Application for the Academy

801 Discovery Boulevard ~ Shelbyville, KY 40065 ~ 502-647-1160 (phone) ~ 502-647-1161 (fax) John R. Leeper II, Principal ~ Donna Jones, Associate Principal Angie Deckard, Assistant Principal ~ Chris Young, Assistant Principal

2015-2016 MLCHS Accelerated Academy Application Personal Information: Applicant’s Name: ___________________________________________________ Address: ______________________ City: ________________ Zip: ____________ Parent’s Name: _____________________________________________________ Parent’s Email: _____________________________________________________ Applicant’s Email: ___________________________________________________ Home Phone: _______________________ Cell Phone: _______________________ Career Pathway: __________________________

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Spanish: ____ OR French: ____

Application Part One: Essays Please attach essays on separate pages. Both essays 1 and 2 are required and are to be typed in Times New Roman, 12 pt. font, double-spaced, and within the 500-750 word range for each essay. 1. Explain why you want to be a member of this program and how this opportunity fits your college and career goals. How will your inclusion in the academy help you become a more productive member of society? What specific qualities do you have that would enrich the academy environment? 2. The MLCHS Accelerated Academy seeks candidates who will be role models to their peers. This includes a commitment to volunteerism. Explain what course of action you will take in order to earn your annual 40 hours of volunteer/ service learning/ humanitarian work. What positive impact do you seek to have as a result? Application Part Two: Teacher Recommendation A teacher recommendation is to be completed on the attached form. The teacher must be one of your 8th grade core content teachers (Math, Science, Social Studies, or English). Recommendation forms must be filled out by the teacher and submitted directly to Ms. Greenwell in the Guidance Office.

801 Discovery Boulevard ~ Shelbyville, KY 40065 ~ 502-647-1160 (phone) ~ 502-647-1161 (fax) John R. Leeper II, Principal ~ Donna Jones, Associate Principal Angie Deckard, Assistant Principal ~ Chris Young, Assistant Principal

Teacher Recommendation Form Teacher Name: ______________________________________________________________ Subject Taught: ____________________________ Student Name: ______________________________________________________________

Please check the number that represents your experiences with this student as related to the qualities listed below. 5 will represent the highest score and 1 represents the lowest score. Participation in class discussions/on task behavior in class

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2

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5

Self-discipline, responsibility, and dedication to follow through Motivation, initiative, and self-starting ability

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5

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5

Cooperation, social, and emotional maturity

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5

Academic integrity and honesty

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Consideration and attitudes toward others

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Contributing member of the school community

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In regards to academics, what are the greatest strengths and weaknesses of this student?

801 Discovery Boulevard ~ Shelbyville, KY 40065 ~ 502-647-1160 (phone) ~ 502-647-1161 (fax) John R. Leeper II, Principal ~ Donna Jones, Associate Principal Angie Deckard, Assistant Principal ~ Chris Young, Assistant Principal

Parent Statement of Commitment and Interest: I understand and agree that if my son/daughter is accepted into the fifth cohort of the Martha Layne Collins Accelerated Academy, that I will ensure the regular participation of my child in all classes and coursework, for each of the four school years. I further realize that my child must maintain high attendance, plus high levels of academic and behavioral success to earn each additional year of participation within the Martha Layne Collins High School Accelerated Academy.

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Parent Signature

Date

Application Materials Checklist:

______ Personal Information _______ Essays 1 and 2 _______ Teacher Recommendation _______ Parent Statement of Commitment and Interest

*Grades, attendance, and behavior will also be considered. School will provide this information with each student’s application.