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José Ángel Ramos Giménez
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Frontier School of Innovation 6700 Corporate Dr. Phone: 816-363-1907 (E): 816-241-6202 (MS) Fax: 816-363-1165 (E): 816-241-6207 (MS) http://www.kcfsi.

1 Frontier School of Innovation 6700 Corporate Dr. Phone: (E): (MS) Fax: (E): (MS) STUDENT INFORMATION Frontier STEM High School 6455 Commerce Ave. Phone: Fax: SUMMER SCHOOL APPLICATION - FROM: MAY 19, 2016 thru JUNE 16, 2016 ***PLEASE RETURN ON OR BEFORE FRIDAY, APRIL 22, 2016*** Name Gender: Male Female Last Name First Name Middle Name Address Street City State Zip Code Home Phone # (816) Social Security Number - - Current Grade Date of Birth / / Grade entering Race/Ethnic Group (Note: The Missouri Department of Elementary and Secondary Education requires this information.) (Mark ONE only) Other American Indian Asian Black Hispanic White Authorization for Emergency Care I understand that I will be notified at once in case of accident or illness to my child, and I will make arrangements for medical care of my child with the physician of my choice. If I cannot be reached to make necessary arrangements, or in a critical emergency requiring medical care, I authorize that it may be necessary for Frontier STEM High School to treat my student for an accident that has occurred during school hours. Name of your Health Insurance Company Policy Number Parent/Family Information CHILD S NAME Parent s Name (List relationship if guardian other than mother) Last Name First Name Home Phone Number Street Address City State Zip Cell Phone Number Indicate number to call first EMERGENCY CONTACT Must be a person other than parents or doctors, have a local number, and live at a different address. 1. Last Name First Name Home Phone Number Street Address City State Zip Cell Phone Number Names of People AUTHORIZED to Pick Up Your Child Names and relationships of person(s) NOT ALLOWED TO PICK UP YOUR CHILD If there is a court document stating this, please provide Frontier School of Innovation with a copy. If your child will receive bus service from Frontier STEM High School during summer school please check the box.> I attest that the information provided on this Application for Summer School Admission and Enrollment is correct and current. Parent/Guardian s Signature Parent/Guardian printed name Date Frontier SchoolSystem admits students of any race, color, national and ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. FSS does not discriminate, or in any way prefer any student over another student, based on race, religion, gender, color, national and ethnic origin, disability, income level, proficiency in English, or athletic ability in administration of its educational policies.

2 Frontier School of Innovation 6700 Corporate Dr. Phone: (E) : (MS) Fax: (E) : (MS) Frontier STEM High School 6455 Commerce Ave. Phone: Fax: SOLICITUD DE ESCUELA DE VERANO MAYO 19, JUNIO 16, 2016 ***FAVOR DE ENTREGAR EN O ANTES DEL VIERNES, 22 DE ABRIL DE 2016*** INFORMACION DEL ESTUDIANTE Nombre Sexo: M F Apellido Nombre Inicial Dirección Calle Ciudad Estado Código Postal Teléfono # (816) Numero de Seguro Social - - Grado Actual Fecha de Nacimiento / / Grado Atenderá Raza/Grupo Étnico (Marque uno) El Departamento de Educación Primaria y Secundaria requiere esta información. Otro Indio Americano Asiático Negro Hispano Blanco Autorización para Atención de Emergencia Entiendo que se me notificara de inmediato en caso de que mi hijo/a sufra un accidente o enfermedad. Yo hare los arreglos para la atención medica de mi hijo/a con el médico de mi elección. En caso de emergencia y que no me puedan contactar, autorizo a Frontier School of Innovation administrar tratamiento si ocurre un accidente durante el horario escolar. Nombre de la Compañía de Seguros Numero de Póliza Información Familiar/Padre Nombre del Nino/a Nombre del Padre (Relación si el tutor no es el padre/madre) Indique a que numero llamar primero Apellido Nombre Numero de teléfono - Hogar Dirección Ciudad Estado Código Postal Numero de teléfono - Celular CONTACTO DE EMERGENCIA debe ser una persona distinta a los padres que tenga un número de teléfono diferente y viva en una dirección diferente 1. Apellido Nombre ( ) Número de Teléfono - Hogar Dirección Ciudad Estado Código Postal Numero de Celular Nombre de Personas AUTORIZADAS a recoger a su hijo/a Nombre de Personas NO AUTORIZADAS a recoger a su hijo/a Si hay un documento de la corte que establezca esto, por favor proporcione una copia a le escuela Si su hijo/a recibirá servicio de transporte de escuela de verano de kcfsi marque aqui.> Doy fe de que la información proporcionada en esta Solicitud de Admisión de Escuela de Verano es correcta y actual. Firma del Padre/Guardián Nombre en Letra de Molde Fecha Frontier School of Innovation admite estudiantes de cualquier raza, color, nacionalidad y origen étnico y todos los derechos, privilegios, programas y actividades generalmente acordadas o disponibles para los estudiantes en la escuela KCFSI no discrimina, o de cualquier manera prefiere a un estudiante sobre otro estudiante, por motivos de raza, religión, sexo, color, origen nacional o étnico, discapacidad, nivel de ingresos, el dominio de Inglés, o la capacidad atlética en la administración de sus políticas educativas

3 FRONTIER STEM HIGH SCHOOL 6455 E Commerce Ave. Kansas City MO (816) (816) FRONTIER STEM HIGH SCHOOL 2016 SUMMER SCHOOL COURSE SELECTION FORM This form must be returned the front office by 04/22/2016 Student Name: Current Grade: Date: 04/11/2016 Monday Please select your appropriate summer school course: Current 8 th Grade (FSI Middle School) Algebra 1 In order to sign up for the Algebra 1: 1. Student must pass his/her 8 th grade math course with a minimum ending grade of a B. 2. Student must have a yearly 90% attendance. Note: In order to earn the credit from above courses, student must satisfy all of the following 3. Complete ALEKS with 100% completion rate(algebra 1 ONLY) 4. Must take the EOC Algebra 1 test at the end of summer school and earn a minimum of proficient level. (Algebra 1 ONLY) Current 9 th Grade: Biology Geometry Note: In order to earn the credit from above courses, student must satisfy all of the following 3. Must take the EOC Test of the subject above at the end of summer school and earn a minimum of proficient level.(biology/geometry ONLY)

4 FRONTIER STEM HIGH SCHOOL 6455 E Commerce Ave. Kansas City MO (816) (816) Current 10 th Grade: Government Note: In order to earn the credit from above courses, students must satisfy all of the following 3. Must take the EOC Test of the subject above at the end of summer school and earn a minimum of proficient level. (Government ONLY) Current 11 th Grade: Physical Education Note: In order to earn the credit from above courses students must satisfy all of the following

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