Palmer AVID Application
2017-2018 School Year

*Please note that students must submit a teacher recommendation form in addition to completing this application. The recommendation can be downloaded from our webiste: http://palmermiddleschoolavid.weebly.com/. Completed recommendations can be delivered to Palmer Middle School or emailed directly by the recommending teacher to Vijay Koilpillai at vijay.koilpillai@cobbk12.org

Student's Last Name
Please capitalize the first letter
Your answer
Student's First Name
Please capitalize the first letter
Your answer
Home Address
Please provide a complete mailing address
Your answer
Current School
Your answer
What grade are you currently in?
Describe your current grades
If you're grades are all A's or all A's and B's, please click "other" and write in your grades
If you have AVID to support you, would you like to be in an advanced class?
If you answered yes to the last question (you want an advance class), which class(es) would you like to be in?
You may list more than one
Your answer
Parent or Legal Guardian Name
Be sure to provide first and last name
Your answer
Preferred Contact Phone Number
Your answer
Email Address - to schedule the student interview
If no email is available, please let us know how best to contact you to schedule the interview
Your answer
Please indicate the highest level of education of Mother (optional)
This information helps with data collection for the AVID program
Please indicate the highest level of education of Father (optional)
This information helps with data collection for the AVID program
Teacher/Counselor/Administrator Recommendation
Please provide the name(s) of at least one person who will complete a recommendation for you. Be sure to provide the recommending adult's email address if you know it
Your answer
AVID Parent and Student Contract
Acknowledgement of AVID Expectations: AVID is an elective class that meets all year long every year of middle school. If students are enrolled in band, orchestra, or chorus in addition to the AVID class, they will take that elective along with AVID for the entire school year. By checking that you agree, the student and parent understand that AVID is an elective program. Students who enroll in the AVID program at Palmer Middle School are making a commitment to remain in the program throughout middle school from the year they enter the program. The AVID curriculum changes each grade level to meet the growing academic needs of students in each grade level, preparing students to meet demands of rigorous coursework and map a plan for success in high school and college. AVID students must maintain a C or better in their coursework, maintain their AVID binder, and prepare and participate in AVID tutorials twice a week in the AVID elective class.
Required
Student Narrative - tell us why you want to be in AVID
In the space below, please write at least ONE LONG PARAGRAPH explaining why you want to be part of AVID and what you expect to get out of the program. Your narrative is your first impression to the AVID Site Team and placement committee. Please respond in COMPLETE SENTENCES and try to include information that tells us about yourself and your goals. While you may ask for your parents or teachers to read over your narrative, we expect that this is your own work and not written by anyone else. We want to get to know who you are and why you believe you have the potential to be an ideal AVID student at Palmer Middle School.
Your answer
Completion of Application
We (parent and student) understand that completing this application does not guarantee placement in the AVID program. All students will undergo a review process of the application, academic progress, school records, recommendations, and interview.
Required
Submit
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