Central Oaks Academy Application: Central Oaks Academy Application 1. * As the parent/guardian, I have read Central Oaks Academy's expectations and will adhere to them if my child is accepted into the school. As the parent/guardian, I have read Central Oaks Academy's expectations and will adhere to them if my child is accepted into the school. Yes No 2. * Date 3. * School year applying for: ex. 2021-22, 2022-23, etc. Student Information 4. * Student Name 5. * Month of Birth January February March April May June July August September October November December 6. * Day of Birth 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 7. * Year of Birth 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 8. * Gender Gender Male Female 9. * Parent/Guardian Name 10. * Current Street Address, City & State 11. * Contact Phone Number 12. E-mail address 13. * Current Grade Level 14. * Are you seeking to enroll your child as a full time Central Oaks Academy program student? Are you seeking to enroll your child as a full time Central Oaks Academy program student? Yes No 15. * Are you seeking to enroll your child as a blended Central Oaks Academy student (part home/online, part on campus)? Are you seeking to enroll your child as a blended Central Oaks Academy student (part home/online, part on campus)? Yes No 16. * Why do you want to enroll your child into Central Oaks Academy? (Please check all that apply.) (1 required) Why do you want to enroll your child into Central Oaks Academy? (Please check all that apply.) I want to have a higher level of involvement in my child's education. I would like to have control over the learning environment and schedule. I would like the ability to incorporate family priorities and values into learning. We need additional time for family, community, or faith-based activities. We require a flexible schedule to accommodate competitive sports, performing arts, or frequent travel. My child would benefit from working at their own pace with more one-on-one attention. My child has special health needs. (A referral from a health provider discussing how virtual schooling would help would be beneficial.) This program was recommended to me. 17. * How will you promote and support your child's home school learning experience with Central Oaks Academy? 18. * Provide an overview of how you structure (or will structure) the learning environment at your home to encourage and support your child's individual learning plan for Central Oaks Academy. 19. * What is your child's preferred learning style? 20. * What motivates your child to succeed as a learner? Identify learning behaviors you believe your child has to help him or her experience success at home, as an online student, or both. 21. Please provide any other information below that would help determine whether or not your child is a good candidate for Central Oaks Academy. 22. * Students in grades 4K-8 currently have the opportunity to attend Central Oaks Academy one day per week for additional supplemental curricular activities and specials (Art, Music, Physical Education). Would your child like to participate? Students in grades 4K-8 currently have the opportunity to attend Central Oaks Academy one day per week for additional supplemental curricular activities and specials (Art, Music, Physical Education). Would your child like to participate? Yes No 23. * Does your child currently have a computer and Internet access at home? Does your child currently have a computer and Internet access at home? Yes No 24. * My child is interested in participating in co-curricular activities. My child is interested in participating in co-curricular activities. No Yes, see next question. 25. If you answered yes to Question 23, please list the activities in which your child would like to participate. 26. * My child is currently attending? My child is currently attending? Public School Private School Home-Based School (requires DPI approval) 27. * Name of school currently attending? 28. * Has your child ever been referred for special education services or other accommodations (ex. 504 Plan, etc.)? Has your child ever been referred for special education services or other accommodations (ex. 504 Plan, etc.)? Yes No 29. If you answered yes to question 27, does your child currently have an IEP, Service Plan, or other accommodations through a 504 Plan? If you answered yes to question 27, does your child currently have an IEP, Service Plan, or other accommodations through a 504 Plan? Yes No 30. If you answered yes to question 28, briefly describe what accommodations are being provided for your child and why? Student Central Oaks Academy Questionnaire (Must be completed by students entering 6th - 8th grade) 31. Why are you choosing to enroll at Central Oaks Academy? 32. What abilities do you have that make you a good fit for Central Oaks Academy? What abilities do you have that make you a good fit for Central Oaks Academy? I am self-motivated and self-disciplined. I am comfortable with e-mail & word processing. I can read analytically and critically. If I set my sights on an end result, I usually achieve it. I am confident in my academic abilities. I believe I am responsible for my own education. I am willing to try something new. I am a good independent worker. I am will to express my thoughts and opinions in writing. 33. I am comfortable with e-mail and word processing. I am comfortable with e-mail and word processing. Yes No 34. I can read analytically and critically. I can read analytically and critically. Yes No 35. If I set my sights on an end result, I usually achieve it. If I set my sights on an end result, I usually achieve it. Yes No 36. I am confident in my academic abilities. I am confident in my academic abilities. Yes No 37. I give up easily when confronted with obstacles. I give up easily when confronted with obstacles. Yes No 38. I believe I am responsible for my own education. I believe I am responsible for my own education. Yes No 39. I have convenient and frequent access to a computer with an Internet connection. I have convenient and frequent access to a computer with an Internet connection. Yes No 40. I am willing to try something new. I am willing to try something new. Yes No 41. I am able to work successfully in a loosely structured environment. I am able to work successfully in a loosely structured environment. Yes No 42. I am willing to express my thoughts and opinions in writing. I am willing to express my thoughts and opinions in writing. Yes No 43. If you intend to use an online curriculum, explain how online learning will help you successfully meet your educational needs. * Enter Your Email Address: I am not a Robot
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