2022-2023 Ambridge Cyber Student Application
1
Ambridge School District Student Application
Student First Name:
*
Student Last Name:
*
What school do you attend?
*
--Please Select--
Economy Elementary
Highland Elementary
State Street Elementary
Ambridge Area Middle School
Ambridge Area High School
Returning to Ambridge Area
New to Ambridge Area School District
Student ID#:
*
Grade Level for 2022-2023 School Year:
*
--Please Select--
K
1
2
3
4
5
6
7
8
9
10
11
12
Does the student have an IEP (Special Education Student):
*
--Please Select--
Yes, IEP
Yes, GIEP
No
Is this application for a partial/blended or full-time cyber schedule?
*
--Please Select--
Partial/Blended - Traditional and Cyber synchronous courses
Full-Time - Synchronous - LIVE in class sessions
Full-Time - Asynchronous - work at your own pace utilizing pre-recorded videos
K - 5 Cyber: Please indicate your class request
Full-time
ELA
Math
Science
Social Studies
Specials - this is a journal based
Other, please specify
Are you unsure of what courses to list below for your schedule? or what is required? If you select yes, a meeting will be scheduled with guidance and cyber coordinators to assist with scheduling.
*
--Please Select--
Yes
No
Grade 6 - 12 SEMESTER 1 - What course(s) are you requesting to take through the Ambridge Cyber Program during the 1st semester? Please see the Program of Studies for course descriptions and numbers.
*
Course #
Course Name
Is this course for Credit Recovery? (yes or no)
1.
2.
3.
4.
5.
6.
7.
8.
9.
SEMESTER 2 - What course(s) are you requesting to take through the Ambridge Cyber Program during the 2nd semester? Please see the Program of Studies for course descriptions and numbers.
Course #
Course Name
Is this course for Credit Recovery? (yes or no)
1.
2.
3.
4.
5.
6.
7.
8.
9.
The Credit Recovery option is only available if you have already failed a course. Credit Recovery courses will receive a pass/fail final grade on your transcript. All course work will be based on an initial prescriptive test. If you are requesting a letter grade on your transcript, you must register for a traditional cyber level course.
Do you have high speed internet access at home?
*
--Please Select--
Yes
No
Is a parent or guardian at home throughout the school day?
--None--
Yes
No
Do you have an interest in participating in extracurricular activities?
--None--
Yes
No
Do you have an interest in participating in athletics?
--None--
Yes
No
I understand and agree to all policies and procedures of Ambridge School District.
Student Signature
*
Student signature acknowledges that you have read and will abide by the terms of the contract.
Student Signature
*
Student signature acknowledges that you have read and will abide by the terms of the contract.
Indicates approval
Parent Signature
*
Parent signature acknowledges that you have read and will abide by the terms of the contract.
Parent Signature
*
Parent signature acknowledges that you have read and will abide by the terms of the contract.
Indicates approval
Parent/Guardian (Primary):
*
First Name:
Last Name:
Home Phone:
Cell Phone:
Parent/Guardian (Primary):
Parent/Guardian 2
First Name:
Last Name:
Home Phone:
Cell Phone:
Parent/Guardian 2
Parent Email(s):
Daily progress reports will be sent to this email address. You may add additional email addresses separated by a semicolon.
How did you learn about the Ambridge Cyber Program?