CENTRAL HIGH HOME PACKET APPLICATION
Receipt # _____________
STUDENT NAME ___________________ HOME PHONE_____________________
ADDRESS__________________________________________________________
P.O. BOX STREET CITY STATE ZIP
AGE____GRADE____STUDENT WK PHO_____________CELL PHONE__________
PARENT NAME____________________WORK PHONE _____________
EMAIL ADDRESS____________________________________________________
HOME HIGH SCHOOL_______________________________________
CLASS REQUESTED (SPECIFIC NAME)___________________________________
DATE BEGAN_____________________ DATE MUST BE COMPLETED_________________
TEXTBOOK NAME___________________________________________________
______________________________________________TEXTBOOK #_________
TEACHER NAME____________________________________PHONE # 359-2337
COUNSELOR SIGNATURE____________________________________
FEE PAID_________________________________
HOME PACKET Guidelines, Rules, and Expectations
1. Home Packet cost $50.00/w refund of $15.00 Madison District Student, $75.00/w refund of $25.00 Out of District Students.
2. You have six weeks to complete this packet. You may extend up to one week without paying extra, but your grade will be cut one
full letter grade. If your packet is due on a Tuesday and you come in the next day, that will count as being one week late. That
means that if your packet is up to a week late and you get a grade of a B+, your grade will be dropped to a C+. If you get a D grade
and are up to a week late, your grade will be dropped to an F. You may extend for two weeks (from your original due date) by
coming into the office BEFORE THE ORIGINAL DUE DATE and paying a $35.00 extension fee. There will be no extensions given
after the original due date, and no extensions beyond the two week period. Your $15.00 or $25.00 deposit will still be given upon
return of intact packet and books, even if beyond the given due dates.
3. Most of the quizzes and tests with your packet are to be taken at home. There is a final test with each packet that must be taken
at school. School hours for tests and turning in packet work are 7:30 to 3:30--Monday through Thursday, or 7:30 to 3:00--Friday.
(That means that you have to be finished with the test by 3:30 [or 3:00 on Friday], not just come in to start it at that time.)
Appointments for the test should be scheduled at least a day prior.
4. Students are encouraged to pick up a home packet. If parents pick up the packet student must contact the teacher with in the first
week. Phone 359-2337. You will need to fill out the necessary paper work and forms while you are here. A counselor signature may
be required; the forms are in their office.
5. You are expected to do your own work. You may ask for help, but should not enlist others (including the Internet) to complete all
or part of assignments for you. Cheating or copying may result in failure of your class.
6. The last day that you can get a home packet for the 2012-2013 school year will be on April 12th, 2013. The last day that you can
turn in work for a home packet grade will be on May 10th, 2013. Please note that you will have less than six weeks (and maybe only
four weeks) to complete any packet picked up after March 29, 2013. There will be NO EXCEPTIONS to these two cut-off dates.
7. Each teacher will include a list of rules and guidelines for each individual home packet. You are responsible for knowing and
following these rules.
8. This packet is the provision for IEP, 504, Special Ed.
I hereby understand and agree to these rules
STUDENT SIGNATURE______________________________________________