START COLLEGE NOW APPLICATION

I.

III STUDENT & PARENT/GUARDIAN SIGNATURES

This section completed by student / parent

STUDENT SIGNATURE IN SIGNING THIS DOCUMENT, I acknowledge the following:

• I understand and will comply with the assurances and conditions outlined in “Student/Parent Specific Responsibilities

• I authorize the high school and technical college to share course and grade information

PARENT/GUARDIAN SIGNATURE Required if student is under 18

• I understand and will comply with the assurances and conditions outlined in “Student/Parent Specific Responsibilities”

• I authorize the high school and college to share course and grade information

Student Name First, Middle, Last

IV. Student Name

This section completed by student / parent

V HIGH SCHOOL BOARD APPROVAL

This section completed by district

Named student is approved to enroll for courses marked “Approved” in Section II: Yes No If no, indicate reason for denial:

Check if student has a record of disciplinary issues

Name of High School Board Approval Authority

VI. TECHNICAL COLLEGE

APPROVAL

This section completed by college

I CERTIFY that the above-named student is eligible to attend the course(s) listed in Section VI and that all these courses are nonsectarian in content. The student will be notified of college admission policies/criteria and record disclosure provisions. The technical college agrees to provide the school district with grade information (and attendance information upon request)..

Not eligible to enroll I CERTIFY that the above-named student is not eligible to enroll in and/or attend the course(s) listed in Section VI The student will be notified of the reasons for ineligibility

Name of Technical College Representative and Title Phone Area/No Email

VII APPEALS

Appeals of school board decision: A student may appeal a school board decision regarding awarding of high school credit or course comparability to the State Superintendent within 30 days of the board’s decision.

Start College Now Release Of Student Informationform

You have certain rights under the Family Educational Rights and Privacy Act of 1974 (FERPA) concerning your school records.

You have the right to privacy Under the provisions of the Family Educational Rights and Privacy Act of 1974 (FERPA), all other student information (excluding directory information) will be treated as confidential information and is subject to disclosure requirements This means that student information (excludingdirectory information) may not be released to anyone without your written consent.

If you wish to allow your information to be released, please complete the following:

Pursuant to the Family Educational Rights and Privacy Act of 1974,

I hereby consent to the release by Western Technical College of the information concerning my student record and my financial information at Western.

Parties to whom such records may be released (Must be completed to be valid)

I wish to revoke my previous request.

Tomah High School – Exercise and Sport Science Credit Substitution Application

Student Name: Grade:

In accordance with Wisconsin law, the Tomah Area School District’s Board of Education adopted the following policy statement: The board may grant, upon a student’s request, permission for that student to take an additional .5 credit in English, social studies, mathematics, science, or health education towards high school graduation requirements in lieu of .5 credits Exercise and Sport Science based on the student’s participation in an organized physical activity the Board deems appropriate for this purpose. The student’s participation in such organized school activity must meet the stated requirements of the Board in terms of duration of participation and verification of same.

Please note that the board considers each request individually. Full and complete information is required in order for your request to be considered. Please list below the courses you have already taken in order to fulfill graduation requirements in these areas. Please also list below the courses you will be taking prior to graduation – listing the additional course you wish to take in the bottom row. Attach transcript / course schedule(s).

English

Social Studies

Mathematics Science

Health

*Additional Course

Being Requested*

Below please provide information about the organized physical activity (OPA) you are requesting be used as a substitute for .5 physical education credit.

Organized Physical Activity (OPA):

Number of years involved OPA:

Number of hours per week in OPA:

Level of attainment in OPA (Awards, Rank, Etc.):

Supervising Coach / Instructor / Advisor:

OPA Affiliation (ex: WIAA, City Rec):

Additional Information:

I understand that my request may not be approved. I further understand that if approved, I am required to submit participation logs verifying 90+ hours of participation in the OPA during the upcoming semester of school

This request has been approved/denied by the Board of Education please circle Board of Education Designee’s Signature Date

Return completed form to the Counseling Office once it has been approved/denied by BOE. The student will be notified of the status of the request.