Admissions

 

 

 

 

Dear Parents/Guardians:

 

To be considered for admission to Center for Literacy & Creativity for the upcoming school year, a student should be entering grades K-8. Parents/Guardians must provide the school with the following information at the time of enrollment:

 

• Submit a completed application for admission for each child seeking admission
• All items must be completed.  Do not leave any spaces blank.
• Provide the original copy of each child’s birth certificate.
• Provide a completed health appraisal, including immunizations.  This form must be signed by a licensed doctor with their official stamp.
• Provide an Individual Educational Plan (IEP) – ONLY FOR SPECIAL EDUCATION
• Provide a copy of the child’s most recent report card or student transcript from their previous school.
• Parents must provide a valid driver’s license or state identification card.
• Faxed applications and requested documents will not be accepted.

All applications must be returned to the school office Monday through Friday only between the hours of 8:30 a.m. – 3:00 p.m.

As required by law, a random selection drawing will occur at the end of the application period if the number of spaces set by the school incoming students is exceeded by the number of applications.  The purpose of the random selection drawing is to ensure equal opportunity for all students.

If there are any questions, call 313.537.9400 between the hours of 8:30 a.m. – 3:00 p.m.

Incomplete applications will not be accepted.

                                                                          

Authorization to Release School Records

(Please print or type)

Student Information:

Name: _______________________________________________________________________________

               First                                                                   Middle                                             Last

Date of Birth: __________________________________                                             Current Grade: _____________

School Last Attended: ___________________________________________________________________

Address: _________________________________ City ____________________ State  ____ Zip________

Year student last attended: ______________________

Authorizing Signature: __________________________________________________________________

Information to be release:

General Education Records: Include all grades at time of transfer, Special Education/Confidential Records (medical, psychiatric psychological, social history, social work reports, MET, IEPC records, etc.)

Parental permission no longer required when records are requested by authorized school personnel in compliance with Federal Education Rights & Privacy Act, Final Rule on Educational Records, Federal Register, June 17, 1976, Volume 41, No. 118, Page 24675.

Office use only

1^st Request: _____                                  Date Mailed/Faxed: __________               Date Received: ___________

2^nd Request: _____                                Date Mailed/Faxed: __________               Date Received: ___________

Affirmation of Prior Discipline Record

Please complete the following information below.  A willful false statement of this affirmation is a violation of the Student Code of Conduct and may result in the student’s expulsion from Center for Literacy & Creativity.

By signing below, the parent/legal guardian affirms that the student named below:

Student Name: _______________________________________

      Has been suspended or expelled

      Has NOT been suspended or expelled

If you checked “Has been suspended or expelled”, please explain the circumstances in detail.  Include the school name, date(s) of suspension or expulsion, and a description of the incident that resulted to the suspension or expulsion.

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Name of sending (former) school district: __________________________________________________

Sending School Please Check One:

___ According to our records, we verify that the information provided above is correct.

___ According to our records, the information provided above is incorrect.

If the student has been involved in offenses involving weapons, alcohol, drugs, willful infliction of injury to person, an act of violence against person and/or property committed on school premises, or at a school sponsored activity, please forward appropriate disciplinary documentation.

____________________                                        ____________________________________________________

Date:                                                                               Signature of Sending School District Administrator/Contact Phone

 

 

Authorized List of Adults for Student Release

 

As the parent and/or legal guardian of _________________________________________, I request that only the following person be allowed to pick-up my child from the Center for Literacy & Creativity PSA School and from sponsored events.

Name	Relationship	Contact Number

PLEASE NOTE THAT PROPER IDENTIFICATION IS REQUIRED AT TIME OF PICK-UP

 

Parent/Guardian Signature: _______________________________       Date: ______________

 

 

 

This document must be on file with CLC and signed by at least one Parent/Legal Guardian before a student can be released. Please return with the enrollment packet.

Dear Parent/Guardian:

Center for Literacy & Creativity has adopted an integrated pest management program.  The school’s primary goal is to reduce pesticide use as much as possible.  Occasionally it may be necessary to apply pesticides; these will only be used as a last resort.

 

You have the right to be informed prior to any pesticide application at your child’s school.  In an emergency, pesticides may be applied without prior notice, but you will be provided notice following any such application. To receive notification, please complete the following information.  If the form is not returned, we will assume you do not want to be notified.

 

If you have questions about the pest management program at CLC, please contact the office at 313.537.9400.

 

----------------------------------------Please detach and return bottom portion-----------------------------------------

 

Fill out the following information and return to the main office (please print)

CLC PRIOR NOTIFICATION FOR PESTICIDE USAGE

 

Parent/Guardian Name:  _________________________________________________________

Student Name: _________________________________________________________________

Address: ______________________________________________________________________

City: __________________________________________ State: _______ Zip Code: __________

Home Phone #: ______________________________ Cell Phone #: _______________________

 

Please check one response:

 

      No, I do not want to be notified?

      Yes, I only want to be notified when there is a major scheduled pesticide application.

      Yes, I want to be notified when all pesticide applications are made such as ant trap, small bait or other least toxic applications.

 

Parent/Guardian Signature: _____________________________________ Date: _____________

 

 

 

 

PARENT INVOLVEMENT CONTRACT

A Learning Partnership between Home and School

 

Parent/Guardian Commitment:

 

I want _____________________________________ with their attendance at Center for Literacy & Creativity to reach his/her full academic potential.  Therefore, I will commit to do all of the following:

• Ensure that my child attends school every day
• Send my child to school on time and ready to learn
• Review homework assignments and offer assistance when needed
• Show an interest in my child’s well-being by attending school functions, supporting school activities, and making every effort to attend parent-teacher conferences
• Personal goal (s) _____________________________________________________________

Parent/Guardian Signature: ___________________________________________ Date: __________

*If extenuating circumstances prevent me from a full commitment, I will offer an explanation to the appropriate administrators and staff members.

Pupil Commitment:

 

I want to reach my full academic potential.  Therefore, I will commit to do all of the following:

• Arrive at school and attend class on time each day
• Show respect at all times to everyone who is part of the school by not acting hostile or creating fear in others
• Conduct myself accordingly by obeying all classroom rules
• Pay attention in class and participate in class discussions
• Complete classroom lessons and homework accurately and neatly
• Immediately ask for help from my teacher if I  have a problem with an assignment
• Personal goal(s) ______________________________________________________________

Pupil Signature: __________________________________________________ Date: _________

Teacher Commitment:

I want ________________________________________________ to reach his/her full academic potential. Therefore, I will commit to do all of the following:

• Set high instructional standards for myself that promote the development of the state, Center for Literacy & Creativity and School Districts content, standards and benchmarks
• Teach effective study skills and strategies to ensure retention of learning
• Notify the parent/guardian as soon as an attendance and/or academic problem develops
• Establish flexible scheduling and create a warm atmosphere for parents/guardians during classroom visits and participation in the activities
• Personal goal(s): ________________________________________________________________

Teacher Signature: _____________________________________________________ Date: ___________

We want all students to reach their full potential.  Therefore, we commit to do the following: Consider accessing possible resources for all extenuating circumstances shared with appropriate staff by the parents/guardians to assist them in realizing a full commitment.

Technology Code of Conduct Policy

 

Parents are to review each guideline with their child.  Each student has the privilege to use the hardware and software that have been placed in the lab and classrooms to facilitate academic growth.  Each user of the hardware and software has the responsibility to follow the guidelines set and act accordingly.

• The computer/technology instructor will install or modify software
• Food, candy, drinks, etc. are not allowed in the lab or classroom.
• Treat all equipment with care.  If there is a hardware or software problem, inform the instructor immediately.  Do not attempt to repair anything on your own.
• Hardware and any manuals are the property of the Center for Literacy & Creativity and are to remain in the lab or classroom unless approval has been granted by the instructor.
• All users must obey the copyright laws.
• It is unethical and possibly illegal to access or copy files that are the private properties of another user unless permission is given by the technology instructor and file creator to do so.
• Use of computer facilities must be in support of education and consistent with the guidelines of the Center for Literacy & Creativity curricula.
• All persons are responsible for seeing that equipment is not used for illegal, inappropriate or obscene purposes, or in support of such activities.  In appropriate use will be defined as a violation of the intended use of the hardware network and/or purpose and goal.  Obscene activities will be defined as a violation of generally accepted social standards for use of publicly operated computer network.
• Users may be required to sign in when using computers.
• Parents are financially responsible for damage to hardware and/or software caused by their children.
• Students are to follow the course as outlined by the technology instructor only unless directed to do otherwise by the technology/computer instructor.
• Computer disks do not leave the room nor are outside disks allowed in the room unless instructed.  Users are responsible for the care of their diskette.  Do not insert any outside diskettes into the computer.
• Users are not to alter nor save information on the hardware.
• The behavior policy is the same as outlined in the Student Code of Conduct.

Any violation of these guidelines will be considered grounds for disciplinary action, loss of computer lab privilege and may result in the loss of class credit in accordance with school policies.

I/we understand and agree to abide by this Technology Code of Conduct, and I/we also understand that the Center for Literacy & Creativity assumes no responsibility for the student’s communication while using such technology.

Student Signature: _____________________________________       Date: _____________________

Parent/Guardian Signature: _____________________________                        Date: _____________________

PARENT/LEGAL GUARDIAN COMMITMENT OF SUPPORT

As the parent or legal guardian of a student accepted for enrollment at Center for Literacy & Creativity (CLC), a Michigan Public School Academy, I understand how important parental involvement is for the success of my child(ren) and all students at CLC.

 

Also, I understand and agree that every parent or legal guardian of a student enrolled in CLC will also be required to make and keep Parent/Legal Guardian Support Commitments in order for their children to remain eligible for continuing enrollment in subsequent school years.

 

As the Parent/Legal Guardian of a student eligible for a free public school education at a Michigan public school, I understand it is my right and choice to enroll my child in CLC, some other public school of choice or an assigned public school based on the school district in which I reside.

 

Lastly, I am choosing CLC with the understanding that as the Parent/Legal Guardian, I am expected and required to be involved, in some manner, in the activities and programs of the school, on behalf of my child(ren).

 

Having read and understand the above statements, and in order for my child(ren) to continue to be eligible for enrollment at CLC, this school year and in subsequent school years, I agree to the following:

 

1. I agree to volunteer a minimum of twenty (20) hours (per family) of support time for the Center for Literacy & Creativity, per calendar school year.  This is an average of two (2) hours per month.
2. I agree that I must choose one or more of the following activities that may qualify as time towards the twenty (20) required hours.

__ Parent Support Group	__ Lunch Time Duty	__ Classroom Assistant
__ Field Trip Chaperone	__ Special Event Assistant	__ School Beautification
__ Before School Assistant	__ School Year Book	__ Computer Lab Aide

1. CLC will maintain activity logs and sign-in sheets for all activities that qualify towards the required hours.  CLC will report total support hours completed and hours remaining per family on a quarterly basis in writing to all Parents/Legal Guardians.
2. All families of students enrolled at CLC must complete the required hours prior to June 30 of each calendar year in order to guarantee their child(rens) enrollment eligibility the following year.  CLC will inform all parents in writing no later than fifteen (15) days following the last day of school whether they have satisfied the minimum support hours.
3. Families are entitled to appeal to the Board of Directors a decision for non-enrollment based on non-completion of the twenty (20) hours of volunteer hours by following the established policy regarding the appeal process.
4. Families may volunteer before during and after school, evenings, weekends, and during all events and activities sponsored by the school, as well as during the fiscal year, July 1 – June 30.
5. CLC pledges to keep its commitments to parents and students, to strive for excellence and quality, thereby ensuring that each of its students has the very best chance of reaching their highest potential.

 

By signing below, I agree that I have read, understand and agree with all of the statements.

 

 

 

Parent/Legal Guardian Signature: ________________________________               Date: ________________________

 

 

 

 

I’m a Winner!

 

I am young and I need guidance.

I am strong, determined and assertive.

I am vibrant, intelligent and capable of doing anything.

I’m a Winner!

 

I am unique in my own way.

There is only one me.

I am a positive being with positive thoughts.

 

I AM A WINNER!

 

I’m a Winner,

And to tell you the truth,

I will make it because I want to.

No matter what others may say or do.

I’m a Winner!

 

I am moving up the ladder of success.

I am aiming high.

No negative persons will block my path,

And I won’t stop until I reach the top

Because…

 

I AM A WINNER!

 

©     2005 Deborah Holt Foster

 

Center for Literacy & Creativity Academy

2012-2013 Enrollment Application

Kindergarten – 8^th Grade

{Required by State}

All student information is protected by the Family Educational Rights to Privacy act for the purpose of protecting student confidentiality

 

STUDENT INFORMATION
Grade Level:	__K     __1st    __2nd     __3rd     __4th     __5th     __6th     __7th     __8th
Student’s Last Name:
Student’s First Name:		Middle Initial:
Student’s Date of Birth:		a  Note:  Must provide Original Birth Certificate
Student’s Gender:	__Male                __Female	Student’s Age:
How will student be      transported to and from school?	__Parent Drive    __Carpool   __Bus   __Walk    __Day Care Van __Parent Walker                    __City Bus           __Other (explain):
Student Home Phone:
Student lives with:	__Both Biological Parents    __Mother Only    __Father Only   __Legal Guardian: Do you have Guardian /Adoption Papers Attached? __Yes    __No __Both Parents Alternately: If both Parents alternately please indicate Custodial Parent:  __Mother   __Father
Student Ethnicity:	__African American    __Hispanic    __White    __African    __Asian/ Pacific Islander

 

The following question is intended to address the McKinney-Vento Act
Student Lives:	__in a house    __in an apartment    __in a shelter    __in a motel, car, campsite __in a house w/more than one family  __with friends or family other than parent/guardian

 

STUDENT ADDRESS INFORMATION
I do__ or do not__ give my permission to include our child and family in the school directory
Street Address Where Student Lives:	Street:
	City:                                   State:  MI                   Zip:
Mailing Address:	__Same as Above	__Use the mailing address below:
	Street:
	City:                                   State:  MI                   Zip:

 

SYBLING INFORMATION
Full names of          other children         living in home	Age		How related to student applicant			Currently attending CLC?		Applied to CLC	Grade in Fall
STUDENT EDUCATION INFORMATION
Previous School:
Address:
City:							STATE: MI                       ZIP CODE:
Previous Grade:				Has your child ever been retained in any grade? __Yes Grade:     __No
Student’s Primary Language:		Primary language spoken by the student: ___________________________
Was your child receiving Special Education Services?		No			Yes Do you have your child’s special education records (IEP)? __If  yes attach copy  __if no, please obtain a copy for enrollment
If your child         receives Special         Services complete         this section:		When and where was testing performed?  Date: ____/____/____   Location: ____________________________ How many hours of Special Education/Services does your child receive per week? ___ Does the child have a 504 Plan? __No  __Yes, Date Plan Developed: ____/____/______

 

PARENT/GUARDIAN INFORMATION
	Mother/Step Mother	Father/Step Father	Legal Guardian
Name:
Address:
City:
State:
Zip Code:
Marital Status:
Occupation:
Employer:
Employer Address:
City:
State:	MI	MI	MI
Zip Code:
Highest Educational Level:	__Some High School __High School __Technical/Trade School __1-3 Years of College __Bachelor’s Degree __Master’s Degree or Higher	__Some High School __High School __Technical/Trade School __1-3 Years of College __Bachelor’s Degree  __Master’s Degree or Higher	__Some High School __High School __Technical/Trade School __1-3 Years of College __Bachelor’s Degree __Master’s Degree or Higher

 

EMERGENCY CONTACT PERMISSION
Contact Person	Relationship	Phone #	Work #	Cellular #

 

Attach on a separate sheet, if you choose to offer additional information or respond further to any item on this application.  However, if the child has records in his/her file that will benefit the educational progress of your child at the Center for Literacy & Creativity, this information should be disclosed.

 

Completion and return of this application does not assure final enrollment.

 

___________________________________________________                                   _____________________

Parent/Guardian Signature                                                                                     Date

 

School Uniform Policy

 

All students attending Center for Literacy & Creativity Academy must be in complete uniform each day of school.

 

Young Ladies – K thru 7^th

• Plain Solid Color RED or BLACK Polo Style Shirt (No Blouses, Designs, Ruffles or Emblems)
• Light Khaki or Black Pleated or A-line skirt (One inch below the knee)
• Light Khaki or Black Uniform Loose-fitting Slacks (Must wear a black or brown belt)
• Knee Socks or Tights (Red, Black or Light Brown Only)
• (No ankles, footies’, sports or psychedelic, socks permitted)
• Solid Red, Tan, Brown or Black Uniform Sweater
• Solid Black or Solid Brown Shoes
  • No shorts, skorts or clothing with emblems or designs

 

 

Young Men - K thru 7^th

• Plain Solid Color RED or BLACK Polo Style Shirt (No Designs or Emblems)
• Light Khaki or Black Uniform Slacks (Slacks should not be larger than the student’s actual waist size.  Slacks are to be worn on the waistline and not below with a black or brown belt at all times)
• Solid Black or Brown Shoes
• Solid Black or Brown Dress Socks
• Solid Red, Tan, Brown or Black Uniform Sweater

 

Young Ladies – 8^th Grade ONLY

• Plain Solid Color PURPLE Polo Style Shirt (No Blouses, Designs, Ruffles or Emblems)
• Light Khaki or Black Pleated or A-line Skirt (One inch below the knee)
• Light Khaki or Black Uniform Loose-Fitting Slacks (Must wear a black or brown belt)
• Knee Socks or Tights (black, brown, tan or taupe only)
  • (No ankles, footies’, sports or psychedelic socks permitted)
  • Solid Purple, or Black Uniform Sweater
  • Solid Black or Solid Brown Shoes
    • No shorts, skorts or clothing with emblems or designs

 

Young Men – 8^th Grade ONLY

• Plain Solid Color PURPLE Polo Style Shirt (No Designs or Emblems)
• Light Khaki or Black Uniform Slacks (Slacks should not be larger than the student’s actual waist size. Slacks are to be worn on the waistline and not below with a black or brown belt at all times)
• Solid Black or Brown Dress or Casual Shoes
• Solid Black or Brown Dress Socks

 

ALL STUDENTS

• No hoodies or jackets of any kind may be worn in school
• Young men are prohibited from wearing earrings in school
• No boots of any kind maybe worn in school
• No jewelry of any kind except earrings not larger than a quarter for young ladies only
• No shorts, skorts or clothing with emblems or designs
• No Flip-flops or sandals
• No Dickies