EDUCATIONAL TALENT SEARCH PROGRAM APPLICATION Phone: (713) Fax: (713) Website:

Transcripción

1 EDUCATIONAL TALENT SEARCH PROGRAM APPLICATION Phone: (713) Fax: (713) Website: Please print clearly School: Grade Level: Today s Date: Address: Student s Name: School ID #: LAST FIRST MIDDLE Address: NUMBER AND STREET APT. NO. CITY STATE ZIP CODE How many years have you lived at your current address? Home Phone #: Cell Phone #: Parent s Cell Phone #: When is the best time to call you after school? Age: Sex: Female Male Race: Date of Birth: / / Place of Birth: STATE OR COUNTRY Citizenship Status (You must be a U.S. citizen or an eligible non-citizen to be a member of this program). Are you a U.S. citizen or an eligible non-citizen? Yes No Alien Registration #: (Required if an eligible non-citizen) How many of your family members live at home with you, including yourself? Please list their names, ages, and their relationship to you. Name Relationship to you Age Name Relationship to you Age Indicate the parent(s)/guardian(s) you lived with the most during the past year. Check only one and list their names on the lines provided below: Mother and father Mother Father Mother and stepfather Father and stepmother Other (please specify relationship) First Name Last Name First Name Last Name Does either parent/guardian you live with have a bachelor's degree (four-year college/university degree)? Yes No Relative s telephone #: (Grandmother, cousin, etc) Best friend s telephone #: Name: Name: (Please turn page over) Revised: August 27, 2014

2 Are you on the free/reduced lunch program? (Do you have a lunch card?) Yes No Do you work after school or on weekends? Yes No Are you enrolled in the ROTC? Yes No Are you planning on joining the military? Yes No Do you want the Educational Talent Search Program to help you to graduate from high school and go to a college Yes No or a technical/vocational school? Are you a member of the Lone Star College Talent Search or Upward Bound Program? Yes No Please list the names of all programs, clubs, or organizations you belong to at your current school. Please tell us something about yourself (hobbies, dreams, extracurricular activities) and why you want to become a member of the Educational Talent Search Program. Participation in the Educational Talent Search Program is completely voluntary. Though we would hope to have you stay in the program through college enrollment, you have the right to withdraw from the program at any time without penalty. I certify that the information on this application is correct to the best of my knowledge. Student s Signature Date The following are needed to complete the application process: 1. ETSP application 2. Parent s 1040 tax form or ETSP Financial/Education Statement 3. ETSP Parent Consent or Child Assent forms 4. Transcript, most recent report card, or progress report Mail to: University of Houston-Downtown Educational Talent Search Program One Main Street Houston, Texas Or return to the ETSP Advisor at your school Revised: August 27, 2014

3 Educational Talent Search Program Phone: (713) Fax: (713) Website: NEEDS ASSESSMENT AND PARTICIPANT CONTRACT Please Print Name School Grade Date 1. What do you like most about yourself? 2. What do you plan to do after you graduate from high school? Please check only one. I don t know Go to college Get a job Join the military Other 3. Do you have a family member in the military? Yes No 4. Circle the grade(s) that you earned most last year. A B C D F 5. Are you satisfied with your grades? Yes No 6. Do you believe that you could make better grades? Yes No 7. Are you having difficulty with or failing any courses? Yes No If yes, which courses? 8. Do you need tutoring for any course(s)? Yes No If yes, please list course(s): 9. Do you have any personal or family problems you want to discuss? Yes No 10. Do you need to meet with me privately to discuss special concerns or needs? Yes No 11. What type of career(s) do you want to pursue? I don t know 12. What type of educational preparation do you need for your chosen I don t know 4 years of college career? (Check one) 2 years of college More than 4 years 13. What college campuses have you visited? None 14. What college/university do you want to attend? I don t know 15. Have you requested information from any colleges or technical schools? Yes No If yes, please list: 16. What is the PSAT? I don t know Have you taken the PSAT? Yes No If yes, date taken: 17. What is the SAT or the ACT? I don t know 18. Have you taken the SAT? Yes No If yes, date taken: 19. Have you taken the ACT? Yes No If yes, date taken: 20. What is the FAFSA? I don t know 21. a) Name three types of financial aid for college b) What is financial literacy? (Please turn page over)

4 22. Place a check by at least 3 items in which you think you will need assistance to you accomplish your educational and career goals. How to study and/or take tests College and/or test applications Campus tours/college information How to take the PSAT, SAT, ACT Financial aid/paying for college Tutoring How to feel better about myself Transition to the next grade level Career exploration/information Choosing a college and/or major What classes to take for college Decision-making skills Help with improving my grades/tutoring Financial literacy Other IF YOU ARE A MIDDLE SCHOOL STUDENT, PLEASE SKIP TO THE PARTICIPANT CONTRACT. 23. Have you passed all sections on TAKS and/or STAAR-EOC? Yes No If no, please list the sections you have not passed: 24. What is the Texas Success Initiative? I don t know 25. Have you taken the THEA, Compass, Asset, or Accuplacer? Yes No If yes, please specify which test(s) you have taken: 26. What graduation plan are you currently under? Minimum Recommended Distinguished SENIORS ONLY: 27. Have you completed the FAFSA? Yes No PARTICIPANT CONTRACT I agree as a member of the ETS Program to meet the following program expectations: (Please Initial) To be the best that I can academically, personally and socially, with the ultimate goal of graduating from high school under the recommended or distinguished plan and enrolling in and completing the college or vocational/technical school of my choice. To meet with my ETSP Advisor at least twice per semester. I understand that failure to do so could result in termination from the program. To participate in ETSP or school tutorials when needed. (Note: Tutorials are optional unless a grade is below an average of 78 for the most recent grading period.) To submit ALL requested forms and documents to your ETSP Advisor including report cards. To remain an active member of ETSP until I graduate from high school or relocate to another school district. To complete and submit the FREE Application For Federal Student Aid (FAFSA) during my senior year. To apply and enroll in a post-secondary institution (i.e., college, technical or vocational school) the summer or fall session following graduation. To GRADUATE from a post-secondary institution (i.e., college, technical, or vocational school). I understand that the staff of the ETS Program will help me to attain my educational, career and personal goals by offering academic, personal, financial aid and career advisement; college guidance and placement services; telephone and/or on-line tutoring and college campus tours. THIS CONTRACT IS VALID FOR THE DURATION OF MY PARTICIPATION IN THE PROGRAM. Participation in the Educational Talent Search Program is completely voluntary. Though we would hope to have you stay in the program through college enrollment, you have the right to withdraw from the program at any time without penalty. Student's Signature Date Signature of ETSP Advisor Date Revised: August 27, 2014

5 Educational Talent Search Program Parent Informed Consent Form I,, have been informed that: Full Name of Parent/Guardian (Please Print) Jennifer Hightower, Executive Director of the Educational Talent Search Program (ETSP) at the University of Houston- Downtown, has requested the submission of my son s/daughter s/ward s application to be considered for participation or continuation in the ETSP. I understand that the purpose of the Educational Talent Search Program is to assist my son/daughter/ward with successfully completing secondary school and enrolling in the postsecondary education institution of his/her choice. I understand that my child s involvement in this program is completely voluntary and all services are free. In addition, if I choose not to have my son/daughter/ward apply, participate or to withdraw from the program at any time, there will be not a penalty. Program acceptance or continuation will entail the following: a. Meeting with an assigned ETSP Advisor for college prep advisement/workshops at his or her designated school during an elective class for approximately 30 to 60 minutes once a month during each school year until high school graduation. b. Attending free college campus and cultural enrichment fieldtrips c. Academic tutoring after school: small group tutoring at his/her school, local library or at the University of Houston-Downtown and online and/or telephone tutoring. d. Assistance with college/scholarship searches and completion of applications e. Assistance with registration/preparation for college entrance examinations (PSAT, SAT, ACT, etc.) during and/or after school. f. Submission and/or access to school transcripts, grade reports, test records free/reduced lunch information and educational or personal data related to program services. g. Non-credit Summer Academic Math Enrichment at the University of Houston-Downtown for rising 8 th, 9 th and 10 th graders. h. Collection of data to complete the program s annual performance report required by the Department of Education. All of the data collected may be published but your child s name will never be used. I understand that there are no foreseeable risks to my son/daughter/ward if I agree to let him/her participate or continue in this program. The benefits of my son s/daughter s/ward s participation or continuation in this program are free college prep, academic tutoring and financial aid information and services to support my child s secondary and postsecondary school endeavors. I know that if I have any questions concerning the Educational Talent Search Program at the University of Houston-Downtown or my son s/daughter s/ ward s participation in the program, I can call Jennifer Hightower at (office) , (cell) or her at hightowerj@uhd.edu. I give consent for my son/daughter/ward,, to participate. Please Print Son s/daughter s/ward s Name Signature of Parent/Guardian Date Phone Number If you agree to your child s participation in the UHD ETSP, please provide the following information. Please Print! Son s/daughter s/ward s Name Current School Age D.O.B. Current Grade Level Any questions regarding your rights as the parent/guardian of a participant of the UHD Educational Talent Search Program may be addressed to the UHD Committee on Standards through its current Chair, Dr. Kristin Anderson at or at andersonk@uhd.edu. All federal grant projects that are carried out at the University of Houston-Downtown are governed by requirements of the University and the Federal Government.

6 Educational Talent Search Program Formulario de Consentimiento Informado Padres Yo,, he sido informado de que: Nombre Completo del Padre / Tutor (letra de imprenta) Jennifer Hightower, Director Ejecutivo del Programa de Búsqueda de Talento Educativo (ETSP) en la Universidad de Houston- Downtown, ha solicitado la presentación de aplicación / de la pupila de mi hijo / hija para ser considerado para la participación o continuación en el ETSP. Entiendo que el propósito del Programa Educational Talent Search es ayudar a mi hijo / hija / pupilo para completar con éxito la escuela secundaria y matricularse en la institución de educación postsecundaria de su / su elección. Entiendo que la participación de mi hijo en este programa es voluntaria y todos los servicios son gratuitos. Además, si decido no tener a mi hijo / hija / pupilo aplicar, participar o retirarse del programa en cualquier momento, no habrá una sanción. Aceptación o continuación del programa supondrán los siguientes: a. Encuentro con un Asesor ETSP asignado para la preparación universitaria asesoría / talleres en su escuela designada durante una clase electiva durante aproximadamente 30 a 60 minutos una vez al mes durante el año escolar hasta la graduación de secundaria. b. Asistir excursiones gratuitas de la universidad y enriquecimiento cultural. c. Tutoría académica después de clases: tutoría en grupos pequeños en su escuela, biblioteca local o en la Universidad de Houston-Downtown tutoría y en línea y / o teléfono. d. Asistencia en búsquedas de universidad / becas y realización de aplicaciones. e. Asistencia con el registro / preparación para los exámenes de ingreso universitario (PSAT, SAT, ACT, etc.) durante y / o después de la escuela. f. Presentación y / o el acceso a transcripciones escolares, reportes de calificaciones, registros de pruebas, información de almuerzo gratis / reducido y datos educativos o personales relacionadas con los servicios del programa. g. Enriquecimiento Académico de Matemáticas en la Universidad de Houston-Downtown durante el verano para el aumento octavo grado, noveno y décimo en cual ningún crédito es acreditado. h. La recopilación de datos para completar el informe de ejecución anual del programa requerido por el Departamento de Educación. Todos los datos recogidos pueden ser publicados, pero el nombre de su hijo nunca se utilizarán. Entiendo que no hay riesgos previsibles a mi hijo / hija / pupilo si estoy de acuerdo para dejarlo / ella participar o continuar en este programa. Los beneficios de la / participación o continuación de la pupila de mi hijo / a en este programa son de preparación universitaria gratuita, tutoría académica y servicios de información y asistencia financiera para apoyar los esfuerzos de secundaria y post-secundaria de mi hijo. Yo sé que si tengo alguna duda sobre el Programa de Búsqueda de Talento Educativo de la Universidad de Houston-Downtown o participación de mi hijo / hija / pupilo en el programa, puedo llamar a Jennifer Hightower al (oficina) (celular) o por correo electrónico a hightowerj@uhd.edu. Doy permiso para que mi hijo / hija / pupilo,, a participar. Por favor escriba el Nombre de su Hijo / Hija Firma del Padre / Tutor Fecha Teléfono Si está de acuerdo con la participación de su hijo en el ETSP UHD, por favor proporcione la siguiente información. Por favor escriba! Nombre de su Hijo / Hija Escuela Edad Fecha de Nacimiento Grado Actual Cualquier pregunta relacionada con sus derechos como padre / tutor de un participante del Programa Educational Talent Search UHD pueden dirigirse al Comité UHD sobre normas a través de su actual Presidente, Dr. Kristin Anderson al o al correo electrónico uhd. edu. Todos los proyectos de subvención federal que se llevan a cabo en la Universidad de Houston-Downtown se gobiernan por los requisitos de la Universidad y del Gobierno Federal.

7 Educational Talent Search Program Applicant s/child s Assent Form I,, have been informed that: Please Print Your Full Name Jennifer Hightower, Executive Director of the Educational Talent Search Program (ETSP) at the University of Houston- Downtown, has requested the submission of my application to be considered for participation or continuation in the ETSP. I understand that the purpose of the Educational Talent Search Program is to assist me with successfully completing secondary school and enrolling in the postsecondary education institution of my choice. I understand that my involvement in this program is completely voluntary and all services are free. In addition, if I choose not to participate or to withdraw from the program at any time, there will be not a penalty. Program acceptance or continuation will entail the following: a. Meeting with an assigned ETSP Advisor for college prep advisement/workshops at my designated school during an elective class for approximately 30 to 60 minutes once a month during each school year until high school graduation. b. Attending free college campus and cultural enrichment fieldtrips c. Academic tutoring after school: small group tutoring at my school, local library or at the University of Houston-Downtown and online and/or telephone tutoring. d. Assistance with college/scholarship searches and completion of applications e. Assistance with registration/preparation for college entrance examinations (PSAT, SAT, ACT, etc.) during and/or after school. f. Submission and/or access to school transcripts, grade reports, test records free/reduced lunch information and educational or personal data related to program services. g. Non-credit Summer Academic Math Enrichment at the University of Houston-Downtown for rising 8 th, 9 th and 10 th graders. h. Collection of data to complete the program s annual performance report required by the Department of Education. All of the data collected may be published but my name will never be used. I understand that there are no foreseeable risks to me if I agree to participate or continue in this program. The benefits of my participation or continuation in this program are free college prep, academic tutoring and financial aid information and services to support my secondary and postsecondary school endeavors. I know that if I have any questions concerning the Educational Talent Search Program at the University of Houston-Downtown or my participation in the program, I can call Jennifer Hightower at (office) , (cell) or her at hightowerj@uhd.edu. I understand and all of my questions have been answered. Please initial only one and return this form to the ETSP Advisor at your school. I want to participate or continue in the UHD Educational Talent Search Program. I do not want to participate or continue in the UHD Educational Talent Search Program. Signature of Applicant Date Age D.O.B. School Grd. Level Person explaining the program: Signature Date Any questions regarding your rights as a participant of the UHD Educational Talent Search Program may be addressed to the UHD Committee on Standards through its current Chair, Dr. Kristin Anderson at or at andersonk@uhd.edu. All federal grant projects that are carried out at the University of Houston-Downtown are governed by requirements of the University and the Federal Government.

8 For office use only: Educational Talent Search Program Phone: (713) Fax: (713) Website: PARENT(S) FINANCIAL & EDUCATION STATEMENT February 2015 January 31, 2016 STUDENT'S NAME S.S.# (Required Information) ADDRESS Number and Street Apt. # City/State Zip DATE OF BIRTH PHONE # SCHOOL GRADE STUDENT S CELL NUMBER PARENT/GUARDIAN CELL NUMBER PARENT/GUARDIAN The next section must be completed and signed by the parent/guardian. This information is required for participation in the Educational Talent Search Program and will be used solely for the determination of applicant's eligibility for project services. All information will be kept confidential. ALL QUESTIONS MUST BE ANSWERED 1. IS YOUR CHILD A U.S. CITIZEN OR PERMANENT RESIDENT? Yes No RESIDENT #: 2. PLEASE INDICATE THE NUMBER OF PEOPLE IN YOUR FAMILY WHOM YOU AND YOUR SPOUSE PROVIDE SUPPORT (FOOD, CLOTHING, SHELTER, MONEY). Don't forget to include yourself and your spouse if applicable! (REQUIRED INFORMATION) 3. HOUSEHOLD TAXABLE ANNUAL INCOME: $ (REQUIRED INFORMATION: DO NOT LEAVE BLANK!) This form will be returned if this question is not answered. "Taxable income" is the total family income AFTER DEDUCTIONS. Your taxable income is found on: Line 06 on the 1040EZ Line 43 on the 1040 Line 27 on the 1040A 4. NONTAXABLE INCOME: Please indicate if you receive any of the following (INITIAL ALL THAT APPLY): Welfare Social Security AFDC Food Stamps Disability Unemployment (Please submit a copy of your latest award letter for verification of nontaxable income such as: welfare, food stamps, AFDC, social security, disability, etc.) REQUIRED! Please answer yes or no to the following questions: 5. Is your son or daughter on the free or reduced lunch program at school? 6. Do you have a bachelor's degree (usually takes four years)? College attended 7. If living in the home, does your spouse have a bachelor's degree? College attended This is to certify that the above information is correct to the best of my knowledge. Signature of Parent/Guardian Date Revised: February 26, 2015

9 For office use only: Educational Talent Search Program Phone: (713) Fax: (713) Website: DECLARACIÓN FINANCIERA Y ACADÉMICA DE LOS PADRES Febrero 2015 Enero 31, 2016 NOMBRE DEL ESTUDIANTE # de S.S. (Información Requerida) DIRECCIÓN Calle Apt. # Ciudad/Estado Zip FECHA DE NACIMIENTO TELÉFONO ESCUELA GRADO NUMERO CELLULAR DE ESTUDIANTE NUMERO CELLULAR DE PADRE CORREO ELECTRONICO DEL PADRE: Esta sección debe ser llenada y firmada por los padres o el tutor. Esta información es requerida para participar en el Educational Talent Search Program y será únicamente usada para determinar la elegibilidad de los servicios proyectados. Toda su información será confidencial. TODAS LAS PREGUNTAS DEBEN SER CONTESTADAS 1. ES SU NIÑO CIUDADANO AMERICANO O RESIDENTE? Sí No # DE RESIDENCIA: 2. POR FAVOR INDIQUE EL NUMERO DE PERSONAS EN SU FAMILIA DE LOS CUALES USTED Y SU CÓNYUGE PROVEEN APOYO ECONOMICAMENTE. No se le olvide incluirse usted y a su pareja si es aplicable! 3. INGRESO IMPONIBLE ANUAL DEL HOGAR: $ (INFORMACION REQUERIDA) "Ingreso imponible anual" es el ingreso total de la familia. DESPUES DE DEDUCCIÓNES. Su ingreso imponible se encuentra en: Línea 06 de la 1040EZ Línea 43 de la 1040 Línea 27 de la 1040A 4. INGRESOS EXENTOS DE IMPUESTOS: Por favor indique con sus iniciales lo que usted recibe: Welfare Seguro Social AFDC Estampillas de Comida Pensión de Incapacidad Desempleo (Por favor someta una copia de la carta más reciente que verifique ingresos exentos de impuestos como: welfare, estampillas de comida, AFDC, Seguro Social, pensión de incapacidad, desempleo, etc.) 5. Está su hijo/hija en el programa de comida gratis o reducción de precio? 6. Tiene usted un título Universitario? Que universidad atendió? 7. Tiene su pareja un título Universitario? Que universidad atendió? Esto es para declarar que la información proveída es correcta de acuerdo a mi conocimiento. Firma del Padre o el tutor Fecha Revised: February 26, 2015

10 For office use only: Educational Talent Search Program Phone: (713) Fax: (713) Website: RELEASE OF STUDENT INFORMATION School/Agency/Test Center Name has permission to release the information listed below on Last Name First Name MI Age Date of Birth Grade to the University of Houston-Downtown Educational Talent Search Program. This information may be used in determining Talent Search eligibility and participation. In addition, the Talent Search Program has permission to release information to the above mentioned school/agency or test center that would be instrumental in the participant s educational, personal or social development. This permission is valid for the duration of student s participation in the program, unless sooner revoked in writing by the student and/or parent/guardian. All information will be kept confidential. Transcripts Grade Reports Test Records Free or Reduced Lunch Information Other Educational or Personal Data Participation in the Educational Talent Search Program is completely voluntary. Though we would hope to have your child stay in the program through college enrollment, you have the right to withdraw him/her from the program at any time without penalty. Student s Signature Date Signature of Parent/Guardian Date Please initial one of the following: I give my permission for photos/videos of my child taken during Talent Search activities to be used in ETSP publications and promotions. I do not want photos/videos of my child taken during Talent Search activities to be used for any purposes. Revised: August 27, 2014

11 For office use only: Educational Talent Search Program Phone: (713) Fax: (713) Website: LIBERACIÓN de INFORMACIÓN ESTUDIANTIL (Escuela, Agencia, Centro de Examen) Tiene mi permiso para otorgar la información descrita debajo Apellido Nombre Inicial Edad Fecha de Nacimiento Grado a la University of Houston-Downtown Educational Talent Search Program para que pueda ser utilizada en determinar la elegibilidad y participación en Talent Search. En adición, el Programa de Talent Search tiene mi permiso para ceder información a la escuela, agencia, o centro de examen mencionado arriba para el desarrollo educacional, personal, o social del estudiante. Este permiso es valido durante la participación del estudiante en el programa a menos que el permiso sea revocado por escrito por el estudiante o el padre. Toda información se mantendrá confidencial. Expediente de calificaciones Calificaciones por semestre Calificaciones de los exámenes Información de Comida Gratis o Reducida en precio. Cualquier otra información educacional o personal Firma Del Estudiante Fecha Firma Del Padre Fecha Por favor ponga sus iniciales en una de las siguientes opciones. Yo autorizo que fotografías/videos de mi hijo(a) sean tomadas durante las actividades del programa Talent Search y usadas para publicaciones y promociones de ETSP. Yo no autorizo que fotografías/videos de mi hijo(a) sean tomadas durante las actividades del programa Talent Search y usadas para publicaciones y promociones de ETSP. Revised: August 27, 2014

12 For office use only: Educational Talent Search Program Phone: (713) Fax: (713) Website: FIELD TRIP AUTHORIZATION Dear Parent/Guardian: Field trips to various post-secondary and secondary educational institutions in Houston and outside the city are an integral part of the University of Houston-Downtown Educational Talent Search Program. Trips will be made by chartered buses and/or private automobiles. Some of the institutions that we have visited and/or plan to visit are University of Texas-San Antonio, University of Houston-Downtown, Sam Houston State University, Prairie View A&M University, Lamar University, University of Texas-Austin, Texas A&M University at College Station, the University of Houston, Texas Southern University, Rice University, Houston Baptist University, Baylor University, Texas A&M University at Galveston, Lone Star College, plus many others. Trips will be well supervised by qualified and responsible Talent Search personnel. Every effort will be made to ensure a safe trip and accomplish the planned educational objectives. However, it should be understood that the University of Houston-Downtown Educational Talent Search Program cannot be held responsible legally for any injuries that might be incurred during a field trip, either at the destination or the traveling to or from said destination. You must sign below if you wish your son/daughter to participate in this important part of the Educational Talent Search Program. Field trip details will be mailed approximately ten days prior to each activity. In addition to this form, the RELEASE AND INDEMNIFICATION AGREEMENT FOR MINORS, is required annually. STUDENTS WILL NOT BE ABLE TO PARTICIPATE ON ETSP FIELD TRIPS WITHOUT TURNING IN BOTH FORMS. This contract is valid for the duration of the student s participation in the program, unless sooner revoked in writing by the student and/or parent/guardian. Student s Name School Grade This is to certify that the above mentioned student has my permission to go on field trips sponsored and chaperoned by Talent Search staff. I hereby release the University of Houston-Downtown Educational Talent Search Program from any and all claims against the school authorities individually or collectively from any injuries which might be received during a Talent Search sponsored field trip, either at the destination or in traveling to or from said destination. I also release the tutor/advisor/administrator/chauffeur from any claims or liabilities. Signature of Parent/Guardian Date Signature of Student Date Revised: March 31, 2015

13 For office use only: Queridos Padres/Guardian: Educational Talent Search Program Phone: (713) Fax: (713) Website: AUTORIZACIÓN de VIAJES de EXCURSIÓN Viajes de Excursión a varias instituciones educacionales secundarias en Houston y fuera de la ciudad son parte integral del University of Houston-Downtown Educational Talent Search Program. Los viajes serán hechos en autobuses alquilados o vehiculos privados. Algunas de las instituciones que hemos visitado y/o planeamos visitar son University of Texas-San Antonio, University of Houston-Downtown, Sam Houston State University, Prairie View A&M University, Lamar University, University of Texas-Austin, Texas A&M University at College Station, the University of Houston, Texas Southern University, Rice University, Houston Baptist University, Baylor University, Texas A&M University at Galveston, Lone Star College, y muchas otras. Los viajes serán supervisados por personal calificado y responsable del Educational Talent Search Program. Todos los esfuerzos serán llevados acabo para asegurar un viaje seguro y llevar a cabo los objetivos educacionales planeados. Sin embargo, debe quedar claro que la University of Houston-Downtown Educational Talent Search Program no puede hacerse responsable de ninguna lesión que ocurra o sea provocada durante el viaje, ya sea que pase en la institución destinada, o en la ida y/o vuelta del viaje. Si desea que su hijo/hija participe en esta parte importante de la University of Houston-Downtown Educational Talent Search Program, firme en el espacio indicado. Los detalles de cada excursion serán mandados por correo aproximadamente diez dias antes de cada actividad. La forma adicional de autorización RELEASE AND INDEMNIFICATION AGREEMENT FOR MINORS, es requerida anualmente. Los estudiantes no podran participar en los viajes si no entregan ambas formas. Este contrato es valido durante la participación del estudiante en el programa a menos que el contracto sea revocado por escrito por el estudiante o el padre. (Nombre del Estudiante) (Escuela) (Grado) Esto es para certificar que el estudiante mencionado anteriormente tiene mi permiso para ir a los viajes de excursión patrocinados y acompañados por el personal de Talent Search. Por este medio, libero a la University de Houston-Downtown Educational Talent Search Program y a las autoridades escolares de cualquier demanda y reclamación por lesiones durante el viaje de ida y/o vuelta a la institución destinada. También libero al profesor/ particular/consejero/administrador/ chofer de todas las demandas que tengan que ver con lesiones. Firma del Padre or Guardian Fecha Firma del Estudiante Fecha Revised: March 31, 2015

14 Educational Talent Search Program Phone: (713) Fax: (713) Website: For office use only: ETSP Advisor PC Date PARENT CONTRACT Student Name School Grade Level As the parent/guardian of the above mentioned student, I am in agreement with the goal of the Educational Talent Search Program to help motivate my son/daughter to be the best that he/she can academically, personally and socially, with the ultimate goal of graduating from high school under the recommended or distinguished plan and enrolling in and completing the college or vocational/technical school of his/her choice. I understand that participation in Talent Search activities is essential in order for the program to successfully help motivate my son/daughter. Therefore, I agree to encourage my son/daughter to do the following: ATTEND SCHOOL REGULARLY and be on time for all classes. STUDY OR READ at least one hour per day and COMPLETE all HOMEWORK assignments. PARTICIPATE in Talent Search and/or school TUTORIALS if his/her grades drop below 78. ATTEND Talent Search ADVISEMENT SESSIONS with the Talent Search Advisor at least TWICE per semester. GRADUATE from high school and ENROLL in the college or accredited technical school of his/her choice the summer or fall semester after graduation. GRADUATE from a college or accredited technical school. I am very supportive of my son's/daughter's educational and career goals and I agree to meet with and/or speak with the Educational Talent Search Program Advisor, at least twice per year to discuss my son s/daughter s progress. This contract is valid for the duration of the student s participation in the program, unless sooner revoked in writing by the student and/or parent/guardian. Please Print Parent/Guardian Name Address City State Zip Code Home Phone # Cell Phone # Work Phone # Parent/Guardian Address Participation in the Educational Talent Search Program is completely voluntary. Though we would hope to have your child stay in the program through college enrollment, you have the right to withdraw him/her from the program at any time without penalty. Signature of Parent/Guardian (REQUIRED) Date Revised: March 31, 2015

15 Educational Talent Search Program Phone: (713) Fax: (713) Website: For office use only: ETSP Advisor PC Date CONTRATO DE PLAN DE APOYO PARA PADRES Nombre del estudiante Escuela Grado Como padre del estudiante mencionado anteriormente, estoy de acuerdo con la meta del Educational Talent Search Program (ETSP) en ayudar a motivar a mi hijo/hija a terminar la escuela y matricularse en un colegio o escuela vocacional/técnica. Yo entiendo que la participación en actividades de Talent Search es esencial para que el programa pueda ayudar a motivar a mi hijo/hija. Es por eso que estoy de acuerdo en dar apoyo a mi hijo/hija para hacer lo siguiente: ASISTIR A LA ESCUELA REGULARMENTE y a estar a tiempo en las clases. ESTUDIAR Y LEER por lo menos una hora al día y a terminar TODAS LAS TAREAS. ASISTIR A SEMINARIOS de ETSP o de A.I.S.D. si los grados de él/ella son menos de 78 en inglés, matemáticas, historia y ciencias. ASISTIR a TALLERES de Talent Search y reunirse con el consejero de Talent Search por lo menos dos veces por semestre. GRADUARSE de high school y MATRICULARSE en un colegio o escuela técnica de su elección. GRADUARSE de un colegio o escuela técnica de su elección. Soy una persona que apoya las metas educacionales y objetivos para la carrera de mi hijo/hija, y estoy de acuerdo en hablar con el consejero de Talent Search por lo menos dos veces al año para hablar sobre el progreso de mi hijo/hija. Este contrato es valido durante la participación del estudiante en el programa a menos que el contracto sea revocado por escrito por el estudiante o el padre. Por favor escriba con letra de molde Nombre del Padre Direccion Ciudad Estado Código Postal Numero del Numero del Numero telefonico del Hogar Cellular trabajo Correo Electronico del Padre Firma del Padre (REQUERIDA) Fecha Revised: March 31, 2015

16

17

18