Cullman Innovation Academy Application 2018-2019
This form is to be completed by prospective students and their parent/guardian. Once admission is granted, the parent/guardian will receive an enrollment code to complete the enrollment packet online.
Student Information
Student Name
Your answer
Street Address
Your answer
City, State, Zip
Your answer
Student telephone number
Your answer
Student email address
Your answer
Student Primary Language
Your answer
Do you have reliable access to a computer with internet access?
Are you willing to dedicate 30+ hours of active engagement to complete your learning activities and assignments each week?
I am interested in
Are there elective or extra-curricular classes in which you prefer to participate?
Your answer
Will your coursework need to meet NCAA eligibility requirements?
Are you prepared to submit all coursework and assignments as original work completed by you? This means that all work will be completed by you, the student; collaboration will be approved by your instructor; you will not practice plagiarism; you will not allow others to copy your work; and you will not misuse content from the internet.
Do you understand that you will be required to attend on the CHS campus any testing required by the Alabama State Department of Education? Failure to do so could jeopardize your ability to graduate on time.
Academic Background
Current School Name
Your answer
Current Grade Level
How do you think online learning can help you achieve your education goals?
Your answer
Describe an academic or personal challenge and how you approached it.
Your answer
What are you most proud of in life?
Your answer
What are your plans after completing high school?
Your answer
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