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  • CONTEMPORARY LEARNING ACADEMYcla.dpsk12.org/wp-content/uploads/2014/12/20172018...CONTEMPORARY LEARNING ACADEMY 200 E. 9TH AVE * DENVER, CO 80203 MAIN OFFICE: 720-423-6900 PUMA PRIDE
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CONTEMPORARY LEARNING ACADEMY 200 E. 9 TH AVE * DENVER, CO 80203 MAIN OFFICE: 720-423-6900 PUMA PRIDE * ESTABLISHED 1987 1 2017 – 2018 ENROLLMENT APPLICATION Enrollment Process • Complete application to the best of your ability • Return application to Main Office located at 200 E. 9 th Ave • CLA staff will contact you to schedule an interview • Interview with an Administrator (Parent/Guardian and Student must both be present) • You will be notified via phone of acceptance • Complete registration packet Application Must Include *Current Denver Public School Student £ Personal Essay (Included in Application) £ Birth Certificate £ Proof of Guardianship (If Applicable) £ Proof of Address (Xcel, Phone Bill, Mortgage Statement, or Rent Receipt/Lease) £ IEP or other Learning Plan Documents (If Applicable) *Student From Another District £ All Documents Listed Above £ School Transcripts (Credit/Course Report) £ Attendance Records £ Behavior Records Incomplete applications will not be considered. Please contact our Main Office with any questions you may have. COMPLETE APPLICATION BELOW (3 PAGES) Student Name:___________________________________________________________________ DPS Student ID#_________________ Gender:________ Primary Address:______________________________________________________________ City:_________________ State:_________ Zip:_____________ Parent Phone #:___________________________________________________ Student Phone #:________________________________________________ Parent/Guardian #1:______________________________________________Relationship to Student:_________________________________________ Parent/Guardian #2:______________________________________________Relationship to Student:_________________________________________ Previous school(s) attended:__________________________________________________________________________________________________________ Current Grade:____________ Total Credits:____________ Date of Birth:______________________ Age:__________ Have you ever been expelled from school? YES NO If yes, why?________________________________________________________________ Are you currently employed? YES NO If yes, what is your schedule?____________________________________________________________ Do you have a Probation Officer, Mentor, and/or Other Service Provider? YES NO If yes, name?_____________________________ Please circle all that apply to you: Special Education 504 Gifted and Talented Individual Learning Plan Does the applicant speak more than one language? YES NO If yes, what language?_________________________________________ What is the primary language spoken at home?__________________________________________ How did you hear about us? CLA Student Friend/Relative DPS School DPS Transitions Website Other Is so, who?__________________ _____________

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Page 1: CONTEMPORARY LEARNING ACADEMYcla.dpsk12.org/wp-content/uploads/2014/12/20172018...CONTEMPORARY LEARNING ACADEMY 200 E. 9TH AVE * DENVER, CO 80203 MAIN OFFICE: 720-423-6900 PUMA PRIDE

CONTEMPORARY LEARNING ACADEMY 200 E. 9TH AVE * DENVER, CO 80203

MAIN OFFICE: 720-423-6900

PUMAPRIDE*ESTABLISHED1987 1

2017–2018ENROLLMENTAPPLICATION

EnrollmentProcess

• Completeapplicationtothebestofyourability• ReturnapplicationtoMainOfficelocatedat200E.9thAve• CLAstaffwillcontactyoutoscheduleaninterview• InterviewwithanAdministrator(Parent/Guardianand

Studentmustbothbepresent)• Youwillbenotifiedviaphoneofacceptance• Completeregistrationpacket

ApplicationMustInclude

*CurrentDenverPublicSchoolStudent£ PersonalEssay(IncludedinApplication)£ BirthCertificate£ ProofofGuardianship(IfApplicable)£ ProofofAddress(Xcel,PhoneBill,MortgageStatement,or

RentReceipt/Lease)£ IEPorotherLearningPlanDocuments(IfApplicable)

*StudentFromAnotherDistrict

£ AllDocumentsListedAbove£ SchoolTranscripts(Credit/CourseReport)£ AttendanceRecords£ BehaviorRecords

Incompleteapplicationswillnotbeconsidered.PleasecontactourMainOfficewithanyquestionsyoumayhave.

COMPLETEAPPLICATIONBELOW(3PAGES)

StudentName:___________________________________________________________________DPSStudentID#_________________Gender:________

PrimaryAddress:______________________________________________________________City:_________________State:_________Zip:_____________

ParentPhone#:___________________________________________________StudentPhone#:________________________________________________

Parent/Guardian#1:______________________________________________RelationshiptoStudent:_________________________________________

Parent/Guardian#2:______________________________________________RelationshiptoStudent:_________________________________________

Previousschool(s)attended:__________________________________________________________________________________________________________

CurrentGrade:____________TotalCredits:____________DateofBirth:______________________Age:__________

Haveyoueverbeenexpelledfromschool?YESNOIfyes,why?________________________________________________________________

Areyoucurrentlyemployed?YESNOIfyes,whatisyourschedule?____________________________________________________________

DoyouhaveaProbationOfficer,Mentor,and/orOtherServiceProvider?YESNOIfyes,name?_____________________________

Pleasecircleallthatapplytoyou:SpecialEducation504GiftedandTalentedIndividualLearningPlan

Doestheapplicantspeakmorethanonelanguage?YESNOIfyes,whatlanguage?_________________________________________

Whatistheprimarylanguagespokenathome?__________________________________________

Howdidyouhearaboutus?CLAStudentFriend/RelativeDPSSchoolDPSTransitionsWebsiteOther Isso,who?_______________________________

Page 2: CONTEMPORARY LEARNING ACADEMYcla.dpsk12.org/wp-content/uploads/2014/12/20172018...CONTEMPORARY LEARNING ACADEMY 200 E. 9TH AVE * DENVER, CO 80203 MAIN OFFICE: 720-423-6900 PUMA PRIDE

CONTEMPORARY LEARNING ACADEMY 200 E. 9TH AVE * DENVER, CO 80203

MAIN OFFICE: 720-423-6900

PUMAPRIDE*ESTABLISHED1987 2

Math LanguageArts Science SocialStudies Reading GriefandLoss

SubstanceAbuse AngerManagement SocialSkills Employment SelfEsteem Relationships

TimeManagement Organization GoalSetting PeerPressure Depression Anxiety

Other(s):__________________________________________________________________________________________________

Challengesyouand/oryourfamilyarecurrentlyfacingorhavepreviouslyfaced–Checkallthatapply

CurrentChallenges£ Truancy£ Behavior£ HealthIssues(Self)£ HealthIssues(FamilyMembers)£ JobObligations£ Unemployment(Family)£ Parenting/ChildCare£ FamilyObligations£ Homelessness£ LegalIssues/Probation/Incarceration(Self)£ Incarceration(FamilyMember)£ Drug/AlcoholUse(Self)£ Drug/AlcoholAbuse(FamilyMember)£ MentalHealth

£ Depression£ Anxiety£ EatingDisorder£ SuicidalThoughts£ Self-InflictedInjury

£ GangInvolvement£ Other:________________________________

PastChallenges£ Truancy£ Behavior£ SchoolSuspensions£ HealthIssues(Self)£ HealthIssues(FamilyMembers)£ Homelessness£ Incarceration(Self)£ Incarceration(FamilyMember)£ Drug/AlcoholUse(Self)£ Drug/AlcoholAbuse(FamilyMember)£ MentalHealth

£ Depression£ Anxiety£ EatingDisorder£ SuicidalThoughts/Attempts£ Self-InflictedInjury

£ GangInvolvement£ ChildAbuse/Neglect£ Other:________________________________

PLEASECIRCLEALLAREASINWHICHYOUNEEDSUPPORT

Areyoupregnantorateenparent?________Pregnant________TeenMom_______TeenDad________NotApplicablePleaselistyourfavoritesubjects/classesandinterests/hobbies:___________________________________________________________________________

Page 3: CONTEMPORARY LEARNING ACADEMYcla.dpsk12.org/wp-content/uploads/2014/12/20172018...CONTEMPORARY LEARNING ACADEMY 200 E. 9TH AVE * DENVER, CO 80203 MAIN OFFICE: 720-423-6900 PUMA PRIDE

CONTEMPORARY LEARNING ACADEMY 200 E. 9TH AVE * DENVER, CO 80203

MAIN OFFICE: 720-423-6900

PUMAPRIDE*ESTABLISHED1987 3

PersonalEssay

StudentName:____________________________________________________________________Date:______________________________

Grade:___________________________CurrentSchool:____________________________________________________________________

Pleaseanswerthepromptbelowinthespaceprovided.Ifyouneedmorespace,pleaseattachadditionalpaper.

PleasetelluswhyyouwouldliketoattendContemporaryLearningAcademyandwhyyoufeelitwouldbeabetterfitforyou.


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