CLA 20-21 Online Application
Enrollment Process
• Complete application to the best of your ability
• CLA staff will contact you to schedule an interview
• Interview with an Administrator (Parent/Guardian and Student must both be present)
• You will be notified via phone of acceptance
• Once Accepted: Complete registration packet
* Required
Email address
*
Your email
Student Name:
*
Your answer
Student Email:
*
Your answer
DPS Student ID#:
*
Your answer
Gender:
*
Your answer
Full Primary Address:
*
Your answer
Parent/Guardian Phone #:
*
Your answer
Student Phone #:
*
Your answer
Parent/Guardian Name:
*
Your answer
Relationship to Student:
*
Your answer
Previous Schools Attended:
*
Your answer
Current Grade:
*
Your answer
Total Number of Credits:
*
Your answer
Age:
*
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Have you ever been expelled from school?
*
Yes
No
If Yes, Explain:
Your answer
Do you have any of the following?
*
Choose
Mentor
Case Manager
Diversion Officer
Probation Officer
Other Service Provider
None
Contact Information for Mentor, Case Manager, Diversion Officer, Probation officer or other.
*
Your answer
Are you currently employed?
*
Yes
No
Currently Looking
Do you have an IEP (Individual Education Plan)?
*
Yes
No
Maybe
Do you have a 504 Plan?
*
Yes
No
Maybe
Are you Gifted and Talented?
*
Yes
No
Maybe
Do you speak more than one language?
*
Yes
No
If yes, what language?
Your answer
What is the primary language spoken at home?
*
Your answer
How did you hear about us?
*
CLA Student
Friend/Relative
DPS School
DPS Transitions
Website
Other:
Current Challenges (Check All that apply.)
*
Truancy
Behavior
Health Issues (Self)
Health Issues (Family Members)
Job Obligations
Unemployment (Family)
Parenting / Child Care
Family Obligations
Homelessness
Legal Issues/Probation/Incarceration (Self)
Incarceration (Family)
Drug/Alcohol Abuse (Self)
Drug/Alcohol Abuse (Family)
Depression
Anxiety
Eating Disorder
Suicidal Thoughts
Self-Inflicted Injury
Gang Involement
None
Other:
Required
Past Challenges (Check All that apply.)
*
Truancy
Behavior
Health Issues (Self)
Health Issues (Family Members)
Job Obligations
Unemployment (Family)
Parenting / Child Care
Family Obligations
Homelessness
Legal Issues/Probation/Incarceration (Self)
Incarceration (Family)
Drug/Alcohol Abuse (Self)
Drug/Alcohol Abuse (Family)
Depression
Anxiety
Eating Disorder
Suicidal Thoughts
Self-Inflicted Injury
Gang Involement
None
Other:
Required
What areas would you like support?
*
Teen Parenting
Gang Involvement
Grief and Loss
Substance Abuse
Anger Management
Social Skills
Self Esteem
Relationships
Peer Pressure
Depression
Anxiety
None
Other:
Required
What academic areas would you like support?
*
Math
Language Arts
Science
Social Studies
Reading
Time Management
Organization
Goal Setting
Employment
None
Other:
Required
Please list your favorite subjects:
*
Your answer
Please list your hobbies:
*
Your answer
Please tell us why you would like to attend Contemporary Learning Academy and why you feel it would be a better fit for you.
*
Your answer
A copy of your responses will be emailed to the address you provided.
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