2011 - 2012 Oxford Application by suchenfz

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									                                                                                                                            For School use only
                                                OXFORD ACADEMY APPLICATION                                                Date Application Rec’d.:
                                      5172 Orange Avenue ● Cypress, CA 90630 ● (714) 220-3068
                        (Must be an Anaheim Union High School District Resident at time application is filled out)



     THE FOLLOWING MUST BE PROVIDED WITH APPLICATION:
     ● Residence Verification Form with required copied proofs of address
     ● Copy of inter-district transfer if student attends a public school outside of the boundaries of the AUHSD.
     ● Copies of student’s final official school report cards for the last two years (June report card for the
       2008 – 09 school year, June report card for the 2009 – 10 school year) and the most recent report card for the
       2010 – 11 school year. All report cards must include the school name.
       Academic grades must indicate that students have earned 3’s and 4’s (on a 4 point scale), 4’s and 5’s (on a 5 point scale) or
       A’s and B’s as their final grades in all core academic subjects and no grades lower than a 2 or a C in all other subjects.
       Official report cards need to demonstrate that students have a satisfactory or above mark in citizenship, effort and attendance.
       7th graders must currently be enrolled in Pre-Algebra and 8th graders must currently be enrolled in Algebra.
      ● Copies of the last two years STAR report or other standardized testing (spring of 2009 and 2010). Students must
        score at “proficient” or above in the areas of English Language Arts and Mathematics. (Copies may be obtained at your
        child’s current school).
                                INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED
Parents/guardians completing this application are requesting that their student take the entrance exam for consideration for acceptance
to Oxford Academy located in Cypress, California, for the school year beginning September 2011.
                                                     PLEASE TYPE OR PRINT
Application deadline:        Friday, February 18, 2011 at 12:00 noon.                              Date of Birth:

Student’s Name:                                                                                                             Male          Female
                                 Last                               First                         Middle
Student’s Address:
                                House No. / Street Name                     Apt. #         City                     State             Zip Code
Email Address:

Father’s Name:                                                                             Home Phone No.:
                                                                                           Cell Phone No.:
Mother’s Name:                                                                             Home Phone No.:
                                                                                           Cell Phone No.:
Guardian’s Name:                                                                           Home Phone No.:
                                 (To be used only for “Court-Appointed” Guardians)         Cell Phone No.:
                                                                                              (Must provide at least 2 different phone numbers.)
AUHSD Home Junior High School:
Current School:                                                                                               Current Grade:
Current School Address:                                                                                6th          7th             8th

HOME SCHOOL DEFINITION: The AUHSD junior high school is based on current residence, whether or not the student is currently attending
                        an AUHSD school.

I have read Oxford Academy’s information brochure and application. I understand and agree to the stipulations pertaining to the entrance
examination, parental transportation responsibility to and from Oxford Academy, sibling status, and student academic attire.
Transportation is the responsibility of the parent; however, bus transportation may be provided by the AUHSD to and from Oxford
Academy at a nominal fee. ( Bus boarding areas are located at Brookhurst, Dale, South, Sycamore, Western, and Loara.)
Parent/Guardian Signature:                                                                   Date:

Testing date is scheduled                                          Saturday                                       Saturday
according to current grade.                                     March 12 2011                                   March 19, 2011
No make-up test will be given.                                8:30 am – 12:00 pm                              8:30 am – 12:00 pm
Test Card must be brought on day of                       (Current 7th and 8th Graders)                      (Current 6th Graders)
testing.
                                          OXFORD ACADEMY
                                    RESIDENCE VERIFICATION FORM

Use this form to verify your residence. Please call 714-220-3068 if you have any questions or need further
assistance.

Student Name                                                                     Date of Birth


Parent/Legal Guardian Name

Address
                         Street                                     City                                 Zip Code

Parent/Legal Guardian must provide two (2) current (within 30 days) forms of verification from Section A or
two (2) current (within 30 days) forms of verification from Sections A and B if applicable in order to submit
an application.

                  PLEASE COMPLETE THE SECTION APPLICABLE TO YOUR SITUATION.
      Falsification of information on this form will be grounds for dismissal of student from school.

                                                        SECTION A
   Copy of current electric, or gas bill and a copy of one of the following in the parent/guardian name
    for residence verification if you own your own home or are renting a house or an apartment.
            Mortgage Verification (with name & address)               Lease/Rental Agreement (with name & address)
            Homeowner’s/Renter’s Insurance Policy                     Close of Escrow Verification (name & address)
            Property Tax Bill


                                                         SECTION B
    If you are renting a room, or living with someone, the owner or renter of the residence must provide
     two items from Section A in his/her name and sign below.
    In addition, present two of the following in the parent/guardian name for residence verification:
             Bank Statement                                          Major Credit Card Statement
             Auto Insurance Policy                                   Cable TV Statement
             Pay Stub                                                Telephone Bill

     I certify to Oxford Academy that the person(s) making this request is living and/or
      renting/leasing at the above address.


    Manager/Landlord/Owner of Residence Print Name                   Signature                   Phone # (for District verification)




    Signature (Parent/Legal Guardian)                                                            Date

NOTE: If your living situation meets the requirements of the McKinney-Vento Homeless Assistance Act, please
inform the Registrar at 714-220-2068.
한국어 번역이 옥스퍼드 아카데미 카운슬링 사무실에서 적용 가능합니다.
Deadline to turn in applications is February 18 at 12:00 p.m. Late applications will NOT be accepted.




                   Please put required documents in the following order:

 _______ Oxford Academy Application

 _______ Oxford Academy Residence Verification Form

If living In a single family permanent residence (house, apartment, condo or mobile home)

 _______ Current gas or electric bill in the parent/guardian name

 _______ Mortgage verification, or homeowner's/renters insurance policy, or property
         tax bill, or official lease/rental agreement, or close of escrow verification in the parent/guardian
         name.

If doubled-up (sharing housing with other families/individuals due to economic hardship or loss)

 _______ Current gas or electric bill

 _______ Mortgage verification, or homeowner's/renters insurance policy, or property
         tax bill, or official lease/rental agreement, or close of escrow verification

 _______ Any two (1 each) of the following: bank statement or auto insurance policy or pay stub or
         cable tv statement or telephone bill or major credit card statement in the name
         of the parent/guardian

 _______ Most recent report card for the 2010 - 2011 school year

 _______ June report card for the 2009 - 2010 school year

 _______ June report card for the 2008 - 2009 school year

 _______ Standardized testing results for spring of 2010 (STAR, IOWA, Stanford, etc.)

 _______ Standardized testing results for spring of 2009 (STAR, IOWA, Stanford, etc.)

If student is attending a public school outside the boundaries of the Anaheim Union High
School District

 _______ A copy of the inter-district transfer

								
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