Baldwin Middle-Senior High
AP Capstone Diploma Program
2015-2016 Student Application
Application must be postmarked on or before April 15, 2015
Please return completed application and all supporting documents to:
Mr. Jeff Tuccillo, Assistant Principal
291 Mill Street West
Baldwin, FL 32011
PART 1:
Please print in blue or black ink.
Name:_____________________________________________________________________________
Last
First
M.I.
Address:_____________________________City:___________________________ZIP____________
Home phone: ( _ _ _ ) _ _ _ - _ _ _ _
Sex: (Circle one) M
Home phone: ( _ _ _ ) _ _ _ - _ _ _ _
F
Student identification number: ID#:__________________ School Number: _________
2014-15 SCHOOL OF ATTENDANCE: ________________________________2014-15 GRADE LEVEL:____
FCAT scores / levels (most recent): Math:_____________ Reading:________ Writing:_____________
Father’s / Guardian’s Name: ____________________________Phone: work: ____________cell__________
Mother’s / Guardian’s Name: ___________________________ Phone: work: ____________cell__________
Email address: ________________________________________
PART 2:
Please circle the appropriate answer to the questions below:
YES
NO
I am taking or have taken Algebra 1.
YES
NO
I am taking or have taken and passed advanced / honors classes in Duval
County Public Schools.
YES
NO
I understand that the AP Capstone Diploma program hosts summer (up to 2
weeks) and occasional Saturday programs. I understand these programs are
designed to support my academic achievement. I am willing to participate in
these programs.
Admission criteria:



2.0 or above GPA in Language Arts, Mathematics, Social Studies, and Science.
Reading at or above grade level.
Part 3 of the application must be signed by parent and student.
PART 3: Contracts of understanding for students and parents.
Student statement of understanding and commitment:
I understand that my enrollment in the Baldwin’s AP Capstone Diploma program will be an opportunity to achieve up to 18
hours of college credit while completing my high school graduation requirements. This opportunity provides an exciting
challenge for me. I understand that I must focus my energies as a highly motivated student in preparation for and
participation in the college curriculum. I understand that this program is rigorous and demanding. I have read and
understand the policies regarding continuation in the Baldwin’s AP Capstone Diploma program stated below (Part 6). I
also commit myself to be on my best behavior and abide fully by the Duval County Public Schools’ Code of Student
Conduct. I will commit myself to attendance every day and to be on-time to every class. If I do not fulfill these
commitments and abide by the expectations, I understand that I may be counseled about alternative options for high
school attendance.
Student signature:________________________________________
Parent statement of understanding and commitment:
I have read, understand, and support my student’s statement of understanding and commitment above. I also commit
myself to playing an active role in my student’s participation in the Baldwin’s AP Capstone Diploma program. I will attend
parent meetings as scheduled by the school and will commit myself to getting to know my student’s teachers. I have read
the policies regarding continuation (Part 6, below) in the AP Capstone Diploma program and agree to abide by their intent
and purpose. I will be regular and persistent in communicating with my student regarding what they are doing at school
and question them about their academic progress. I understand that if my student does not progress according to the
academic plan by maintaining the required minimum standards, I will be counseled about alternative high school options
for my student.
Parent(s) / Guardian signature(s): ________________________
________________________
PART 4: Please write a paragraph explaining why you want to become part of the AP Capstone Diploma program and
attach to this application.
PART 5:
Performance criteria and continuation requirements for students in the AP Diploma program: All students
must meet the following criteria for continued enrollment and proper progression in the program. If any one of the criteria
is not met, the student will be counseled about alternative options for the completion of high school. The student will have
or complete:
(1) A 2.0 GPA at the end of the ninth and tenth grades;
(2) A “C” or better in both capstone courses;
(3) At least one AP class each year outside of the two AP Capstone courses;
(4) An attempt at a College Placement Test, ACT or SAT, prior to the end of the sophomore year; and
(5) A thesis paper and a presentation of academic performance as a part of the capstone program.
PART 6: Please check each circle below to insure that your application is complete.





All parts of the application are completed.
My written paragraph is attached.
I have signed the student statement of understanding.
My parents/guardians have signed their statement of understanding.
Two teacher recommendations in sealed envelopes are attached.
Once your application is received, it will be reviewed by the selection committee. If your application is approved, you will
receive a notification letter. Please follow all instructions in the notification letter. Contact Mr. Jeff Tuccillo if you need
additional information.