Corvallis School District
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Expanded Options Program Application
If you want to participate in the Expanded Options
Program, complete this form and submit it by May 15 to one of the following:
·
Extended Learning Specialist in your school (Kathleen
Muravez at Corvallis High School or Mukta Gupta at Crescent Valley High School)
·
The counseling office in your school.
Student
Name:_____________________ Grade:_____
Address:______________________________________________
Home
Phone:______________ Parent Name(s):____________________________
Parent’s Work Phone:_____________
Student
E-mail:________________________ Parent(s) E-Mail:_________________________ High
School:__________
Student
Cell Phone: ____________________ Parent
Cell Phone: __________________________________________
1.
____ I will be 16 when
school starts in the fall. I will be enrolled at either Corvallis High School
(CHS) or Crescent Valley High School (CVHS) while participating in this
program.
2.
____ I understand that if
student applications exceed the credits available, the district will eliminate
incomplete applications and give priority to students “at risk” and to students
in upper grades.
3.
____ I understand that I
will not be able to take courses similar to those offered at a district high
school without applying for and receiving a waiver from the Coordinator of
Alternative Education.
4.
____ I understand that I
may not exceed 7 credits per year when my high school credits and equivalent
college credits are combined unless I apply for and receive a waiver from the
Coordinator of Alternative Education.
5.
____ I understand that my
parent/guardian and I are responsible for transportation to and from the
college class(es).
6.
____ I understand that I
will not be able to take courses for more than two academic years if I am a
current sophomore OR one academic year if I am a current junior.
7.
____ I did not
participate in the Expanded Options program last year as a senior. I have not received a high school diploma.
8.
____ I am not a foreign
exchange student.
9.
____ I agree to work
towards all state and district requirements for a high school diploma and/or
counselor approved post-secondary educational plans.
10. ____ To continue in Expanded Options, I will attend my college
course(s) regularly and make adequate academic progress in these class(es).
11. ____ I understand that eligible students will first
need to be accepted by Linn Benton Community College, and LBCC has the right to
deny access to any or all of the classes they offer.
12. ____ I understand that the grades I earn in Linn Benton
Community College classes will be posted on my transcript and used to calculate
GPA, class standing, and valedictorian/salutatorian status.
13. ____ I will follow all behavioral and academic
expectations of Linn Benton Community College and all Expanded Options rules
and guidelines identified by the state, district, and high school.
14. ____ I understand that the Corvallis School District
will not pay for unapproved courses.
15. ____ I understand that textbooks provided to me as part
of the Expanded Options program must be sold to the Linn Benton Community
College book store during finals week of the term of enrollment.
16. ____ I understand that, unless I am 18, I will need to
show parent permission in writing to the school prior to enrolling in any
post-secondary course.
17. ____ I understand that I also have access to Advanced
Placement classes and College Now classes to pursue my post-secondary goals and
that the district must pay fees for these programs for at risk students.
18. ____ I authorize the school district to access my
Expanded Options grade reports from the college or university.
19. ____ I agree to review my progress in college classes
with the Extended Learning Specialist in my high school every week during any
term that I am enrolled in Expanded Options.
20. ____ I understand the role of the extended learning
specialist and the counselor in supporting and approving students in this
program.
Please fill in the following
information regarding the courses you are requesting for consideration.
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General
Course Categories (Above and Beyond High School Offerings) |
Preferred
Term if Class Is Available (Fall,
Winter, Spring) |
Relationship
of Course to Post-Secondary Goals |
Estimated #
of Credits |
Counselor
Initial |
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1st choice: |
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2nd choice: |
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3rd choice: |
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4th choice: |
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The counselor has explained
to the student how the course fulfills graduation requirements and how much
high school credit will be awarded for each course.
Student
Signature_____________________________________ Date_____________
Counselor
Approval___________________________________ Date_____________
I
have verified that the student meets the district criteria of at risk:_______________________________
Counselor
Initials
Counselor
Comments:
____________________________________________________________________________________________________________________________________________________________________________________________________
If
you need a waiver to any of the above procedures, see the Extended Learning
Specialist in your school for a form and attach it to this application.
Status
of placement test: _____ _____ _____
UEF