Summer School 2015 Registration Form

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Summer School 2015 Registration Form

Location: Darby High School, 4200 Leppert Road

Phone: (614) 921-7300

Dates: Session I: June 3– June 19; Session II: June 22-July 9 (no class July 3)

Times: 7:30 am—12:10 pm

SECTION I. STUDENT INFORMATION

2014-15 Grade Level

Student Name _____________________________________________________ Student I.D. #

Address City , OHIO Zip

Home Phone _________________ Work Phone _______________ Emergency Phone E-Mail

Circle One - Home School:

Darby Bradley Davidson Not enrolled in Hilliard Schools

(for 2014-15 school year) Name of School

SECTION II. COURSE REGISTRATION (Please refer to the Summer School Program of Studies)

**On the following page, please check course and session desired for both sessions. Please complete selections that are your first choice and your second choice for registration. If summer school classes are filled for your first selection, you will be placed into your second selection.**

A minimum enrollment of 15 students is required for an academic class to be offered.

Circle One — Course is taken as:

Enrichment Grade Replacement* Remediation

*If course is taken for Grade Replacement, please complete the accompanying “request to repeat a course.”

Signature of Guidance Counselor*

*Guidance Counselor signature is not required for PE 1, PE 2 , Health or ICT 21 registration though a guidance consultation is recommended.

Signature of Student _______________________

Signature of Parent _________________________________

Does your child have an Individual Education Plan (IEP)? _ Yes _ No

NOTE to Students Not Enrolled in Hilliard City Schools:

Students who do not attend Hilliard City Schools during the school year will need to pay the additional costs for Hilliard City Schools Summer School as outlined on the next page. Further, Hilliard City Schools does not guarantee credit for courses offered to these students. This can only be done by the school district that the student attends. The student/parent needs to consult their home school guidance counselor before signing up for Hilliard City Schools’ summer courses to establish credit guidelines for these courses.

All registrations include a $50 non-refundable processing fee. Mail registrations to: Summer School Registration, Hilliard City Schools, 4200 Leppert Road, Hilliard, OH 43026. Registrations will not be accepted at the schools. Full payment, including any class fees, must be received with the registration, payable to Hilliard City Schools. Master Card and Visa will be accepted for payment when registering at Hilliard Darby High School located at 4200 Leppert Road. Registration hours are Monday-Friday, 9:00 a.m.-3:00 p.m.

Questions? Contact your guidance counselor, or Joyce Brickley @ 921-7300 or email: [email protected].

Attendance Policy: Summer school attendance is extremely important and relates directly to credits earned

to-wards graduation.

 One absence per session is allowed.

 Attendance is mandatory on the last day of class each session, as there will be a final examination.

 Three tardies are equal to one absence.

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Tuition & Fees

Please select classes and fee for which you are registering.

Some of our classes have fees. Fees are due at the time of registration.

2014 Summer School Course Offerings Students not enrolled

Circle I or II inHilliard City Schools Class Session Course Credit Class Early Tuition Tuition may register

Offered # Fee (by 5/2) (after 5/5) (after 5/22/14)

_____ ICT21 I & II *15SS01/02 .50 7.00 245 270 375 _____ Algebra 1 Both 50SS10 1.00 10.00 345 370 475 _____ Geometry Both 50SS20 1.00 345 370 475 _____ Physical Ed 1 I & II *45SS11/12 .25 245 270 375 _____ Physical Ed 2 I & II *45SS21/22 .25 245 270 375 _____ Health 10 I 45SS10 .50 245 270 375

_____ English 9A (online) I 30OL01 .50 245 270 375

_____ English 9B (online) II 30OL03 .50 100 100 100

_____ British Literature 1 (online) I 30OL72 .50 245 270 375

_____ British Literature 2 (online) II 30OL74 .50 100 100 100

_____ Contemporary Literature (online) I 30OL04 .50 245 270 375

_____ Media Awareness (online) I 30OL02 .50 245 270 375

_____ Algebra 2 (online) Both 50OL06 1.00 345 370 475

_____ Geo & Alg Conn 1A (online) I 50OL17 .50 10.00 245 270 375

_____ Geo & Alg Conn 1B (online) II 50OL27 .50 100 100 100

_____ Geo & Alg Conn 2A(online) I 50OL18 .50 10.00 245 270 375

_____ Geo & Alg Conn 2B(online) II 50OL28 .50 100 100 100

_____ Science 9 A (online) I 55OL51 .50 11.50 245 270 375

_____ Science 9 B (online) I 55OL52 .50 11.50 245 270 375

_____ Environmental Sc (online) I 55OL53 .50 7.00 245 270 375

_____ Freshwater & Marine Ecosystems (online) I 55OL54 .50 16.00 245 270 375

_____ U S History I (online) I 60OL71 .50 245 270 375

_____ U S History II (online) I 60OL72 .50 100 100 100

_____ U S Government (online) I 60OL73 .50 245 270 375

_____ Economics (online) I 60OL74 .50 5.00 245 270 375

_____ World Studies 1 (online) I 60OL70 .50 245 270 375

_____ World Studies 2 (online) I 60OL70 .50 100 100 100

______Biology A (online) I 55OL08 .50 245 270 375

______Biology B (online) II 55OL09 .50 100 100 100

______Personal Decisions (online) I 35OL05 .50 245 270 375

______Careers/Money Mgmt.(online) I 35OL01 .50 245 270 375

*Indicates first and second session course codes.

OGT Registration - See Page 3.

Note to students not enrolled in Hilliard Schools

: Students registering for Summer School will not be enrolled without a parent’s signa-ture acknowledging the information below: Hilliard City Schools does not assume any responsibility for class credit not accepted by your home district or school. Parent/Guardian Signature

Tuition & Fees

Please select classes and fee for which you are registering.

Some of our classes have fees. Fees are due at the time of registration. 2015 Summer School Course Offerings Students not enrolled Circle I or II in Hilliard City Schools Class Session Course Credit Class Early Tuition Tuition may register after Offered # Fee (by 5/1) (after 5/4) 5/22/15 _____ ICT21 I & II *15SS01/02 .50 7.00 245 270 375 _____ ICT21 (online) I 15OL01 .50 7.00 245 270 375 _____ Algebra 1 Both 50SS10 1.00 10.00 345 370 475 _____ Geometry Both 50SS20 1.00 345 370 475 _____ Physical Ed 1 I & II *45SS11/12 .25 245 270 375 _____ Physical Ed 2 I & II *45SS21/22 .25 245 270 375 _____ Health 10 I 45SS10 .50 245 270 375 _____ English 9A (online) I 30OL01 .50 245 270 375 _____ English 9B (online) II 30OL03 .50 100 100 100 _____ English 10A (online) I 30OL05 .50 245 270 375 _____ English 10B (online) II 30OL06 .50 100 100 100 _____ English 11A (online) I 30OL45 .50 245 270 375 _____ English 11B (online) II 30OL46 .50 100 100 100 _____ British Literature 1 (online) I 30OL72 .50 245 270 375 _____ British Literature 2 (online) II 30OL74 .50 100 100 100 _____ Contemporary Literature I 30OL04 .50 245 270 375 (online) _____ Media Awareness (online) I 30OL02 .50 245 270 375 _____ Algebra 2 (online) Both 50OL06 1.00 345 370 475 _____ Geo & Alg Conn 1A (online) I 50OL17 .50 10.00 245 270 375 _____ Geo & Alg Conn 1B (online) II 50OL27 .50 100 100 100 _____ Geo & Alg Conn 2A (online) I 50OL18 .50 10.00 245 270 375 _____ Geo & Alg Conn 2B (online) II 50OL28 .50 100 100 100 _____ Science 9 A (online) I 55OL51 .50 11.50 245 270 375 _____ Science 9 B (online) I 55OL52 .50 11.50 245 270 375 _____ Environmental Sc (online) I 55OL53 .50 7.00 245 270 375 _____ Freshwater & Marine Ecosystems (online) I 55OL54 .50 16.00 245 270 375 _____ U S History I (online) I 60OL71 .50 245 270 375 _____ U S History II (online) I 60OL72 .50 100 100 100 _____ U S Government I (online) I 60OL73 .50 245 270 375 _____ U S Government II (online) I .50 245 270 375 _____ Economics (online) I 60OL74 .50 5.00 245 270 375 _____ World Studies 1 (online) I 60OL70 .50 245 270 375 _____ World Studies 2 (online) I 60OL70 .50 100 100 100 ______Biology A (online) I 55OL08 .50 245 270 375

______Biology B (online) II 55OL09 .50 100 100 100

______Personal Decisions (online) I 35OL05 .50 245 270 375

______Careers/Money Mgmt.(online) I 35OL01 .50 245 270 375 *Indicates first and second session course codes.

OGT Registration - See Page 3.

Students taking online courses are required to meet on the first and last day of the course and possibly other dates as determined by the teach-er for that course. Students will receive a schedule of the required dates on the first day of class.

Note to students not enrolled in Hilliard Schools: Students registering for Summer School will not be enrolled without a parent’s signature ac-knowledging the information below:

Hilliard City Schools does not assume any responsibility for class credit not accepted by your home district or school.

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Summer School 2015 Registration Form

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OGT Registration, Grades 10-12:

Students not enrolled in

HCSD may Early Tuition Tuition register after (by 5/1) (after 5/4) 5/22/15

Ohio Graduation Test Prep / check courses needed below:

$100** $100* $150***

**First subject is $100, additional subjects are $50 each.

***First subject is $150, additional subjects are $100 each.

___ Math _ Reading _ Writing _ Science ___ Social Studies

Please write in the amount due:

Tuition:

_____________

Class Fees:

TOTAL DUE:

**IN-DISTRICT STUDENTS WHO TAKE COURSES BOTH SESSIONS WILL PAY FULL TUITION FOR THEIR FIRST

COURSE AND $100 FOR AN ADDITIONAL COURSE IN SESSION II.

CLASS FEES ARE EXTRA.

All registrations include a $50 non-refundable processing fee. Mail registrations to: Summer School Registration, Hilliard City Schools, 4200 Lep-pert Road, Hilliard, OH 43026. Registrations will not be accepted at the schools. Full payment, including any class fees, must be received with

the registration, payable to Hilliard City Schools. Master Card and Visa will be accepted for payment when registering at Hilliard Darby High School

located at 4200 Leppert Road. Registration hours are Monday-Friday, 9:00 a.m.-3:00 p.m.

Questions? Contact your guidance counselor, Joyce Brickley @ 921-7300 or email: [email protected].

Note: Students in Grade 9 may enroll in Test Prep Courses, but may not take OGT until March of their 10th grade

year (according to the State of Ohio).

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OHIO GRADUATION TEST PREPARATION (OGT)

Students who have at least 10th grade status will need to pass all five sections of the Ohio Graduation Test in

order to receive a high school diploma. The Hilliard City School District offers summer school classes for

students who would like tutoring for the OGT. These five preparation classes will be invaluable to students who

need intervention on the OGT. This program combines test-taking skills with appropriate subject matter to guide

students toward a better performance on the test. Although no program can offer guarantees, we feel that the quality

of these summer school preparation classes will provide students with much needed assistance.

Purpose: To assist Hilliar d City School Distr ict students in gr ades 10-12 who need intervention in acquiring skills necessary

to find success on the Ohio Graduation Test. Students in grade 9 may enroll in Test Preparation courses but may not take the

OGT until March of their 10th grade year (according to the State of Ohio). However , all 9th grader s who enr oll in Test

Preparation courses through summer school will leave with an assessment of their current progress toward OGT requirements.

Registration: Student numbers will be limited to 25 per class. Students may register for one subject area or all four.

Cost: $100 for first subject; $50.00 for each additional subject. This fee will cover any/all pr epar ation classes taken by a

student.

Dates & Times: ALL TUTORING & TESTING WILL BE AT DARBY HIGH SCHOOL

TUTORING: June 8-12, 2015

TESTING DATES: June 15, 16, 17, 18, 19

TUTORING TIMES (June 8-12) TEST DATES

*Reading & Writing 7:30-9:30 am Reading — June 15

Math 9:45-11:45 am Math — June 16

Science 12:00-2:00 pm Writing — June 17

Social Studies 2:15-4:15 pm Science — June 18

Social Studies — June 19 *Please note: Reading and Writing Tutoring classes are combined, but their testing dates are different.

Please note: Students who have not passed the OGT are eligible to take the summer administration of the OGT. Please make the

summer school administrators and testing coordinators aware of IEPs and other accommodations before the Test Preparation course begins.

Translators will not be provided for ELL students for this administration. Students qualifying for a translator may use any other accommodations entitled to them. If the student requires a language specific dictionary, the student must bring one with

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Summer School 2015 Registration Form

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Student Name:

ID #:

Summer School

EMERGENCY MEDICAL FORM

In the event reasonable attempts to contact me

(name)

at

(daytime phone) have been unsuccessful, I hereby give my consent for:

(1) The administration of any treatment deemed necessary by Dr.

(physician)

at

(phone), or if the designated preferred practitioner is not available, by

an-other licensed physician or dentist; and (2) the transfer of the child to

(preferred hospital) or any hospital reasonably accessible. The authorization does not cover major

surgery unless the medical opinions of two other licensed physicians or dentists, concurring in the

necessity for such surgery, are obtained prior to the performance of such surgery. Facts

concern-ing the child’s medical history includconcern-ing allergies, medications, and any physical impairment to

which a physician should be alerted must be included.

Date

Signature of Parent/Guardian

(OR REFUSAL TO CONSENT)

I do not give my consent for emergency medical treatment of my child. In the event of illness or

injury requiring emergency treatment, I wish the school authorities to take no action or to

.

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Summer School 2015 Registration Form