2019 Middle Creek HS Academy Application
Applications to attend the Digital Media Academy or the Engineering & Design Academy at Middle Creek High School will only be processed if the student is assigned to Middle Creek High School.
Thank you for applying for membership into the one of the Middle Creek High School Career Academies. This is a unique opportunity for you to participate in a small, career‐focused, learning community with other students who share many of the same interests.

Please read over all information carefully and enter your information correctly so that the application may be processed.

More information about the Digital Media Academy can be found at http://www.mchsdigitalmedia.com/

More information about the Engineering and Design Academy can be found at http://www.mchsengineeringdesignacademy.com/

Questions can be addressed to
Christina Councill - Academy Coordinator
at ​(984) 212-6237
or by email at ccouncill@wcpss.net.

STUDENT INFORMATION
To which academy are you applying for? *
Student First Name *
Your answer
Student Last Name *
Your answer
Gender *
Ethnicity *
Select all that apply
Required
Date of Birth *
MM
/
DD
/
YYYY
Current School *
Your answer
Expected High School Graduation Year *
Your answer
Student ID Number (if already assigned one)
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Student Phone (Cell) *
Your answer
Student e-mail address *
Your answer
Adult Polo Shirt Size *
Parent / Guardian Information
Parent / Guardian Name *
Please include first and last name.
Your answer
Parent / Guardian Relationship with student *
ie. Mother, Father, Aunt, Grandparent
Your answer
Parent / Guardian e-mail address *
Your answer
Parent / Guardian Phone Number *
Home Number or Cell Number where parent / guardian can be reached.
Your answer
Secondary Parent / Guardian Name *
Please include first and last name.
Your answer
Secondary Parent / Guardian Relationship with student *
ie. Mother, Father, Aunt, Grandparent
Your answer
Secondary e-mail address *
Your answer
Secondary Parent / Guardian Phone Number *
Home Number or Cell Number where parent / guardian can be reached.
Your answer
Supplemental Information
This section should be filled out by ONLY the student applying.
Write a brief paragraph describing yourself and your career goals. Describe why you want to be a part of this academy. Please mention any experiences that you may have relating to the focus of the academy in which you are applying (digital media or engineering). *
Your answer
What would you say is your greatest strength? *
Your answer
Describe one of your weaknesses. *
Your answer
What are two or three words or phrases you would use to describe yourself? Explain your answer. *
Your answer
Which foreign language do you plan to study in high school? *
Recommendations
Two teacher recommendations are required as part of the Career Academy application process.

You must direct these two teachers to this online form to fill out their recommendation:
https://tinyurl.com/mchsacademyteacherrec/

Recommendation #1 - Full Name *
DIGITAL MEDIA APPLICANTS: This recommendation must be a current English teacher. ENGINEERING APPLICANTS: This recommendation must be from a current Science teacher.
Your answer
Recommendation #1 - Job Title *
DIGITAL MEDIA APPLICANTS: This recommendation must be a current English teacher. ENGINEERING APPLICANTS: This recommendation must be from a current Science teacher.
Your answer
Recommendation #1 - e-mail address *
Please verify that a correct email is given for your recommendation.
Your answer
Recommendation #2 - Full Name *
This recommendation may be any current or former teacher, counselor or administrator.
Your answer
Recommendation #2 - Job Title *
This recommendation may be any current or former teacher, counselor or administrator. If recommendation is a teacher please include subject area, i.e. Math Teacher
Your answer
Recommendation #2 - e-mail address *
Please verify that a correct email is given for your recommendation.
Your answer
Have you provided the link to the recommendation form to both of your recommending teachers? https://tinyurl.com/mchsacademyteacherrec/ *
Memorandum of Understanding
Please read carefully. If selected as a member of the Academy program, my parents and I understand that:

* I am making a commitment to the full four (4) years of the program that includes the courses outlined in the curriculum sequence.

* Regular updates may be sent home via email to both the Academy member and parent/guardian. It is necessary for me to have a valid email address on file.

* I must report to Academy activities, off-site/on-site learning experiences, job shadowing, and internship opportunities dressed appropriately in business attire and/or our specified Academy uniform.

* After graduation, I will be expected to fill out a periodic information sheet, keeping the Academy Coordinator updated of my progress.

* I must maintain academic excellence while enrolled in the Academy. This includes striving to maintain a cumulative GPA of a 2.5 at the end of each academic year. Dismissal from the program may result if my GPA falls below this standard. (A performance improvement plan will be completed before being removed)

* All Academy students must successfully complete Academy requirements (course selections, job shadowing, internships, field trips, etc.).

* I fully understand that the 135-hour internship is a district-mandated requirement in order to graduate from the Academy. This will be for academic credit and should be completed the summer between junior and senior year. I understand that I will receive a grade for this requirement as an internship course on my transcript. Failure to complete the internship will result in a failing grade on my high school transcript.

* I understand that by participating in the academy I may not be able to participate in band, chorus, or the AP Capstone Academy, due to scheduling conflicts with Academy course requirements.

* Dismissal from the program may result from continuing disciplinary problems with any teacher or after a suspension (ISS or OSS) from school. A behavior improvement plan will be completed before being removed.

* I will join a Career & Technical Student Organization (CTSO), such as SkillsUSA, during my 4 years in the academy.

* I will be required to pay a non-refundable $50 Academy Fee to cover an Academy Polo shirt, graduation cord, etc. Financial assistance may be available, if needed.

* If I have any questions or problems with regard to any aspect of the Academy program, I can contact the Academy Coordinator, Christina Councill at ​(984) 212-6237 or by email at ccouncill@wcpss.net.

Application Completion and Information
Please submit this online application by March 31st.

Note that these are highly competitive programs and space is limited in each of our academies. We accept up to 24 students into each academy, each year.

Electronic Signatures
Both the student and a parent/guardian must read the following before completing the application. By entering your electronic signatures below, you are agreeing to the following:

* In compliance with federal law, Wake County Public School System administers all education programs, employment activities, and admissions without discrimination against any person on the basis of gender, race, color, religion, national origin, age or disability.

* Applications to attend the either Career Academy at Middle Creek High School will only be processed if the student is assigned to Middle Creek High School.

* Both Middle Creek High School Academies are four (4) year programs that require successful completion of specific courses and several work-based learning experiences, including an internship. These requirements must be met for completion of the Career Academy. Parents and students are in agreement with this application and commit to being a student in the Career Academy for 4 years.

* Placement in a Middle Creek High School Career Academy is a privilege that both students and parents must take seriously. Each Career Academy program relies heavily on parent/guardian participation. Many opportunities will be offered to support these programs such as time, community outreach, committee service, fundraisers, etc. By signing below, you acknowledge that you are aware of the impact that parent participation has on this program and that you will be contacted at various times throughout the four years to provide support.

Parent Signature *
Enter your full name as your signature.
Your answer
Student Signature *
Enter your full name as your signature.
Your answer
THANK YOU!
In compliance with federal law, Wake County Public School System administers all education programs, employment activities and admissions without discrimination against any person on the basis of gender, race, color, religion, national origin, age or disability.
Submit
Never submit passwords through Google Forms.
This form was created inside of Wake County Public School System. Report Abuse - Terms of Service