Applicant Name ____________________________________________________
Last Name, First Name
International Baccalaureate
Diploma Program
Student and Parent Application for
Highland High School IB Placement
2166 S. 1700 E. Salt Lake City, Utah 84106
Thank you for your interest in pursuing IB for your high school experience.
Applications must have all of the following items must be attached for consideration:
1. This fully completed Application Form
2. Two transcripts
a. Most current transcript from this school year
b. Final transcript from the previous school year
3. Two paragraphs
a. Student’s written reasons for desiring an IB placement
b. Parent/guardian’s written reasons for desiring an IB placement
4. One signature on reverse of this application
a. Current Mathematics teacher recommending student placement
NOTE:
Applications
accepted
year round.
First Deadline: Thursday,
November
19, 2010
for 2010-2011
school year consideration.
Return
Application
to:year
Highland
High School,
Attentionto:
IB Extended Learning Prake City
Applications
accepted
round.Return
Application
2166 S. 1700 E. School
Salt Lake
City, Utah 84106
istrict
440 East 100 South, Salt Lake City, Utah 84111
Student Name Last, First
Birthdate
Mailing Address
Apt #
City
Current Grade
First Language
State
Current School
GPA
SLCSD Student ID#
Family Email
Alternate Phone
Ethnic/Cultural Heritage
Student Signature
Gender
Current ELP Student: Yes No
For research purposes only, not for selection
Home Phone
Parent/Guardian Name
Zip Code
For research purposes only, not for selection
Relationship to Student
Parent Signature
The Salt Lake City School District does not discriminate on the basis of age, color, disability, national origin, pregnancy, race, religion, or sex in its programs and
activities. The following person has been designated to handle inquires regarding non-discrimination policy: Kathleen Christy, Assistant to the Superintendent,
440 East 100 South, Salt Lake City, Utah 84111, (801)578-8251. You may also contact the Office for Civil Rights, Denver, CO, (303)844-5695.
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Applicant Name ____________________________________________________
Last Name, First Name
International Baccalaureate
Diploma Program
Student and Parent Application for
Highland High School IB Placement
2166 S. 1700 E. Salt Lake City, Utah 84106
Current Teacher Signature Page
Student Last Name, First Name
Birthdate
Dear Teachers of Language Arts and Mathematics:
Dear Teachers of Mathematics:
The above named student is making an application to the International Baccalaureate Program at
West
High School.
Please make
a recommendation
BEST ACADEMIC
PLACEMENT
for at
this
The above
named student
is making
an applicationregarding
to the International
Baccalaureate
Program
student
inHigh
the 2010-2011
school
year,
by circling the recommended
course.
Highland
School. Please
make
a recommendation
regarding BEST
ACADEMIC PLACEMENT for
this student in the 2015-2016 school years, by circling the recommended course.
Your recommendation will not be a factor for acceptance, only placement.
Your recommendation will not be a factor for acceptance, only placement.
Thank you,
IB
Selection
Thank
you, Committee
Highland High School IB Selection Committee
Mathematics:
Secondary Math 1
Secondary Math 1 Honors
Secondary Math 2 Honors
Student should have success in preceding course.
Math Teacher Name
Math Teacher Signature
Date
Highland High IB Information Meetings: December 1, 2011; January 19, 2012, and February 23, 2010
Questions: Please contact Mary Lane Grisley
7:00– PM
IB Director (marylane.grisley@slcschools.org)
Highland High School: 2166 S. 1700 E.
Questions: Please contact, Missy Whiteurs (coordinator) missy.mackay-whiteurs@slcschools.org or 801-484-4343
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