Course: Advanced Placement United States History (APUSH)
Instructor: Dr. Nwaosu, Ogueri.
2013-2014 School Year
Course Description
This course is designed to provide a college-level experience and preparation for the AP Exam
that will be given in May 2014. The major emphasis of this course is placed on mastering
significant course topics and information (heavy emphasis is placed on course readings, outlines,
and notes), interpreting documents, and learning how to write critical essays. Moreover, students
should expect daily homework assignments, quizzes, and multiple-choice and essay exams. The
following are the major topics that will be covered in this course:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
M.
N.
O.
Colonial America
American Revolution
The Constitutional Era/Development
Jeffersonian/Jacksonian Democracy
Nineteenth-Century Reform Movements
Manifest Destiny/Sectional Crisis
The Civil War and Reconstruction
Immigration/Industrialization/The Gilded Age
Populism/Progressivism
World War I
The Twenties/The Jazz Age
The Great Depression/The New Deal
World War II
The Cold War/The Vietnam War
The Post-Cold War Era/The United States at the beginning of the twenty-first century
In addition to the aforementioned topics, the College Board has incorporated significant themes
that are essential to a comprehensive study of United States History. The themes will include
both an overview and discussion of American diversity and ethnicity, the origin of the American
identity, the formation of American Culture, demographic changes within the course of American
history, the development of political institutions and the components of citizenship, the role of
religion and its contributing factors on the development of a multicultural society in America,
social reform movements in American history, the United States in a global arena, the United
States and its role in war and diplomacy, and finally, the history and legacy of slavery and its
impact on American society.
TEXTBOOKS
*Gonick, Larry. The Cartoon History of the United States. New York, N.Y.: HarperPerenial, 1991.
Murrin, John M., Johnson, Paul E., McPherson, James E., Gerstle, Gary., Rosenberg, Emily S.,
and Rosenberg, Norman L., Liberty, Equality, Power: A History of the American People
4th edition. Belmont, CA.: Thomas Learning Inc., 2005
*Madaras, Larry., and SoRelle, James M. Taking Sides: American History, Volume I
Eleventh edition. Dubuque, IA.: McGraw-Hill Co Inc., 2005
*Madaras, Larry., and SoRelle, James M. Taking Sides: American History, Volume II
Eleventh edition. Dubuque, IA.: McGraw-Hill Co Inc., 2005
*Newman, John J. and Schmalbach, John M. United States History: Preparing for the Advanced
Placement Examination 2nd edition. New York: AMSCO School Publications, Inc., 2010.
*Zinn, Howard, A People’s History of the United States: 1492-Present, Revised Edition. New
York: HarperPerennial, 2003.
*Zinn, Howard and Arnove Anthony, Voices of a People’s History of the United States. New York:
Seven Stories Press, 2004.
*Supplemental texts used in class
Each unit also utilizes discussions of and writing about related historiography: how interpretations
of events have changed over time, how the issues of one time period had an impact on the
experiences and decisions of subsequent generations, and how such reevaluations of the past
continue to shape the way historians see the world today.
Unit 1: Colonial History to 1763
Required Reading and Assignments:
 Reading and outlining Chapters 2, 3 and 4, in the (Liberty Textbook) and complete study
guide questions and topics on Colonial America.
 Historiography: Were the First Colonists in the Chesapeake Region Ignorant, Lazy, and
Unambitious? Historical Debate between Edmund S. Morgan and Russell R. Menard
Taking Sides: American History: Volume I
 DBQ on Chesapeake and New England Colonies
 Comparison Chart on Chesapeake and New England Colonies
The first four classes of the school year are devoted to an overview period that includes how to
prepare for reading and lecture quizzes, how to prepare and study for multiple-choice exams, and
how to read and analyze documents for the DBQ. Students are presented with large number of
primary documents on Colonial America and class discussions are centered on four major
colonial themes for discussion:
1.
2.
3.
4.
The Salem witch trials
Puritan beliefs and lifestyle
Differences between the Chesapeake and New England Colonies
The African American Experience in Colonial America
As students read various historiographies, students are advised to “think like a historian” and are
introduced to the concepts of categorizing documents, recognizing bias in documents, and
gleaning historical evidence from the documents. Students are then introduced to the process of
historical analysis by having to identify the author’s thesis. An essay interpreting the documents
in context concludes the unit.
Unit 2: The American Revolution (1763-1783)
Required Reading and Assignments:
 Reading and note taking Chapters 5, 6 (Liberty Textbook) and complete study guide
questions and topics
 Historiography: Was the American Revolution a Conservative Movement?
Historical Debate between Carl N. Degler and Gordon s. Wood
Taking Sides: American History Volume I
 Students are to develop a chart outlining the many British Tax Policies imposed on the
colonists by Parliament. (Chart 1)
 Students are to develop a flow chart (with necessary dates) of the Causes of the
American Revolution (Chart 2)
 DBQ on the Causes of the American Revolution
Unit 3: The Republican Experiment (1781-1789)
Required Reading and Assignments:
 Reading and note taking Chapters 7, 8 (Liberty Textbook) and complete study guide
questions and topics
 Primary Document: “Shays Rebellion”
 Comparison Chart on Federalist vs. Antifederalists
 Maps and charts on sources of Federalist and antifederalists support
 DBQ on the Ratification of the Constitution
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
Articles of Confederation/Structure of government under the Articles of Confederation
Weaknesses of the Articles of Confederation
The Constitutional Convention
The Constitution as a “bundle of compromises”
The role of Alexander Hamilton and James Madison
The Debate over ratification of the Constitution
The Federalist Papers

Historiography: Were the Founding Fathers Democratic Reformers?
Historical Debate between John P. Roche and Alfred F. Young
Taking Sides: American History Volume I
Unit 4: The Federalist Era (1788-1800)
Required Reading and Assignment
 Read and Review Chapter 8, Read Chapter 9 (Liberty Textbook) and complete study
guide and topics
 DBQ on the Alien and Sedition Acts
Discussion Topics
1.
2.
3.
4.
5.

Overview of the U.S. Constitution (1787)
Hamilton vs. Jefferson
The rise of political parties
Foreign affairs with Europe (Great Britain, France, and Spain)
“Revolution of 1800
First take-home DBQ: The Growth of Political Parties
Students are to carefully read and analyze all documents for class discussion.
Discussion Question: What led to the rise of political parties in the 1790’s?
Unit 5: Republicans in Power (1801-1828)
Required Reading and Assignments:
 Read Chapter 10 (Liberty Textbook) and complete study guide questions and topics
Discussion Topics
1.
2.
3.
4.
5.
Jefferson belief system and style of leadership
Causes and Effects of the War of 1812
The events that led to the demise of the Federalist Party
Jefferson as a strict constructionist
Early industrial advancements in America

Historiography: Was President Thomas Jefferson a Political Compromiser?
Historical Debate between Morton Borden and Forrest McDonald
Taking Sides: American History Volume I
DBQ on the War of 1812
Historiography for Class Discussion: Was the Monroe Doctrine of 1823 a WellDesigned Policy to Protect Latin American Countries from European Intervention?
Historical Debate between Dexter Perkins and Ernest R. May
Taking Sides: American History Volume I
*Students should take notes in order to prepare for class discussion


Unit 6: The Jacksonian Era (1828-1840)
Required Reading and Assignments:
 Read Chapters 11, 12 (Liberty Textbook) and complete study guide questions and topics
 Historiography: Was Andrew Jackson’s Indian Removal Policy Motivated by
Humanitarian Impulses?
Historical Debate between Robert V. Remini and Anthony F.C. Wallace
Taking Sides: American History Volume I
 DBQ on the “Jacksonian Democracy”
 Second take-home DBQ the College Board’s 1990 Jackson DBQ
 Comparison Chart: Jeffersonian Democracy vs. Jacksonian Democracy
Discussion Topics
1.
2.
3.
4.
5.
Democracy and the “rise of the common man”
Jackson vs. Calhoun
Jackson’s view on Nullification
Jackson’s war of the bank
Who were the Whigs
Unit 7: Manifest Destiny and the Mexican War
Required Reading and Assignments:
 Read Chapter 13 (Liberty Textbook) and complete study guide questions and topics
 DBQ : The Causes of the Mexican-American War
 Map Activity: Westward Migration and the United States after the Mexican-American War
Historiography: Was the Mexican War an Exercise in American Imperialism
Historical Debate between Rodolfo Acuna and Norman A. Graebner
Taking Sides: American History Volume I
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
President Polk and ‘Manifest Destiny”
“Go West Young Man”
Polk and war with Mexico
The Lure of the West
Texas, New Mexico, Utah, and Oregon
Treaty of Guadalupe Hidalgo
Comparison of the Missouri Compromise and the Compromise of 1850
Unit 8: The Slave System and the Coming of the Civil War
Required Reading and Assignment:
 Read and take notes Chapter 14, 15 (Liberty Textbook) and complete study guide
questions and topics
 Historiography: Did Slavery Destroy the Black Family?
Historical Debate between Wilma A Dunaway and Eugene D. Genovese
Taking Sides: American History Volume I
 Secondary- source readings on slavery and abolition: Historical Text, From Slavery to
Freedom: A History of African-Americans in the United States, Author: John Hope
Franklin
 DBQ: The College Board’s 1987 Prelude to Civil War
 Comparison Chart: What were the differences between the Antebellum North and
Antebellum South
Discussion Topics:
1.
2.
3.
4.
5.
6.
Peculiar Institution
Abolitionism
Free Soil Movement
Key Compromises and Agreements: Missouri Compromise, Wilmot Proviso,
Compromise of 1850, Kansas-Nebraska Act
Lincoln and the New Republican Party
The South’s threat of secession
Unit 9: The Civil War and Reconstruction (1861-1877)
Required Reading and Assignment:
 Read and take notes Chapter 16, 17 (Liberty Textbook) and complete study guide
questions and topics
 Flow Chart/Timeline on the Causes of the Civil War. Students should make a list of the
major causes leading up to the Civil War. (Dates should be included)
 DBQ: What caused secession?
 Historiography: Have Historians Overemphasized the Slavery Issue as a Cause of the
Civil War?
Historical Debate between Joel H. Silbey and Michael F. Holt
Taking Sides: American History Volume I
 Comparison Chart: Advantages/Disadvantages of Union and Confederacy
Discussion Topics:
1.
2.
3.
4.
5.
6.
President Lincoln vs. President Davis
Emancipation Proclamation
The end of the Civil War/Effects of the Civil War
Lincoln Plan for Reconstruction/Radical Reconstruction
The Sharecropping System
The Compromise of 1877
First in-class non-DBQ free-response essay: Students are given topics to research over a one
week period and will be asked to answer an essay question based on one of the topics.
The topics will be taken from the Antebellum Era and Civil War/Reconstruction Units. Students
will be expected to research the following topics:
 Slavery and Abolitionism during the Antebellum Era
 Specific events of the 1850s and 1860s
 The Freedmen’s Bureau
 The Ku Klux Klan
 W.E.B. Du Bois vs. Booker T. Washington
 Historiography for Class Discussion: Was Reconstruction a “Splendid Failure”?
Historical Debate between Eric Foner and La Wanda Cox
Taking Sides: American History Volume I
*Students should take notes on reading in order to prepare for class discussion
Unit 10: The Gilded Age (1865-1900)
Required Reading and Assignments:
 Read and take notes Chapters 18, 19, and 20 (Liberty Textbook) and complete study
guide questions and topics
 Historiography for Class Discussion: Was John D. Rockefeller a “Robber Baron”?
Historical Debate between Matthew Josephson and Ron Chernow
Taking Sides: American History Volume II
*Students should take notes on reading in order to prepare for class discussion
 DBQ: The College Board’s DBQ: The Federal Government and Laissez-Faire
 Historiography: Did William M. Tweed Corrupt Post-Civil War New York?
Historical Debate between Alexander B. Callow Jr. and Leo Hershkowitz
Taking Sides: American History Volume II
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
8.
Laissez-Faire Politics during the Gilded Age
The Effects of Urbanization and Immigration
Exploitation of workers and immigrants
The Rise of the “Robber Baron”
The Social Gospel vs. Gospel of Wealth
Populism
Politics of the 1890s
Political Machines/Political Bosses
Unit 11: The Progressive Era (1900-1917)
Required Reading:
 Read and take notes Chapter 21 (Liberty Textbook) and complete study guide questions
and topics
 Chart of Progressive Reforms in the following categories: Political, Economic, Social
 Comparison Chart: Populist Reforms and Progressive Reforms (Students should
examine the similarities between these two reform movements)
 DBQ: College Board’s (1983) DBQ: The Populists
 Historiography: Did the Progressives Fail?
Historical Debate between Richard M. Abrams and Arthur S. Link
Taking Sides: American History Volume II
Discussion Topics:
1.
2.
Who were the Progressives?
Muckrakers
3.
4.
5.
6.
The Square Deal (Theodore Roosevelt)
“Trustbusting” (Defined)
The New Freedom (Woodrow Wilson)
Major Accomplishments of the Progressive Presidents: Theodore Roosevelt, William H. Taft, and
Woodrow Wilson
Unit 12: Foreign Policy (1898-1920)
Required Reading and Assignments:
 Read and take notes Chapters 22, 23 (Liberty Textbook) and complete study guide
questions and topics
 Fourth take-home DBQ: The Debate Over American Imperialism
 Historiography: Did Yellow Journalism Cause the Spanish-American War?
Historical Debate between W.A Swanberg and David Nasaw
Taking Sides: American History Volume II
 In-class DBQ: Why Did the United States Enter World War I (Timed DBQ-40 Minutes)
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
8.
American Imperialist Arguments
“Remember the Maine”
The effects of the Spanish-American War
The Roosevelt Corollary
The Panama Canal
Dollar Diplomacy
American Neutrality (1914-1917)
The Treaty of Versailles
Unit 13: The Roaring Twenties
Required Reading and Assignments:
 Read and take notes Chapter 24 (Liberty Textbook) and complete study guide questions
and topics
 Class discussion: The issue of “Sacco and Vanzetti” and American Diversity.
Historiography: Was Prohibition a Failure?
Historical Debate between David E. Kyvig and J.C Burnham
Taking Sides: American History Volume II
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
The Presidential Administrations of Harding, Coolidge, and Hoover
The Red Scare
New Immigration Laws
Ku Klux Klan
Harlem Renaissance
The Stock Market Crash
Major Causes of Great Depression
Unit 14: The Great Depression (1929-1940)
Required Reading and Assignments:
 Read and take notes Chapter 25 (Liberty Textbook) and complete study guide questions
and topics
 Chart on the New Deal Programs divided into three categories: Relief, Recovery, Reform
 Twelve readings from the Golden Owl Publishing Company’s Jackdaw entitled “The New
Deal”, which include all six essays on various aspects of the Depression and New Deal.
 DBQ: In-class DBQ using the documents and question from the 1984 AP Exam which
asked students to characterize FDR and Hoover in terms of the labels of “liberal” and
“conservative”.
 Historiography: Did the New Deal Prolong the Great Depression?
Historical Debate between Jim Powell and Roger Biles
Taking Sides: American History Volume II
Discussion Topics:
1.
2.
The Causes and Effects of the Great Depression
Hoover’s “Rugged Individualism”
3.
4.
5.
Franklin Roosevelt and the Hundred Day’s
Critics of the New Deal
Franklin Roosevelt’s “Courtpacking” Plan
Unit 15: America During the Second World War
Required Reading and Assignments:
 Read and take notes Chapter 26 (Liberty Textbook) and complete study guide questions
and topics
 Historiography: Did President Roosevelt Deliberately Withhold Information About the
Attack on Pearl Harbor from the American Commanders?
Historical Debate between Robert A. Theobald and Roberta Wohlstetter
Taking Sides: American History Volume II
 DBQ: In-class DBQ using the documents and question from the 1988 AP Exam which
asked students to analyze the U.S. decision to drop the atomic bomb on Japan.
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
8.
9.
Failure of American Isolationism
American Neutrality
Lend-Lease Act/Cash and Carry Act
Pearl Harbor
War on the home front
European/Pacific Theater
U.S. policy in Europe, Latin America, and Asia during the 1920s and 1930s
Turning Point Battle in the Pacific
The decision to drop the Atomic Bomb
Unit 16: Presidents: Truman, Eisenhower, and JFK
Required Reading and Assignments:
 Read and take notes Chapter 27 (Liberty Textbook) and complete study guide questions
and topics
 Free Response Essay on review topics. Topics include: The Great Depression, The New
Deal, American Isolationism and Neutrality, the U.S. in World War II
 Historiography: Did Communism Threaten America’s Internal Security After World War II
Historical Debate between John Earl Haynes and Harvey Klehr and Richard M. Fried
Taking Sides: American History Volume II
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Cold War in Europe
Policy of Containment
Truman Doctrine/Eisenhower Doctrine
Marshall Plan
NATO
Crisis in Berlin
The loss of China to the Communists
The Korean War
The policies of John Foster Dulles
McCarthyism
JFK and ‘Flexible Response”
The Cuban Missile Crisis
Unit 17: The Fair Deal to the Great Society
Required Reading and Assignments:
 Read and take notes Chapter 28 (Liberty Textbook) and complete study guide questions
and topics
 DBQ: The Civil Rights Movement
 Historiography: Did the Brown Decision Fail to Desegregate and Improve the Status of
African Americans?
Historical Debate between Peter Irons and Richard Kluger
Taking Sides: American History Volume II
Discussion Topics:
1.
2.
3.
4.
5.
The rise of the suburbs
The policies of the New Frontier
The Warren Court
The Civil Rights Struggle in the 1950s and 1960s
The policies of the Great Society
Unit 18: The Vietnam War and Watergate-Protest and Turmoil
Required Reading
 Read and take notes Chapter 29 (Liberty Textbook) and complete study guide questions
and topics
 In-class practice DBQ using the DBQ from the May 1995 AP Exam to review the past two
units.
 Historiography: Was the Americanization of the War in Vietnam Inevitable?
Historical Debate between Brian VanDeMark and H.R. McMaster
Taking Sides: American History Volume II
Discussion Topics:
1.
2.
3.
4.
5.
6.
7.
8.
9.
The U.S. escalation in Vietnam
Tet Offensive
Student Protests in the 1960s
Black Power Movement/Women’s Lib Movement
President Johnson’s Final Days in office
Election of 1968
Policies of Nixon and Kissinger
Watergate Break-in
Nixon’s Resignation
Unit 19: Ford, and Carter in the Seventies
Required Reading:
 Read and take notes Chapter 30, 31 (Liberty Textbook) and complete study guide
questions and topics
Discussion Topics:
1.
2.
3.
4.
5.
6.
OPEC and the Oil Crisis
Inflation/Stagflation
Policies of Affirmative Action
ERA Movement
The election 1976
Cold War Issues
Unit 20: A 10-Day Review for the AP U.S. History Exam
The aspects of the review period are the assignment of three or four chapters per night for review
and a number of quizzes made up of selected questions taken from previous AP multiple-choice
questions. During these final days of review, students have an opportunity to practice writing
both free-response and document based questions as well as gain clarity on key time periods in
American History.
END
APUSH Binder Sections
1. Lecture Notes (Any
notes taken in class)
2. Reading Journal (Levels
of Questions, Outlines,
and Subheadings)
3. Article & Debate Review
4. Quizzes & Exams
5. Miscellaneous (Maps,
Projects, Grade Reports,
etc.)
END 2
Binder Sections
1. Notes
2. Outlines
3. Classwork
4. Quizzes &
Exams
5. Miscellaneous
END 3 C
US History Syllabus—2013-2014
Dr. Nwaosu—Room H12
Tutoring Hours: Monday through Thursday from 7:15am-7:50am
Email: otn6325@lausd.net
 Course Description:
Students will examine some of the major themes in American history in the twentieth
century and its impact on other parts of the world. They will study the developments in
immigration; causes and effects of various wars; the impact of labor and the economy;
and various political and social movements and their impact in the US. Students should
expect daily homework assignments, quizzes, and multiple-choice and short answer
exams. In addition, students will conduct research pertaining to the themes mentioned
above and create projects that are presented in class. This course will also focus on the
geography of the United States. Whenever possible, documentaries and film will be used
to enhance students learning.
 Textbooks:
Clayton, Andrew, Perry, Elisabeth Israels, Reed, Linda, and Winkler, Allan M. America:
Pathways to the Present. Boston: Prentice Hall, 2007.
Zinn, Howard. A People’s History of the United States, Volume II: The Civil War to the
Present, Abridged Teaching Addition. New York: The New Press, 2003.
 Major Themes Covered:
 First Semester:
1. Causes and Effects of War on the US and the World
2. Causes and Effects of Immigration on the US and the World
 Second Semester:
1. Causes and Effects of Labor and Economy on the US and the World
2. Causes and Effects of Political and Social Movements on the US and the World
 Rules, Procedures, Materials, and Policies:
Dear Parent(s) or Guardian(s),
Welcome to the 2013-2014 school year. I will be instructing your child in US History this
year. In order to guarantee your child the excellent educational climate they deserve, I
have developed a classroom management plan that will be in effect at all times.
When in my class, students must comply with the following RULES:
1. BE RESPECTFUL
2. BE RESPONSIBLE
If a student breaks a rule, the following consequences will occur:
1. Warning
2. Loss of participation points
3. Call home
4. Referral to office
 MATERIAL(S) Required:
1. One (1) 1-inch (BIG) 3-ring binder with dividers (1 pack)
 ATTENDANCE:
1. A student will be marked tardy if he/she is not inside the room when the bell
rings.
2. After returning from an absence you have one additional day per day missed to
turn in late assignments. Failure to turn in assignments will result in a zero. It is
the student’s responsibility to find out assignments missed during an
absence, by consulting me and my webpage on the Foshay website
(foshaylc.org) or via email at mrjohnsonaof@gmail.com.
3. Unexcused absences will result in the assessment of late penalties.
 GRADING:
1. There are no make-up exams. You must show up on exam day.
2. All work from a unit of study is due on the day of the unit exam. No work will be
accepted after this day.
3. Students grades will be shown to them periodically, however, a student may
request to see his/her grade any time before or after class.
4. Grades on late work will be lowered ONE GRADE for each day the assignment
is late, up to 50%.
5. Any student caught cheating (including copying or plagiarism) will receive a zero
on that assignment/exam.
6. Extra credit opportunities will be offered during all units. The student may create
his/her own assignment at any time as long as he/she gets teacher approval before
beginning. Extra credit is limited to one assignment per student per week AND
WILL NOT REPLACE ANY TEST/EXAM.
7. Each unit will have a participation grade added to it.
8. Binder checks will be performed periodically for a participation grade. Therefore,
binders need to be kept organized and up-to-date regularly.
Grading Categories:
Grading Scale:
Quizzes/Exams

30%
90 – 100% = A
Projects & Presentations
25%
80 -- 89% = B
Classwork

20%
70 -- 79% = C
Homework

10%
55 -- 69% = D
Class Participation

15%
0 -- 54% = F
 HOMEWORK:
1.
Homework is assigned on a daily basis: usually to review notes taken inclass; read textbook; outline assigned chapter/section; and/or study for
exam/quiz.
2. Homework is listed in a daily basis on the Foshay website
(www.foshaylc.org) under my name and class. (Check regularly)
Included in my discipline plan are ways to positively reinforce students who behave
appropriately. In addition to using frequent praise, I will reward students with
participation points for those individuals that contribute positively to the classroom
atmosphere. These points are a great opportunity for every student to improve his/her
class grade.
In order for your child to understand the goals and objectives of this class, his/her first
homework assignment is to review the content standards for this class on the California
Department of Education’s website (www.cde.ca.gov) . On this website, click on
Standards and Frameworks. Then click on Content Standards. Click on the content
standards for History-Social Science. Finally, click on your grade level and review
them.
In order for this plan to have the greatest effect, I need your support. Please discuss this
letter with your child. If you have any questions for me please contact me at school (323)
373-2700 or by email at mrjohnsonaof@gmail.com with the Class Name,period, and
student name.
Thank you for your cooperation. I look forward to a productive and mutually beneficial
school year working with you and your child. Please fill out the tear-off below to
acknowledge receipt of this letter and so that I may be able to update you of any future
changes.
Sincerely,
Mr. Johnson
-----------------------------------------------------------------------------------------------------------*Please complete and return this form to Mr. Johnson—Period 2*
______________________________
Parent Name (Print)
______________________________
Student Name (Print)
______________________________
Parent Signature
______________________________
Student Signature
Home Address with City and Zip Code
______________________________
Home Phone #
______________________________
Cell Phone # &/or Work Phone #
______________________________
Parent Email Address
______________________________
Student Email Address END
END