2012 AP Summer Academy Registration Form by ZyECgmN


									                                          Strength of Character and College Ready

                                Advanced Placement Summer Academy Registration
                                       Registration Deadline: May 1, 2012
                                         Central High School (location)
                                      June 18-21, 2012 & June 25-28, 2012
                                                8:30 AM-12:30 PM
                                   There is no cost to students for this program.
                                     Bibb County School District Students
                                      Rising 9, 10, 11 & 12 Grade Students

              Student Requirements:
              -Registered for an AP Course during the 2012-2013 School Year
              -Limited to the first 200 Registrants
              -Forms will be accepted from April 5 - May 1, 2012

Print - Student Name______________________________Grade ( 2012-2013)________School_____________

Student Id. Number______________________________Birth Date_________________

Address_____________________________City ______________State____________Zip Code __________


Parent’s Name_____________________________________________Phone__________________

Emergency Contact Name___________________________________________Phone___________________

Does your child have any illness or allergy? _____Yes ____No

If yes, please explain_______________________________________________________

Medicine cannot be administered to students during this program.
Transportation will be provided from the home school site to Central High School and back to the home school site free of
charge. Students must secure transportation to their home school and back to their home each day. Students must be
picked up from their home school site by 1:00 PM each day. On June 28, the students will participate in a field trip
and must secure transportation to and from Central High School. On that date, the program will be extended.
Students must submit a signed field trip request form to the coordinator, Jason Williams, before June 27.

____My child will ride the bus to and from the AP Summer Academy. I understand that supervision at the home school
site will not be provided.

____ I will provide transportation to and from the AP Summer Academy at Central High School.

Media Coverage: During the AP Summer Academy, we are sometimes featured in the newspaper or on television. We
need your permission for your child to participate. Please check one:____Yes____No

Parent Signature____________________________________________Date__________

Student Signature___________________________________________Date__________

                                          Mail registration forms by May 1, 2012:
                                                Bibb County School District
                                           Gifted Education/Advanced Academics
                                                    484 Mulberry Street
                                                   Macon, Georgia 31201

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