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CTE Pathway Application Form for 2019-2020 School Year
Directions:

1. Complete all fields within this form.
2. Send the most recent copy of your transcript/report card to:
Cumberland High School
Attn: Heather Delfino, Assistant Principal & Director of Pathways
2600 Mendon rd
Cumberland, RI 02864

Early decision applications are due January 20, 2019. Any applications submitted after 1/20/19 will be placed into a lottery. Lottery deadline is March 30, 2019.

Application Info: https://goo.gl/YF4WBv

Email address *
Student First Name *
Your answer
Student Last Name *
Your answer
Student email address (if different from the one listed above)
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Student Address (INCLUDE: House #, Street Name, City, State, Zip Code) *
Your answer
Primary Home Phone *
Your answer
Student Current School *
Your answer
Student's CURRENT grade *
Parent/Guardian #1 First Name
Your answer
Parent/Guardian #1 Last Name
Your answer
Parent/Guardian #1 Email
Your answer
Parent/Guardian #1 Cell Phone
Your answer
Parent/Guardian #2 First Name
Your answer
Parent/Guardian #2 Last Name
Your answer
Parent/Guardian #2 Cell Phone
Your answer
Parent/Guardian #2 Email
Your answer
Please select the CTE pathway you want to apply to as your 1st choice: *
Required
Please select the CTE pathway you want to apply to as your 2nd choice (Optional):
How did you hear about Cumberland's Pathways? Select One: *
Why do you want to attend Cumberland High School? *
Your answer
School records may include, but are not limited to, course grades, standardized tests, Individualized Education Plans (IEPs), attendance and health records, extracurricular activities, conduct reports, and psychological/educational evaluation reports. I hearby give permission to my child's current school/district to utilize the school records of my child (named in the above form) for the purpose of application/admission/placement into a Cumberland High School Pathway. *
School record permission PARENT'S SIGNATURE & DATE: My signature below signifies my approval of this application and agreement to encourage punctual and regular attendance.
Your answer
Parent Approval of Application *
Photo Permission: I grant permission for Cumberland High School to include images of my child in promotional materials
Signature of student: By signing, I acknowledge that all information in this application is accurate, and I agree to all terms specified by the Cumberland High School for Pathway Enrollment.
Your answer
Date of signature
Your answer
Resident District Signatures:
If you are accepted and plan to enroll at Cumberland High School, submit a copy of this application to the superintendent of schools in the district where you live, obtain their signature below and return the completed, signed application to our School Counseling Department. This is to ensure the district in the town where you live is aware of the potential out-of-district enrollment for budgetary purposes. It is suggested to print this application now, so you do not need to look back and find it upon acceptance.


Superintendent Signature: _____________________________________________

Date of Signature: ____________________________________________________

Home District Guidance Dept. Signature (Optional):_________________________________________

A copy of your responses will be emailed to the address you provided.
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