Eagle Academy Application Packet
This application packet is meant to be completed by the STUDENT who is applying to Eagle Academy, not the parent or guardian.
Eagle Academy is designated an Alternative Education Campus (AEC) by the Colorado Department of Education. This designation means 95% or more of our students fall into at least one of the at-risk categories identified by Colorado Statute (SB 09-163). Questions in this application help determine if a student qualifies in one or more of these categories and if they are a good fit to join the Eagle Academy community.

About Eagle Academy
Eagle Academy is Douglas County School District's afternoon/evening high school dedicated to serving the needs of high school students seeking an alternative path to earning a high school diploma. Eagle students attend school Monday through Thursday from 2:30 – 8:30 pm. Smaller class sizes, personalized instruction and a family atmosphere are the hallmarks of the Eagle Academy community that rekindles a student’s desire and passion to learn. To be considered for admission to Eagle Academy, students must be between the ages of 16 and 20 and have attempted at least one year of high school.

Application Process
Eagle Academy accepts new students each quarter on a first come first served basis until 150 student slots are filled.
Students wanting to be placed on the waiting list to attend Eagle Academy must complete and submit the online Eagle Application and have the online Counselor Recommendation completed on their behalf.
If the applicant is on and IEP (Individual Learning Plan), the parent or guardian needs to send a copy of it to our office as soon as possible for review.
Once a completed Student Application and Counselor Recommendation are received, they will be reviewed by Eagle Academy staff and your parent or guardian will be contacted about scheduling a one-on-one meeting with an administrator.
Accepted students and their parent/guardian are required to attend an orientation meeting before the quarter start, to further learn about Eagle and decide if it is the best place for the student.

Last Name *
Your answer
First Name *
Your answer
Middle Name
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Home phone number
Your answer
Student Cell phone number
Your answer
Name of Parent/Guardian *
Your answer
Relationship *
example: mother, stepmother, grandparent, etc.
Your answer
Parent/Guardian cell phone *
Your answer
Parent/Guardian Email *
Your answer
Are you currently employed: *
If yes, where are you employed?
Your answer
Current Supervisor's name
Your answer
Do you have a valid Colorado Driver’s License? *
If yes, what is your Driver's License number?
Your answer
Will you be driving a vehicle to school? *
If yes, what the make, model, color and license plate number of your car?
Your answer
Are you currently attending school? *
Most recent grade attended: *
Most recent High School attended *
If "Other", what is the name, address and phone number of the most recent high school.
Your answer
Your Counselor's name at most recent school
Your answer
Check all High Schools you have attended *
Required
How many high school credits have you earned? *
If you attend a school outside DCSD, please fax, email or bring a copy of your most recent transcript to Eagle Academy.
Your answer
Do you currently receive any special services? Check all those that apply. *
If yes, please fax, email or bring a copy to Eagle Academy.
Required
If yes, who is your case manager?
Your answer
Are you currently enrolled in an online class with a DCSD school? *
If yes, what class(s) and who is your teacher.
Your answer
Evaluate Your Skills: Reading *
Evaluate Your Skills: Writing *
Evaluate Your Skills: Math *
Have you ever been expelled from school? *
If yes, for what reason(s)?
Your answer
Have you ever been suspended from school? *
If yes, for what reason(s)?
Your answer
Do you have multiple in-school or out-of-school suspensions? *
Required
When was the onset of your school behavioral issues? *
Do you have, or ever had, attendance issues? *
excused, unexcused, tardies, missed periods
If yes, for what reason(s) were you absent?
Your answer
Do you have a history of truancy? *
(3 unexcused absences in a month, or 10 unexcused absences in a year)
Required
Have you had contact with any law enforcement agencies in the past 6 months? *
This includes law enforcement agencies outside of Douglas County.
Required
Have you ever been arrested? *
If yes, for what reason(s)?
Your answer
Are you currently on probation? *
If yes, for what reason(s)?
Your answer
Name of Probation Officer
Your answer
Phone number of Probation Officer
Your answer
Do you have a history of substance use/abuse (current or in the past)? *
Required
Is there a history of drug use or abuse in your family? *
Required
Onset of personal drug and/or alcohol involvement? *
Required
Is there a history of violence in your home? *
Required
When was the onset of your school academic issues? *
When was the onset of your truancy issues? *
Do you have a diagnosed psychological or behavioral disorder? *
Required
Have you ever underwent a threat or suicide assessment? *
Required
Have you ever dropped out of school? *
Required
Are you a parent? *
Required
Are you, or have you ever been homeless? *
Required
Have you experienced any grief or loss? *
Ex: loss of a loved one, divorce, abandoned by a parent, adopted
Required
If yes, share a short description of the grief or loss issue(s).
Your answer
Have you experienced a traumatic event? *
major accidents, health problems of a family member, health problems (self), witness to a traumatic event etc.
Required
If yes, share a short description of the traumatic event(s)?
Your answer
Please check any interventions that apply to your background *
Choose all that apply
Required
With whom are you currently living? *
Your answer
How would you describe your relationship with your parents? *
Your answer
Describe a positive high school experience. *
Your answer
Describe a negative experience in high school. *
Your answer
What do you like to do when you are not at school or work? *
Your answer
What else would you like us to know about you? *
Your answer
How did you learn about Eagle Academy? *
Your answer
What do you think you can contribute to our program? *
Your answer
Why do you want a high school diploma? *
Your answer
What do you hope to do after you graduate from high school? *
In a short paragraph, explain why coming to Eagle Academy will allow you to be successful with attaining your life goals. *
Your answer
Type your first and last name here. Your signature indicates that all of the information you have provided in this packet is correct and was completed by you. Any misleading or false information on this form will result in immediate removal from the Eagle Academy waiting list, and/or immediate dismissal from Eagle Academy. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of DCSD. Report Abuse - Terms of Service