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El Rancho Unified School District STEAM ACADEMY @ Burke STUDENT APPLICATION (Page 1 of 2) Student Name: Current School: ____________________________ Student’s Current Grade (2016-17): 5 6 7 Parent Name(s): Email Address: _____________________________ Mailing Address: City: Zip: ______________ Home Phone #: Cell/Work Phone #:_____________________________________ Siblings/Grades: ____________________________________________________________________________ Areas of Interest: Art Engineering Technology Music Foreign Language Please be sure the following documents are attached: Most recent report card. Most recent CAASPP scores. Teacher recommendation form must be sent directly from the teacher to the STEAM Academy. Recommendation forms can be sent via email to [email protected], via mail to the school address, or faxed to (562) 801-5067. RETURN APPLICATION TO: STEAM Academy @ Burke 8101 Orange Ave., Pico Rivera, CA 90660 or send via email to [email protected] Signature of Student I understand that the STEAM Academy offers a rigorous academic program. I realize that my participation in the STEAM Academy will give me a brighter future by providing me with a foundation and proven path to high school, college and career success. If admitted, I am prepared to make this commitment and will give my all while participating in this program. X Signature of Parent/Guardian I understand that the STEAM Academy and its elective programming is taught in conjunction with a rigorous academic curriculum further supported by my child’s consistent attendance and work ethic. If my child is admitted, I commit to su pport my student fully in this program. X Date X_________________________ Date X_________________________ Application must be received no later than Friday, March 31, 2017.

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El Rancho Unified School District

STEAM ACADEMY @ Burke

STUDENT APPLICATION (Page 1 of 2)

Student Name: Current School: ____________________________

Student’s Current Grade (2016-17): ☐ 5 ☐ 6 ☐ 7

Parent Name(s): Email Address: _____________________________

Mailing Address: City: Zip: ______________

Home Phone #: Cell/Work Phone #:_____________________________________

Siblings/Grades: ____________________________________________________________________________

Areas of Interest: ☐ Art ☐ Engineering ☐ Technology ☐ Music ☐ Foreign Language

Please be sure the following documents are attached: ☐ Most recent report card.

☐Most recent CAASPP scores.Teacher recommendation form must be sent directly from the teacher to the STEAM Academy. Recommendation forms can be sent via email to [email protected], via mail to the school address, or faxed to (562) 801-5067.

RETURN APPLICATION TO:

STEAM Acade my @ Burke

8101 Orange Ave., Pico Rivera, CA 90660

or send via email to [email protected]

Signature of Student I understand that the STEAM Academy offers a rig orous academic program. I realize that my participation in the STEAM Academy will

give me a brighter future by providing me with a foundation and

proven path to high school, college and career success. If admitted, I am prepared to make this commitment and will give my all while

participating in this program.

X

Signature of Parent/Guardian I unde rstand that the S TEAM Acade my and its elec tive progr amm ing is

taught in conjunction with a rigorous academic curriculum further supporte d by my chil d’s c onsistent attenda nce a nd work ethic. If my child is admitted, I comm it to su pport m y student full y in this pro gram.

X

Date

X_________________________

Date

X_________________________

Application must be

received no later than

Friday, March 31, 2017.

El Rancho Unified School District

STEAM ACADEMY @ Burke

STUDENT APPLICATION (Page 2 of 2)

Numbers 1 & 2 of this section MUST be completed entirely by the student.

Candid student responses will allow the admissions committee to better understand each student.

For this reason it is very important for the student to compose these answers. If more space is needed,

feel free to attach another page.

1. Compose a paragraph that explains your reasons for applying to the STEAM Academy and how this program

will help you achieve your goals for the future.

2. Compose a paragraph explaining why you think it is important to collaborate with your peers in class, on

assignments, projects, etc. Include what you do to ensure that your peers see you as a valuable contributor

in your groups.

3. At the STEAM Academy, we believe how you spend your time outside of school is just as important as

time spent in school. Give us some examples of how you spend your time outside of school (interests,

hobbies, etc.). Include strategies you use to manage your time wisely and to balance these activities while

still focusing on your academics.

PARENT RECOMMENDATION: To be completed by the parent/guardian of the applicant.

4. As a parent, what do you hope your child will get out of the STEAM Academy? What will you do to

contribute to your child’s success at our school?

STEAM ACADEMY @ BURKE TEACHER RECOMMENDATION FORM

This form must be received in the STEAM Academy office no later than March 31, 2017.Please complete this form and MAIL it to: You may also E-MAIL this form to:

STEAM Academy @ Burke [email protected]

8101 Orange Ave., Pico Rivera, CA 90660 Subject: STEAM Recommendation

Applicant’s Name: __________________________________________________________________

Please consider how the student compares to ALL other student in current grade level.

No basis

for

judgment

Below

Average

Average

(Top 50%

in District)

Good

(Top 25%

in District)

Excellent

(Top 10% in

District)

Outstanding

(Top 5%

in District)

Mathematics Ability 0 1 2 3 4 5

Science Ability 0 1 2 3 4 5

Writing Ability 0 1 2 3 4 5

Reading Comprehension 0 1 2 3 4 5

Critical Thinking Skills 0 1 2 3 4 5

Academic Motivation: initiative, pride in

work, willingness to go above and beyond 0 1 2 3 4 5

Teamwork Ability 0 1 2 3 4 5

Organization and Work Habits 0 1 2 3 4 5

Citizenship/Behavior/Attendance 0 1 2 3 4 5

Academic Vision:

Do you recommend this student for the Magnet Program?

Yes No With reservations (*explain below, if any.)

Please explain your recommendation, as well as any rankings below Excellent, as to why acceptance to the

academy would be beneficial to the student.

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Teacher’s Name: ________________________________________ School: ____________________________________

Subject/grade you taught this student: _____________________________________ School year: __________________

Signature: _____________________________________________________________ Date: ______________________

In order for this application to be considered, this form MUST BE MAILED, FAXED, or E-MAILED directly to the school by the deadline.

For questions regarding this application, contact the STEAM Academy at (562) 801-5059 or [email protected]. A PDF form of this recommendation may be downloaded at steam.erusd.org.

You may also fax to:(562) 801-5067