Admissions Office Virtual Learning Academy Charter School P.O. Box 1050, Exeter, NH 03833 T: 603.778.2500 F: 866.651.5038 guidance@vlacs.org APPLICATION FOR ADMISSION AS A FULL­TIME HIGH SCHOOL STUDENT Instructions: Please complete all sections of this application. If you need this application in another language, please contact guidance@vlacs.org. Print and mail the completed application to: Admissions Virtual Learning Academy Charter School P.O. Box 1050 Exeter, NH 03833 ______ I am applying as a New Hampshire resident. Please proceed to Section I. New Hampshire residents can attend the Virtual Learning Academy Charter School free of charge. As per RSA 193:12, VLACS reserves the right to request proof of residency. ______I do not reside in New Hampshire. Please enclose a non­refundable check for $30 to cover registration fees. Please make the check payable to: Virtual Learning Academy Charter School. Non­resident students who are admitted to the school will be assessed a tuition fee of $460 per half credit, $920 per credit and/or for Advanced Placement courses. Section I. Student Information Last Name__________________________First__________________________ Middle________________ Date of Birth ______/______/______
Gender: Male____ Female____ Place of Birth: City__________________________________ State________ Legal Street Address:___________________________________________________________ City______________________________________________ State________ Zip___________ Mailing Address:______________________________________________________________ City______________________________________________ State_________ Zip__________ Home Telephone Number (______)_______________ Cell Phone_______________________ E­mail Address________________________________________________________________ Section II. Parent/Legal Guardian Information Mother or Legal Guardian: Last Name___________________________First_______________________ Legal Street Address:___________________________________________________________ City______________________________________________ State________ Zip___________ Home Telephone Number___________________________Work/Cell Phone_______________________ Email Address____________________________________Legal Custody of Student Yes_____No_____ Father or Legal Guardian: Last Name__________________________First________________________ Legal Street Address:___________________________________________________________ City______________________________________________ State________ Zip___________ Home Telephone Number___________________________Work/Cell Phone_______________________ Email Address____________________________________Legal Custody of Student Yes_____No_____ Section III. Current School Information School Name___________________________________________________________________ School Address_________________________________________________________________ City_____________________________________________State________Zip_______________ School Telephone Number_______________________Fax Number_______________________ Guidance Counselor__________________________Email Address________________________ Current Grade Level_________Years at present school__________ Is the student currently attending this school? YES ____ NO ____ If NO, when did the student withdraw? ________________________ Have you filed an “intent to home­school” letter? YES ____ NO ____ If the student is under the age of 18 and you choose to withdraw him or her from your local school prior to their acceptance to the full­time program at VLACS, you must submit an “intent to home­school” letter to your local superintendent, principal of a nonpublic school, or the Commissioner of the Department of Education within 5 business days of the official withdrawal from the local public school. Please contact your local SAU if you have any questions. Name of previous school if student has attended current school less than one year: __________________________________________ Section IV. Required Testing Full­time VLACS students shall participate in statewide assessments as required by the Statewide Education Improvement and Assessment Program (RSA 193­C). Full­time students shall also be required to participate in annual standardized assessments as well as certain college and career readiness assessments as required. Section V. Support Services and School Discipline Please answer all questions 1. Does the student have an active Individual Education Plan (IEP) for which he/she receives accommodations? Yes______ No______ 2. Does the student have an active 504 Plan for which he/she receives services? Yes_____No______ 3. Does the student have an existing condition that would affect his/her potential to function at VLACS or in an online environment? Yes______No______ If yes, please explain: Section VI. Student Questions 1.
Why would you like to become a full­time VLACS student? 2.
Describe your strengths as an online learner. How will flexibility and other benefits of becoming a full­time VLACS student support your learning needs? 3.
What do you anticipate will be challenging about learning online versus what you were used to at your previous school? 4.
Think about how you approach your VLACS courses each week. How do you organize yourself and stay on pace? Section VII. PARENT QUESTIONS Please answer the questions below. 1.
Why would you like your child to become a full­time VLACS student? 2.
Describe your child’s academic strengths and weaknesses. 3.
What supports do you anticipate that your child will need from you in order to be successful in an online learning environment? 4.
Will your child have access to a computer and high­speed internet on a regular basis in your home? YES_____NO_____ Section VIII. : Signatures Student Signature___________________________________________________Date_______________ Parent/Guardian Signature___________________________________________Date_______________ NOTE: You are not a full­time student with VLACS until you meet all requirements and are accepted by the VLACS Admissions Committee. If you have any questions, please call 603­778­2500 or email guidance@vlacs.org. THANK YOU!!! Section IX. GRADUATION MAP Below is a summary of the courses that are required to earn a VLACS high school diploma. Please review the courses you have completed at your local school and the courses you have completed at VLACS. Do your best to place them in the area you feel the course best meets in the chart below. You can reference your local school’s program of studies to determine which New Hampshire graduation requirements your courses meet. There is a space below the chart to write any questions you may have about the courses you have completed to date. The admissions counselor will address these questions during your Admissions Plan Meeting. REQUIRED SUBJECTS Art Education Information & Communications Technology (ICT)
English 1 English 2 English 3 English 4 Algebra Geometry Mathematics Elective Physical Science Biology US and NH History US and NH Government
Economics World History Health Education Physical Education Electives Enter an “x” if you met this graduation requirement at your Credits previous school or Required VLACS Write the name of the course(s) you are currently taking next to the corresponding graduation requirement Write the name of the course you completed to meet this graduation requirement 0.5 0.5 1 1 1 1 1 .5 1.5 1 1 1 0.5 0.5 0.5 0.5 1 up to 8 (varies) Dual Enrollment Course 1 Advisory (for each year enrolled (.5 to 2) at VLACS) varies Total credits required 22 N/A N/A N/A Do you have any questions about the courses you listed above or course selection at VLACS? Admissions Office Virtual Learning Academy Charter School P.O. Box 1050, Exeter, NH 03833 T: 603.778.2500 F: 866.651.5038 Transcript Release Form The following student is applying for full­time admission to the Virtual Learning Academy Charter School. This student should remain enrolled in his or her current school program until your school is notified of an admissions decision. The Virtual Learning Academy Charter School is required to obtain written consent from the parent or eligible student before personally identifiable information from a student's education records is disclosed to any party other than those who are permitted access by law. Consent is also required before personally identifiable information is used for any other purpose than to aid in the planning for and provision of appropriate educational services to the student. Parents/Guardian:____________________________________________________________ Student:_____________________________________________________________________ Address:_____________________________________________________________________ Records to be disclosed: [ ] Official academic transcripts
[ ] Grade 11 NECAP test results
[ ] 504 Plan (if applicable) [ ] Individual Education Plan (IEP)(if applicable) [ ] Standardized test results Is the above named student currently expelled from school? YES_____ NO _____ Records to be disclosed by:
School:________________________________________________ Fax #:_________________________________________________ Address:_______________________________________________ ________________________________________________ PARENTS: Please indicate your response to this request by checking the box, which reflects your decision, and then sign the document in the space provided. A copy of the records to be released will be provided to you upon request. Thank you. [ ] I CONSENT to the disclosure of the information as described above within one year of date below. [ ] I DO NOT CONSENT to the disclosure of the information as described above. Parent/Guardian Signature:_____________________________________ Date:________________ Parent/Guardian Printed Name:_______________________________________________________ Admissions Office Virtual Learning Academy Charter School P.O. Box 1050, Exeter, NH 03833 T: 603.778.2500 F: 866.651.5038 ADDITIONAL INFORMATION FOR PERSPECTIVE STUDENTS Attendance Requirements Full­time students must complete 5 credits between July 1st and June 30th each year. Course completion each year is similar to attendance and is mandatory to remain enrolled in the full­time VLACS program. Standardized Testing Requirement All full­time students are required to take a standardized test at regularly scheduled times, including but not limited to, within 30 days of acceptance and prior to graduation. ADMISSIONS TIME TABLE # of COURSES* in Progress *at least one course must be a core academic course (see chart) Approximate time before application review (official time determined during Admissions Plan Review Meeting) 1­2 VLACS courses* 16 weeks or completion of one segment 1­2 VLACS courses* plus courses at local school 8­12 weeks 3­4 VLACS courses* 8­12 weeks Completed one or more core academic courses* To be determined by admissions counselor List of Core Academic Courses ENGLISH English 1 English 2 English 3 English 4 AP English Language and Composition AP English Language and Composition SCIENCE Physical Science Biology MATH Algebra 1 Geometry Algebra 2 or Liberal Arts Math Pre­Calculus AP Calculus AB or AP Calculus BC AP Statistics SOCIAL STUDIES World History US and NH History Economics US and NH Government