please note: summer academy enrollment form€¦ · space is limited! register by june 19, 2015!...

I wish to request a bus pass for the duration of the AP Summer Academy at

Carnegie Mellon University. Please note: Bus passes are not guaranteed. They

are based on a �nancial need and are �rst come, �rst served.

2015−2016 PHOTO AND VIDEO RELEASE FORMFrom time to time during the summer, representatives of the media and the Pittsburgh Public Schools Division of

Communications and Marketing may come to the AP Summer Academy to provide news coverage. Your student may

be interviewed and/or photographed by representatives of the external news media and the Division of Communications

and Marketing. Your student’s image, name, work product and school may be revealed in the presentation. Additionally

your student’s work and/or photograph may be published on the Pittsburgh Public Schools internet web pages and

for internal and external promotion of the Pittsburgh Public Schools. Please sign the form below. This form will be

valid for the duration of your child’s attendance in the Pittsburgh Public Schools AP Summer Academy. Please

check one of the following boxes.

I/we GRANT PERMISSION to have our student photographed/videotaped as described in the above letter.

I/we DO NOT GRANT PERMISSION to have our student photographed/videotaped as described in the above letter.

Student Name: Parent/Guardian Name:

Parent/Guardian Signature: Date:

I give permission for my student (student name) to attendthe 2015 AP Summer Academy.

Parent/Guardian Name:

Parent/Guardian Signature: Date:

SUMMER ACADEMYENROLLMENT FORM

Student Name:

Student Age: Student Birth Date:

Current School: Current Grade:

Anticipated School for the 2015−16 School Year:

Anticipated Grade for the 2015−16 School Year:

Address:

City, State, Zip Code:

Parent/Guardian Name:

Relationship to Student:

Home Phone:

Work Phone:

Cell Phone:

Parent/Guardian E-mail:

Student E-mail:

Emergency Contact Person:

Relationship to Student:

Emergency Contact Phone:

Student T-Shirt Size (Adult Sizes): S M L XL 2XL 3XL

PLEASE LIST YOUR STUDENT’S...

Medications:

Allergies:

Dietary Restrictions:

Physical Restrictions:

PLEASE BE SURE TO COMPLETE ALL 5 SECTIONSOF THIS FORM AND RETURN IT IN THE ENVELOPEPROVIDED BY JUNE 19, 2015!

The Advanced Placement Summer Academy is open to all students enrolled in anAP course for the 2015−16 school year. This intensive summer workshop will be held Monday−Friday, July 13−31 at Carnegie Mellon University at NO COST. Students who enroll are expected to attend for the duration of the program.

Please return your completed enrollment form in the enclosed envelope or to the address listed below. Please

visit the Advanced Placement page on the District’s website or call 412-529-3082 for more information. You will

be noti�ed of your acceptance status on a rolling basis.

Office of Gifted and Talented Education341 S. Bellefield Avenue, Room 462

Pittsburgh, PA 15213

On the chart below, locate your school in the �rst column. Then, select the AP course(s) you are taking

during the 2015−16 school year in the second column, and your AP Summer Academy session preference(s)

in the last column. You may enroll in a maximum of one morning session and one afternoon

session. Morning sessions are held from 9am−12pm and afternoon sessions are held from 1−4pm.

Space is limited! Register by June 19, 2015!

Please Note: You can only enroll in an AP Summer Academy session if you are signed up for that AP

course in the 2015−16 school year. Check with your counselor to ensure you are enrolled in the course.

All sessions are subject to change pending student enrollment.

AP Calculus AB

AP Chemistry

AP English Language & Composition

AP English Literature & Composition

AP Physics 1

AP Psychology

AP Statistics

AP US History

PITTSBURGHCARRICK

Morning Session Afternoon Session

Afternoon Session ONLY


Morning Session ONLY





PITTSBURGHPERRY

PITTSBURGHSCI TECH

PITTSBURGHWESTINGHOUSE

AP Calculus AB

AP Chemistry



AP Physics 1

AP US History







PITTSBURGHUPREP

AP Calculus AB



AP US History







AP Psychology




AP Calculus AB



AP Statistics





AP Calculus AB

AP Chemistry



AP Physics 1

AP Psychology

AP Statistics

AP US History

PITTSBURGHALLDERDICE









AP Calculus AB

AP Chemistry



AP Physics 1

AP Psychology

AP Statistics

AP US History

PITTSBURGHBRASHEAR









MY SCHOOLFOR 2015−16

THE AP COURSE(S) I AMTAKING IN 2015−16

I WOULD LIKE TO ENROLL IN THEFOLLOWING AP SUMMER ACADEMYSESSION(S)...

AP Calculus AB



AP Physics 1

AP Psychology

AP Statistics

AP US History

PITTSBURGHCAPA








At the AP Summer Academy, you will have the opportunity to visit several colleges and universities. Pleaserank the colleges/universities 1–5, 1 being the one you are most interested in visiting. Please note that

all college visits are subject to change, and we cannot guarantee that all students visit their preferred ranking.

AP SUMMER ACADEMY COLLEGE TOURS

University of Pittsburgh & Carnegie Mellon University

Slippery Rock University & Allegheny College

Robert Morris University & La Roche College

Cal. U of PA & Washington & Jefferson College

Seton Hill University & Saint Vincent College

Other:

please note: summer academy enrollment form€¦ · space is limited! register by june 19, 2015!...

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