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Summer School 2010 Registration Form - HOUSTON LEARNING ACADEMY

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Summer School 2010 Registration Form - HOUSTON LEARNING ACADEMY Powered By Docstoc
					                                     HOUSTON LEARNING ACADEMY – FORT BEND CAMPUS                           New Student 
                      3964 Bluebonnet  Stafford, TX 77477  (281) 240-6060  FAX (281) 240-0022       Returning Student 
                        Office Registration Hours: Monday-Friday 8 a.m. to 2 p.m.  Fax 24 hours a day

                                       SUMMER SCHOOL REGISTRATION
Student Last Name:    ___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___
Student First Name: ___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___
Date of Birth: ___/___/_____ Home Phone: _________________ School: ______________________________________
Street Address: __________________________________________________ City: _________________ Zip: _________
Mother’s Name: ____________________________________ Mother’s Phone: _________________ cell work (circle one)
Father’s Name: _____________________________________ Father’s Phone: _________________ cell work (circle one)
Mother’s E-mail: ___________________________________ Father’s E-mail: ___________________________________


              2 LOCATIONS: 3964 Bluebonnet & 4010 Bluebonnet, Stafford (next door)

Session 1:   June 7 – June 18         8:30 a.m.-1:30 p.m. (A courses only) _____________________________________

                                      2:30 p.m.-7:30 p.m. (B courses only) _____________________________________

Session 2:   June 21 – July 2         8:30 a.m.-1:30 p.m. (B courses only) _____________________________________

                                      2:30 p.m.-7:30 p.m. (A courses only)_____________________________________

Session 3:   July 12 – July 23        8:30 a.m.-1:30 p.m. (A courses only) _____________________________________

                                      2:30 p.m.-7:30 p.m. (B courses only)_____________________________________

Session 4:   July 26 – August 6       8:30 a.m.-1:30 p.m. (B courses only)_____________________________________

                                      2:30 p.m.-7:30 p.m. (A courses only) _____________________________________


Session 5:   August 9 - August 20     8:30 a.m.-1:30 p.m. (B courses only) ____________________________________


CURRENT SCHOOL APPROVAL:
Courses approved to take:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
School Name: _______________________________ Counselor Name: ________________________________________
Counselor Signature: ____________________________________ Date: ___/___/_____


If your school is not in FBISD, complete the following:
School address: ____________________________________________________________________________________
Counselor Phone: _________________________ Counselor Fax: ___________________________
                                                 PAYMENT POLICY:

Payment is due at the time of registration. Payment must be in the form of check, money order, MasterCard,
or VISA. NO cash, please!
SERVICE CHARGES:
(1) $100 fee will be assessed for class, campus or subject changes.
(2) 50% refund may be given if written notice is received PRIOR to the start of the session.
(3) A $25 fee will be assessed for NSF checks. An NSF check will result in the student being placed on financial
suspension and grades will not be released until restitution is made.
(4) NO REFUND WILL BE GIVEN ONCE A SESSION HAS BEGUN.

POLICY AGREEMENT:
I have read and agree to the terms and conditions of the Houston Learning Academy Summer Policy, including the
obligation to pay for all tuition and fees, and in all events be responsible for the financial obligations of my child.
Parent’s name: (please print) ________________________ Student’s name: (please print) ________________________
Parent Signature: _________________________________________________________________ Date: ___/___/_____
PAYMENT:
 Check/MO# ____________________ Amount $________ Driver’s License # ________________ DOB: ___/___/_____
 VISA  MasterCard #_____________________________________________________________ Exp. Date ___/_____
Name on Card: _____________________________________________________________________________________
I hereby authorize Houston Learning Academy to charge above referenced credit card per course as indicated above for
the sum of $_____. I understand that that the payment authorized represents payment in advance of services rendered.
Date: ___/___/_____ Printed name: _____________________ Authorization Signature___________________________


FOR OFFICE USE ONLY:

Payment 1: Amount $______________ payment type: ______________________ date:__________ Rcd by: ________

Payment 2: Amount $______________ payment type: ______________________ date:__________ Rcd by: ________

Payment 3: Amount $______________ payment type: ______________________ date:__________ Rcd by: ________

Payment 4: Amount $______________ payment type: ______________________ date:__________ Rcd by: ________

Payment 5: Amount $______________ payment type: ______________________ date:__________ Rcd by: ________

REFUND:

Refund 1: Amount $_______________ for __________________________________ date: __________ sent to HO: ___

Refund 2: Amount $_______________ for __________________________________ date: __________ sent to HO: ___

                                                         Comments:
                                                 HOUSTON LEARNING ACADEMY – FORT BEND CAMPUS
                                     3964 Bluebonnet  Stafford, TX 77477  (281) 240-6060  FAX (281) 240-0022
                                    Office Registration Hours: Monday-Friday 8 a.m. to 2 p.m.  Fax 24 hours a day

                             HOUSTON LEARNING ACADEMY SUMMER POLICY
Enrollment constitutes acceptance of HLA, Fort Bend Campus school policies and decisions. Full payment for each class must be included.
Check, money order or credit card for the amount of the course will secure your registration. There is a $100 charge for any class, campus
or subject change once a student is registered. 50% refund may be given if written notice is received PRIOR to the start of the session.
Once the session starts, there will be no refunds for cancellations. Should we cancel a course for any reason; a full refund will be made. No
refunds will be made for students that are dismissed because of attendance, suspension, or inappropriate behavior. Attendance is
mandatory. Any class time lost due to an absence must be made up.

REGISTRATION AND BOOKS: Registration is on a first come, first             tops, halter tops, strapless tops, spandex, cut offs, questionable
serve basis. Registration form, fees, and signatures by all parties        printing/slogans, and obvious distractions. Shorts and dresses
are mandatory for enrollment. Books are provided for the use of            must be no higher than mid thigh. Attire must fully cover the
students but remain HLA and must be returned at the end of the             abdomen and back. Students inappropriately dressed may be
session. Students are responsible for damaged or lost textbooks.           sent home as an unexcused absence. All clothing must fit neatly.
Students must supply pen/pencil, a spiral notebook, calculator,
or other supplies stated by teacher.                                       SUBSTANCE‐FREE CAMPUS: HLA will not tolerate substance
                                                                           abuse. Possession of any substance or drug (prescription/non
ATTENDANCE: Continuous attendance along with completion of                 prescription drugs, alcohol, or tobacco) within 500 feet radius of
all work and tests are required. Due to state regulations, any             the campus is cause for immediate expulsion without refund.
student missing more than one class in a session will be                   Director, security personnel or authorized teacher has the right
dropped from the class without refund. HLA is a closed campus;             to search any student and their possessions if reasonable or
students may not leave the building without the consent of the             probable cause exists. A student will be suspended if
student’s teacher and principal. A doctor or court order receipt           appearance or smell of substance use is suspected at any time.
with a signed parent’s note is necessary for an excused absence.
A student’s unexcused absence make‐up work will receive a                  DISCIPLINARY ACTION: Disciplinary action will be taken
maximum of 80% credit. Students must work and stay in their                immediately for a student’s disrespect, defiance, profanity,
assigned class. Classes are dismissed by the school bell only.             disruption, verbal or physical abuse, cheating, truancy, theft,
                                                                           malicious mischief, reckless driving in the parking lot,
GRADES AND FINALS: Grades will only be granted when all                    unauthorized departure, and other conduct or acts deemed
student requirements are met. Students must complete all work              unacceptable by HLA or law authorities. All cell phones must be
assigned by the teacher, or zeros will be given for “refusal to            turned off during class time. Students shall not possess devices
work”. One-half credit will be granted for each subject passed. A          of radios, tapes, videos, CD, or electronic equipment. Parents
minimum score of 70 is considered passing. The final exam is               may reclaim student’s property for a $15 FEE. Food and drinks
25% of the grade. There are no student exemptions from final               cannot be brought to or consumed in class. Students cannot
exams. Finals will be completed on the assigned day and time.              distribute or solicit items, pamphlets, events or services.
Students MUST pass the final exam to receive credit for the
course. A second final exam may be offered at the discretion of            PARKING LOT: Students and vehicles in the immediate campus
the administration for a fee of $50. Grade reports will be mailed          area, including visual site, are under HLA rules and regulations.
to their home and their home school after the second and fourth            No student parking is allowed in red “Staff” zones or in front of
session. Each course offered is considered an “Academic” course            any other offices. Safe driving in the parking lot is 5 MPH.
and is weighted accordingly.                                               Students should enter the facility immediately and not remain in
                                                                           the parking lot. Unsafe driving in the parking lot is cause for
CURRICULUM: HLA follows Texas Assessment Knowledge & Skills                dismissal without refund.
(TAKS) and course requirements for a high school diploma. HLA
does not offer Special Education or 504 Services.                          SERVICE CHARGES:
                                                                           (1) $100 fee will be assessed for class, campus or subject
DISCLOSURE: Any special needs or circumstances must be                     changes.
discussed with the principal at the time of registration.                  (2) 50% refund may be given if written notice is received PRIOR
                                                                           to the start of the session.
ATTIRE: The attire of all students must be neat, clean and                 (3) A $25 fee will be assessed for NSF checks. An NSF check will
modest. The judgment of the appropriateness of attire rests with           result in the student being placed on financial suspension and
the principal or admin supervisor. Blue jeans, shorts, t‐shirts, and       grades will not be released until restitution is made.
sandals are acceptable. The following are unacceptable: tank               (4) NO REFUND WILL BE GIVEN ONCE A SESSION HAS BEGUN.
                                             HOUSTON LEARNING ACADEMY – FORT BEND CAMPUS

                                    SUMMER SCHOOL COURSE SCHEDULE
                                                           $290 for each ½ credit course
                         Please print the course name in your desired time slot on the Summer School 2010 Registration Form.

         MATH:                    English 2B                         Physics B                         Spanish 2A
Algebra 1A                           Session 2 - 8:30am - 1:30pm       Session 2 - 2:30pm - 7:30pm        Session 1 - 8:30am - 1:30pm
  Session 1 - 8:30am - 1:30pm        Session 4 – 8:30am - 1:30pm       Session 4 – 8:30am - 1:30pm        Session 2 – 2:30pm - 7:30pm
  Session 2 – 2:30pm - 7:30pm        Session 5 – 8:30am – 1:30pm     Environmental Syst A                 Session 3 – 8:30am - 1:30pm
  Session 3 – 8:30am - 1:30pm     English 3A                           Session 1 - 2:30pm - 7:30pm        Session 4 – 2:30pm – 7:30pm
  Session 4 – 2:30pm – 7:30pm        Session 1 - 8:30am - 1:30pm       Session 3 – 8:30am - 1:30pm     Spanish 2B
Algebra 1B                           Session 2 – 2:30pm - 7:30pm     Environmental Syst B                 Session 1 – 2:30pm – 7:30pm
  Session 1 – 2:30pm – 7:30pm        Session 3 – 8:30am - 1:30pm       Session 2 - 2:30pm - 7:30pm        Session 2 – 8:30am – 1:30pm
  Session 2 – 8:30am – 1:30pm        Session 4 – 2:30pm – 7:30pm       Session 4 – 8:30am - 1:30pm        Session 3 – 2:30pm – 7:30pm
  Session 3 – 2:30pm – 7:30pm     English 3B                                                              Session 4 – 8:30am – 1:30pm
                                                                        SOCIAL STUDIES:
  Session 4 – 8:30am – 1:30pm        Session 1 – 2:30pm – 7:30pm                                             ELECTIVES:
                                     Session 2 – 8:30am – 1:30pm
                                                                     Wld Geography A
Geometry A                                                             Session 1 - 8:30am - 1:30pm     Communications
  Session 1 - 8:30am - 1:30pm        Session 3 – 2:30pm – 7:30pm
                                     Session 4 – 8:30am – 1:30pm       Session 3 – 8:30am - 1:30pm     Applications (Speech)
  Session 2 – 2:30pm - 7:30pm                                                                             Session 1 - 8:30am - 1:30pm
  Session 3 – 8:30am - 1:30pm        Session 5 – 8:30am – 1:30pm     Wld Geography B
                                                                       Session 2 - 8:30am - 1:30pm        Session 2 - 8:30am - 1:30pm
  Session 4 – 2:30pm – 7:30pm     English 4A                                                              Session 3 – 8:30am - 1:30pm
                                     Session 1 - 8:30am - 1:30pm       Session 4 – 8:30am - 1:30pm
Geometry B                                                             Session 5 – 8:30am – 1:30pm        Session 4 – 8:30am - 1:30pm
  Session 1 – 2:30pm – 7:30pm        Session 2 – 2:30pm - 7:30pm
                                     Session 3 – 8:30am - 1:30pm     Wld History A                     Health
  Session 2 – 8:30am – 1:30pm                                                                             Session 1 - 8:30am - 1:30pm
  Session 3 – 2:30pm – 7:30pm        Session 4 – 2:30pm – 7:30pm       Session 1 - 8:30am - 1:30pm
                                                                       Session 3 – 8:30am - 1:30pm        Session 2 - 8:30am - 1:30pm
  Session 4 – 8:30am – 1:30pm     English 4B                                                              Session 3 – 8:30am - 1:30pm
Algebra 2A                           Session 1 – 2:30pm – 7:30pm     Wld History B
                                     Session 2 – 8:30am – 1:30pm       Session 2 - 8:30am - 1:30pm     Foundations of Fitness
  Session 1 - 8:30am - 1:30pm                                                                             Session 1 - 8:30am - 1:30pm
  Session 2 – 2:30pm - 7:30pm        Session 3 – 2:30pm – 7:30pm       Session 4 – 8:30am - 1:30pm
                                     Session 4 – 8:30am – 1:30pm       Session 5 – 8:30am – 1:30pm        Session 2 - 8:30am - 1:30pm
  Session 3 – 8:30am - 1:30pm                                                                             Session 3 – 8:30am - 1:30pm
  Session 4 – 2:30pm – 7:30pm        Session 5 – 8:30am – 1:30pm     US History A                         Session 4 – 8:30am - 1:30pm
Algebra 2B                                SCIENCE:                     Session 1 - 8:30am - 1:30pm
                                                                       Session 2 – 2:30pm - 7:30pm     Child Development
  Session 1 – 2:30pm – 7:30pm     Integrated Phy/Chem A                                                   Session 1 - 8:30am - 1:30pm
  Session 2 – 8:30am – 1:30pm        Session 1 - 8:30am - 1:30pm       Session 3 – 8:30am - 1:30pm
                                                                       Session 4 – 2:30pm – 7:30pm        Session 2 - 8:30am - 1:30pm
  Session 3 – 2:30pm – 7:30pm        Session 3 – 8:30am - 1:30pm                                          Session 3 – 8:30am - 1:30pm
  Session 4 – 8:30am – 1:30pm     Integrated Phy/Chem B              US History B                         Session 4 – 8:30am - 1:30pm
Math Models A                        Session 2 - 8:30am - 1:30pm       Session 1 – 2:30pm – 7:30pm
                                                                       Session 2 - 8:30am - 1:30pm     Criminal Justice
  Session 1 - 8:30am - 1:30pm        Session 4 – 8:30am - 1:30pm                                          Session 1 - 8:30am - 1:30pm
  Session 3 – 8:30am - 1:30pm                                          Session 3 – 2:30pm – 7:30pm
                                  Biology A                            Session 4 – 8:30am - 1:30pm        Session 2 - 8:30am - 1:30pm
Math Models B                        Session 1 - 8:30am - 1:30pm       Session 5 – 8:30am – 1:30pm        Session 3 – 8:30am - 1:30pm
  Session 2 - 8:30am - 1:30pm        Session 2 – 2:30pm - 7:30pm                                          Session 4 – 8:30am - 1:30pm
  Session 4 – 8:30am - 1:30pm        Session 3 – 8:30am - 1:30pm     Government
                                                                       Session 1 - 8:30am - 1:30pm     Sociology
Pre-Calculus A                    Biology B                            Session 2 - 8:30am - 1:30pm        Session 1 - 8:30am - 1:30pm
  Session 1 - 8:30am - 1:30pm        Session 2 – 8:30am – 1:30pm       Session 3 – 8:30am - 1:30pm        Session 2 - 8:30am - 1:30pm
  Session 3 – 8:30am - 1:30pm        Session 3 – 2:30pm – 7:30pm       Session 4 – 8:30am - 1:30pm        Session 3 – 8:30am - 1:30pm
Pre-Calculus B                       Session 4 – 8:30am – 1:30pm       Session 5 – 8:30am – 1:30pm        Session 4 – 8:30am - 1:30pm
  Session 2 - 8:30am - 1:30pm     Chemistry A                        Economics                         Art 1A
  Session 4 – 8:30am - 1:30pm        Session 1 - 8:30am - 1:30pm       Session 1 – 2:30pm – 7:30pm        Session 1 - 8:30am - 1:30pm
        ENGLISH:                     Session 2 – 2:30pm - 7:30pm       Session 2 – 2:30pm - 7:30pm        Session 3 – 8:30am - 1:30pm
                                     Session 3 – 8:30am - 1:30pm       Session 3 – 2:30pm – 7:30pm     Art 1B
English 1A
  Session 1 - 8:30am - 1:30pm     Chemistry B                          Session 4 – 2:30pm – 7:30pm        Session 2 - 8:30am - 1:30pm
  Session 3 – 8:30am - 1:30pm        Session 2 – 8:30am – 1:30pm       Session 5 – 8:30am – 1:30pm        Session 4 – 8:30am - 1:30pm
                                     Session 3 – 2:30pm – 7:30pm            SPANISH:                   PE (contractual)
English 1B                           Session 4 – 8:30am – 1:30pm
  Session 2 - 8:30am - 1:30pm                                        Spanish 1A                        All classes require a minimum of
  Session 4 – 8:30am - 1:30pm     Physics A                            Session 1 - 8:30am - 1:30pm     10 students or may be subject to
  Session 5 – 8:30am – 1:30pm        Session 1 - 2:30pm – 7:30pm
                                     Session 3 – 8:30am - 1:30pm     Spanish 1B                        cancellation or transfer to
English 2A                                                             Session 2 – 8:30am – 1:30pm     another session. Classes may
  Session 1 - 8:30am - 1:30pm                                                                          contain multiple subjects.
  Session 3 – 8:30am - 1:30pm

				
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