Durham Performance Learning Center - Enrollment Interest Form
If you are interested in enrolling at the DPLC, please complete the form below. Once complete, one of our counselors will be in touch with you with more information. Please note - completion of this form does not guarantee acceptance into the DPLC.
Student First Name
Student Last Name
Student Current School
Hillside New Tech
JD Clements Early College
School for Creative Studies
Parent Phone Number
Parent Email Address
Student Cell Phone Number
Student Email Address
What is the reason you are interested in or were referred to the DPLC? (check as many as are applicable)
Apathy/Disinterest in School/Lack of Motivation
Social Issues (i.e. poor self-esteem/peer interaction)
Physical Health Impacts on School Progress
Mental Health Impacts on School Progress
Who referred you to the DPLC?
Why do you wish to attend the Durham Performance Learning Center? Please include the following information: academic strengths and weaknesses and post-high school plans.
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This form was created inside of Durham Public Schools.