PUHSD 2017 FRESHMAN ACADEMY APPLICATION
SUMMER SCHOOL
1. STUDENT SAIS ID NUMBER
LOCATED ON YOUR AZMERIT REPORTS OR SEE YOUR 8TH GRADE TEACHER/SCHOOL FOR THIS NUMBER
Your answer
2. STUDENT LAST NAME
Your answer
3. STUDENT FIRST NAME
Your answer
4. STUDENT DATE OF BIRTH
MM/DD/YYYY
Your answer
5. STUDENT ADDRESS
PLEASE TYPE EXACT ADDRESS - THIS INFORMATION WILL BE USED FOR MAILING INFORMATION TO YOU
Your answer
6. APARTMENT NUMBER
Your answer
7. CITY
8. STATE
9. ZIP CODE
Your answer
10. CURRENT 8TH GRADE SCHOOL DISTRICT
11. 8TH GRADE SCHOOL YOU CURRENTLY ATTEND
Your answer
12. FRESHMAN ACADEMY SITE
Where are you planning to attend summer school? Mark only one.
13. HIGH SCHOOL YOU WILL ATTEND IN THE FALL
What high school will you attend for the 2017-2018 school year?
14. COURSE SELECTION
Which course do you want to take this summer? Select only ONE.
15. LAST NAME OF PARENT/GUARDIAN
Your answer
16. FIRST NAME OF PARENT/GUARDIAN
Your answer
17. PARENT/GUARDIAN PHONE NUMBER
(xxx) xxx-xxxx
Your answer
18. YES, I understand my son/daughter must currently be enrolled to attend a PUHSD school for the Fall of 2017 in order to earn .5 credit
19. YES, I understand the PUHSD Summer School Attendance Policy and if my student misses more than one day of Freshman Academy, he/she may not earn the .5 credit.
20. PARENT/GUARDIAN SIGNATURE:
Entering your name below will serve as an electronic signature giving your child permission to enroll in Freshman Academy 2017.
Your answer
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