, 6685 Forest Hill Blvd, Room 206 Greenacres, Florida A written request for appeal must be Postmarked no more than thirty (30) days after the date of the certified mailing of the notification of expulsion/revocation of credentials. VII. The President shall review all pertinent documentation, consulting will all parties as necessary. The President will render a decision within thirty (30) days of receipt of the written notice of appeal. The President will inform all parties of his/her decision in writing, delivered by registered U.S. mail within thirty (30) days of rendering his decision. SCHOLASTIC HONESTY CODE ACKNOWLEDGEMENT FORM For All Students: By affixing my signature below, I hereby affirm that I have read, understand and agree to abide by the provisions of the Goliath Academy Scholastic Honesty Code Acknowledgement Form. Student Signature Date / / PRINTED NAME For Students Under the Age of 18: By affixing my signature below, I hereby affirm that I am the parent or legal guardian of the student, whose signature appears above. BOTH the student and I have read, understand and agree to abide by the provisions of the Goliath Academy Honesty Code. Parent/Guardian Signature Date / / PRINTED NAME PLEASE SIGN AND RETURN WITH ENROLLMENT APPLICATION.

7 GOLIATH ACADEMY N.W. 77TH Ave. Ste.2003 Miami Lakes, Florida Off: Fax: Credit Card Authorization Form I,, hereby authorize Goliath Academy Satellite: Project New-Direction, to charge my credit card account in the amount, not to exceed: $ from my ( ) VISA ( ) MasterCard : Credit Card Number: / / /, Expiration Date: / VID Code:. Credit Card Owner: Name: Billing Address:, City:,State: Zip Code: Country: (if not US) Telephone: ( ) - Requested Shipping Address: Street:,City:,State: Zip Code: Country: (if not US) Telephone: ( ) - As the credit card holder, I hereby authorize receipt of goods & services at the shipping address above. Date: / / Cardholder's Signature Date As the credit card holder, I also authorize Goliath Academy/Project New-Direction, to charge my credit card for future payments toward my tuition; verbally approved by me. Authorization Valid Until: / Initials Here: Your completion of this authorization form helps us to protect you, our valued customers, from credit card fraud. Goliath Academy will keep all information entered on this form strictly confidential. Please provide a copy of your photo identification card, for your protection.

8 GOLIATH ACADEMY S PROJECT NEW-DIRECTION PARENT/GUARDIAN CONSENT FORM I certify that I am the parent / legal guardian of the participant listed below, and I give my consent for him/her to enroll in Goliath Academy s Project New-Direction, High School Program. I understand that enrollment in the adult-education high school program involves dedication, time,and effort, in the pursuit of a high school diploma. I fully understand the program structure and curriculum, as well as the tuition and payment options, and agree to assist my son/daughter in the educational process as much as possible. Parent/Guardian (Print) Students Name Parent/Guardian Signature Instructors Signature DATE DATE

9 PROJECT NEW-DIRECTION 617 Eddie Robinson Sr. Drive Baton Rouge, Louisiana Ph: (225) Fax: (305) Date: TRANSCRIPT REQUEST FORM I,, social security - - Student and D.O.B., attended High School from to. date date I am giving permission to have my transcript forwarded to the above school. Please indicate the main reason why you are requesting a transcript. I have NOT graduated but I am transferring to another institution. I need it for employment purposes. I need it for licensing and / or certification purposes. I need a copy for myself. Other, Please specify:. Thank you for your cooperation. Respectfully, Student

10 STUDENT: PROJECT NEW DIRECTION Paid to: Receipt No.: ADULT-EDUCATION HIGH SCHOOL COMPLETION PROGRAM Program Cost - Amount Services : The Adult-Education High School Completion Program, offers traditional classroom setting, college preparatory curriculums, certified teachers, all of the required subjects to complete and earn an accredited diploma, printing of the diploma with the leatherette case, small wallet size laminated diploma, transcripts and picture with the cap and gown. PROGRAM COST: $.00 MINUS FOR DISCOUNT( S) TAX Date: Paid by: Received by: Paid to: Receipt No.: Description Services : The Adult-Education High School Completion Program, offers traditional classroom setting, college preparatory curriculums, certified teachers, all of the required subjects to complete and earn an accredited diploma, printing of the diploma with the leatherette case, small wallet size laminated diploma, transcripts and picture with the cap and gown. PROGRAM COST: $.00 MINUS FOR DISCOUNT( S) TAX Amount - Date: Received by: Paid by: Paid to: Receipt No.: Description Services : The Adult-Education High School Completion Program, offers traditional classroom setting, college preparatory curriculums, certified teachers, all of the required subjects to complete and earn an accredited diploma, printing of the diploma MINUS FOR Amount

11 Paid by: Paid to: Receipt No.: Description Services : The Adult-Education High School Completion Program, offers traditional classroom setting, college preparatory curriculums, certified teachers, all of the required subjects to complete and earn an accredited diploma, printing of the diploma with the leatherette case, small wallet size laminated diploma, transcripts and picture with the cap and gown. PROGRAM COST: $.00 Date: Received by: with the leatherette case, small wallet size laminated diploma, transcripts and picture with the cap and gown. PROGRAM COST: $.00 MINUS FOR DISCOUNT( S) TAX DISCOUNT( S) TAX Amount Date: Received by: Paid by: Paid to: Receipt No.: Description Services : The Adult-Education High School Completion Program, offers traditional classroom setting, college preparatory curriculums, certified teachers, all of the required subjects to complete and earn an accredited diploma, printing of the diploma with the leatherette case, small wallet size laminated diploma, transcripts and picture with the cap and gown. PROGRAM COST: $.00 MINUS FOR DISCOUNT( S) TAX Amount Date: Received by: Receipt No.:

12 Paid by: Paid to: Description Services : The Adult-Education High School Completion Program, offers traditional classroom setting, college preparatory curriculums, certified teachers, all of the required subjects to complete and earn an accredited diploma, printing of the diploma with the leatherette case, small wallet size laminated diploma, transcripts and picture with the cap and gown. PROGRAM COST: $.00 MINUS FOR DISCOUNT( S) TAX Amount