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June 6 - June 24, 2016 Morning Session Schedule

Afternoon Session Schedule

M-F: 8:00 AM - 12:00 PM

M-F: 12:15 PM - 4:15 PM

Register Early to SAVE $$$! 2616 E. Greenway Rd. Phoenix, AZ 85032 / 602-765-9555

$50 per course if you register by May 13 (Course fee goes up to $65 after May 13, 2016) Each session earns a 0.5 credit

Courses offered for AM Session:

Course offered for PM Session:

Algebra 2A (2nd yr. first semester)

English 6 (3rd yr. second semester)

Computer Based Online Course

Computer Based Online Course

Selection of computer based courses offered: (Maximum of 2 classes to be selected, 1 AM session and 1 PM session) English 1 – 8

Biology 1-2

American Government

Algebra 1-2

Chemistry 1-2

American History 1-2

Geometry 1-2

Earth Science 1-2

World History 1-2

Algebra 3-4

Physical Science 1-2

Economics

2016/2017 Summer School Student's Last Name

Student's First Name

Date of Birth (Month / Day / Year)

Allergies or Medications:

/

STUDENT INFORMATION Student's Middle Name

Age:

Gender:

Fall 2015/16 Grade Level:

Student's Cell Phone:

(

/

)

TRANSCRIPT INFORMATION Previous School:

Home Address to send transcripts (if different from Primary Contact Information):

Transcripts are to be mailed to which School:

PARENT/LEGAL GUARDIAN/ ADULT STUDENT (over 18) INFORMATION Primary Contact: Name (Last, First) Home Address

City

State

____OK to pick-up ____Legal Custody ____Lives with ____Receives Mailings

Secondary Contact: Name (Last, First)

Zip Code

City

____OK to pick-up ____Legal Custody ____Lives with ____Receives Mailings

Home Address

Mailing Address (if different from above)

State

Zip Code

City

State

Zip Code

Mailing Address (if different from above)

City

State

Zip Code

Home Phone (__Primary #)

Work Phone (__Primary #)

Home Phone (__Primary #)

Work Phone (__Primary #)

Cell Phone (___ Primary #)

Relationship to Student

Cell Phone (__Primary #)

Relationship to Student

Email Address:

Email Address:

Please Circle: CLASSES AVAILABLE JUNE 6 - JUNE 24, 2016

COST

AM SESSION, 8am-12pm

Cost: $50, if you register by May 13 (Course fee goes up to $65 after May 13)

PM SESSION, 12:15pm-4:15pm

Algebra 2A (2nd yr. first sem.)

English 6 (3rd yr. second sem.)

Online Course:

Online Course:

** Each course must have a minimum of 20 students enrolled to be offered.**

TO THE BEST OF MY KNOWLEDGE THE INFORMATION I HAVE PROVIDED ON THIS FORM IS ACCURATE AND TRUE. (FALSCIFICATION OF INFORMATION IS A CLASS 6 FELONY - A.R.S 13-2-107) STUDENT WILL BE WITHDRAWN FOR FALSE INFORMATION

X _________________________________________________________ PARENT / GUARDIAN / ADULT STUDENT SIGNATURE

_________________________________

DATE

THIS SECTION IS FOR OFFICE USE ONLY

Paid Amount $______ Cash/Cr.Card/ Check #_________

Date: _____/______/ 2016

School Official's Initials: _________

Paid Amount $______ Cash/Cr.Card/ Check #_________

Date: _____/______/ 2016

School Official's Initials: _________