2024-2025 Application
55 Questions
This enrollment form must be completed by a guardian, unless the student qualifies for McKinney-Vento protections as an unaccompanied minor living away from their legal guardian.
Completion of this form does not enroll a student at Armadillo Community Charter School.
After completion of this form, you will receive a call to schedule an interview.
If you have not done one of the above, please pause, call our office and schedule to attend prior to filling out this application.
Note that enrollment is dependent on availability and eligibility
Please provide information about your student.
Many questions relate to Oregon Department of Education & Federal reporting requirements for funding our public school.
This is what will appear on class rosters
Please enter the legally defined sex/gender
Physical address where student resides
City, State, Country
Choose all the apply
Provide name of Tribe, if applicable
Provide information regarding any medication TAKEN WHILE AT SCHOOL, and/or any conditions that might impact student health while at school. Examples: diabetes, allergies, seizures, epi pen usage
Removal of barriers to provide educational stability, ensuring educational rights and protections for children and youth experiencing housing difficulties or loss of housing. PLEASE CHOOSE THE OPTION THAT RELATES TO YOUR HOUSING SITUATION
Include all adults and children living in the home with whom expenses are shared
Using the household size number on the left, note the income level to the right. Choose if this is number is equal to or less than, or greater than your households income level for household size. For example: if your household size is 2 and your income is $30,000 you would choose "equal to or less than" Household size - Total Household Annual Income 1 - $23,828 2 - $32,227 3 - $40,626 4 - $49,025 5 - $57,424 6 - $65,823 7 - $74,222 8 - $82,621 Additional Household members +$8399
Please relay all information accurately.
These questions help us receive the right information from previous schools.
Each student is part of a 4-year cohort & we need an accurate date for Oregon Department of Education reporting.
Select all that apply, regardless of the length of time enrolled/attended
Select all that apply
This section relates to guardians & other support systems
Unaccompanied minors must list at least one adult advocate for contact during an emergency
If different from students, please enter here
Select all that apply
Unaccompanied minors must list at least one adult advocate for contact during an emergency
If different from students, please enter here
Select all that apply
Provide name & phone number
Name & contact for other support personnel. Examples: coaches, parole officers, and/or mentors)
Please read the following carefully
My student cannot be assigned to enroll. After enrollment, choosing not to attend and/or not follow the policies set forth in the ACCS handbook may be understood by ACCS as choosing to enroll at a different school.
My student may receive a truancy citation and/or other disciplinary actions in the event they do not attend at least 90% of scheduled school days.
ACCS uses technology as part of instruction. Technology includes school and personal hardware and software. My student AND myself (guardian) agree to appropriate use of technology during AND outside of school hours when interacting with ACCS students, staff, families, and/or community members. I understand if this is violated, the use of technology while at school may be removed.
Students may not respond to communications on personal devices during class. In the event there is an emergency or you need to contact your student, you will contact the front office & a message will be relayed to your student. Violation of this policy may result in the cell phone not being allowed on campus and/or secured at the front desk during class time.
It is important your student remain engaged throughout the school day. You agree to NOT pick up your student unless you have communicated with the front office. If your student contacts you directly to go leave school, you agree to have the student make contact with their Team Leader and make a plan to remain on campus or go home; based on the Team Leaders recommendation.
I give permission to ACCS staff to communicate directly with my student regarding academic progress, attendance, program participation, and self management. These communications may take place in person, via text, phone call, or other application such as Google Classroom or Rooms
I give permission for my student's image (photo or video), voice, and name to appear in ACCS materials. Including presentations, reports, social media marketing, newsletters, yearbooks, and other materials for informational and/or promotional purposes
IN CASE OF AN EMERGENCY, when a guardian cannot be immediately reached, I authorize the staff and/or a designated representative to seek medical treatment and/or admit my child to a medical facility to be treated by a licensed medical provider.
I assure that, to the best of my knowledge, all information provided on this form is accurate and complete, and that I am authorized to provide such information and enroll the student listed on this form. BY SIGNING BELOW, I authorize the use of my electronic signature and authentic representation.
Signature I understand that my typed signature is the legal equivalent of my handwritten signature on this document.Forms
5 forms were found.