2023-2024 AEA YEAR 3 STUDENT/FAMILY Applicant Form

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Email *

DPS STUDENT ID#

(If your child attends school in a district other than DPS, type the name of the school district)

Type your (child's) complete FIRST NAME *

Type your (child's) complete LAST NAME *

Type your (child's) PREFERRED NAME (what they like to be called) *

Type your (child's) PREFERRED PRONOUNS *

STUDENT (Your child's) CELL PHONE Number *

STUDENT (Your child's) EMAIL *

My child participated last Summer in the AEA (2023) *

Yes

My child is interested in AEA peer mentorship (at next year's AEA Program - Summer of 2025)

And would like peer mentorship development opportunities throughout the 2024 - 2025 academic school year.

Yes

Please share with us how (your child) identifies

(select all that apply)

Asian/Asian-American

Black/African-American

Bi-racial/multi-racial

Latino/Latina/Latinx

Native Hawaiian or Pacific Islander

Native American/American Indian/Indigenous

White

Other:

Required

Parent/guardian: A portion of your (your child's) day will be spent in community solely with your (your child's) affinity group.

Please select the affinity group you (your child) would like to participate in during the affinity group time

Asian/Asian-American/Pacific Islander (AAPI)

Black/African/African-American

Native American/Indigenous

Latino/a/Latinx

Other:

Select the school name that (your child) currently attends *

Select the grade (your child) will enter FALL of 2024

(School Year 2024 - 2025)

Grade 9

Grade 10

Grade 11

Other:

My child receives 504 or Individualized Education Plan (IEP) services (detailed in Infinite Campus/Parent Portal)

Yes

Other:

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