CTCApplication2012v1.doc - Westinghouse College Prep

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					                           George Westinghouse College Prep
                                           “Preparing Students for College, Careers and Beyond”


                                  COLLEGE TO CAREERS PROGRAM APPLICATION

PART I: TO BE COMPLETED BY THE STUDENT

  1. Name:

  2. Date of Birth:                             (MM/DD/YYYY)               CPS ID#:

  3. Telephone #:                                                       Alternate:

  4. Email Address:

  5. Parent/Guardian Name:

  6. Home Address:

    City                                                                   St                        Zip Code

  7. Mailing Address:
    (If different from home address)

    City                                                                   St                        Zip Code

  8. Ethnicity:         African American          White     Latino      Asian/Pacific Islander          Other

  9. Gender:         Male              Female

  10. Elementary School:

  11. Is your current school a private or charter school?                     Yes        No

  12. Have you taken a high school course for credit?                       Yes       No

       If yes, which course?

  Please select the program that you are applying to. (Rank in order from 1-3, 1 representing your first choice)
  *Acceptance into the College to Careers Program does not guarantee admissions into the Health Science Academy. Once
  accepted into Westinghouse College Prep, additional criteria will be used for those students applying to the Health Science
  Academy.

  Health Science Academy*
  Business Academy
  Broadcast Journalism Academy
  Information Technology Academy



PART II: TO BE COMPLETED BY THE STUDENT (please attach to the application)
On a separate sheet of paper, please submit a typed essay using no more than a 12 point font, double
spacing, and include with the application. Please include the following information in the essay:

  A.     Why are you a good candidate for Westinghouse College Prep?
  B.     Which College to Career Program Academy are you most interested in and why?
                                     GEORGE WESTINGHOUSE COLLEGE PREP
                     3223 W. Franklin Blvd ♦ Chicago, IL 60624 ♦ P773-534-6400 ♦ F773-534-6422
                                             http://newwestinghouse.org
                                          “Preparing Students for College, Careers and Beyond”



  C.     What are your goals for the future?

  Letter of Recommendation: Students should request a letter of recommendation from a teacher, counselor, or
  administrator at your current school.
               a. The letter should address the following topics:
                           i. Why is the student a good candidate for Westinghouse College Prep?
                           ii. How has the student contributed to the current school?
                       iii. Discuss attendance, behavior and grades.



Part III: TO BE COMPLETED BY THE STUDENT AND PARENT/GUARDIAN

I hereby certify that all the information provided is complete and accurate. I understand that any
falsifications of personal or academic information through omissions of misstatement by me or anyone
who may have assisted me in the submission of this application may result in not being admitted to
Westinghouse College Prep.

_____________________________________                       __________________________________________
Applicant’s Signature          Date                         Parent/Guardian Signature           Date


PART IV: TO BE COMPLETED BY THE 8TH GRADE COUNSELOR/CASE MANAGER

1. Please submit a copy of the following with the application:
          th
    A. 7 Grade ISAT Scores                     Reading Stanine:                   Math Stanine:
    B. Cumulative Card
          th          st
    D. 8 grade, 1 quarter report card
    E. Individualized Education Plan (if applicable)
2.. Does the student have an Individualized Education Plan?                 Yes      No
3. Does the student have a 504 Plan?              Yes      No

_____________________________________________________
Counselor/Case Manager Signature             Date




                    Please submit the completed application and attachments to:
                                         Attn: Rebecca Miller
                                  George Westinghouse College Prep
                                       3223 West Franklin Blvd.
                                          Chicago, IL 60624
                                                GSR#34




                                   GEORGE WESTINGHOUSE COLLEGE PREP
                   3223 W. Franklin Blvd ♦ Chicago, IL 60624 ♦ P773-534-6400 ♦ F773-534-6422
                                           http://newwestinghouse.org

				
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