Phelan Language Academy DUAL LANGUAGE IMMERSION Providing a World of opportunities for students DUAL LANGUAGE IMMERSION APPLICATION FORM
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1 Phelan Language Academy DUAL LANGUAGE IMMERSION Providing a World of opportunities for students DUAL LANGUAGE IMMERSION APPLICATION FORM PLEASE NOTE: Applications need to be received by the due date and completely filled out. The first 30 students will be placed in a classroom. After the 60 spots are filled, your child will be placed on a waiting list in the order received. If you have questions while filling out the application, please call Application for the School Year Application Date Student Last Name: Middle: First: Student Date of Birth: Gender F/M Current Grade Level: Address: Street: City: State: Zip Code: Child s 1 st Language: Please check here if your child is an English Language Learner (ELL) Language spoken most often at home: Is your child already fluent in the language you are applying for? NOTE: Children whom are already proficient (with native-like oral proficiency) in the immersion language may receive preference in acceptance to the program. If yes is selected, Phelan School may follow up with language proficiency testing. This would not apply to students that have received tutoring or lessons in Spanish, but is meant to target highly proficient, native-like speakers. 1
2 Has your Child attended a Dual Immersion program previously? If yes, list name of school and language: Will the student have siblings applying for a permit to attend the traditional program? If yes, How many siblings? Sibling names: Sibling Grades: (check all that apply) TK Kindergarten Does the student have a twin/triplet also applying for the program?: Note: Parents of multiples will need to fill out an application for each child applying. If yes, list student name(s): Does your student live within the Whittier City School District Boundary? Y/N School Currently Attending: District Currently Attending: Parent or Guardian: PARENT/GUARDIAN INFORMATION First Name: Last Name: Relationship: Primary Phone: Secondary Phone: Agreement: I have read and agree to the Conditions for Placement in the Dual Language Immersion Program Conditions for Placement in Dual Immersion Program in Whittier City School District. 1. If the child is accepted to attend the dual immersion program, it is the responsibility of the parents to provide transportation for the student to and from school. 2. Research indicates that an immersion program is most effective when students remain in the program for a sustained period of time. The students will be expected to continue with the program through 5 th grade unless a team decision is made involving the parent, school staff, and district specialists that it is in the best interest of the student to be placed in another program or placement. Please check here if you agree to the terms above. 2
3 Name of person completing the application: Signature: Academia de Lectura y Lenguaje de la Escuela Phelan Inmersión en Dos Idiomas Proporcionar un mundo de oportunidades para los estudiantes FORMULARIO/APLICACION NOTA: Las aplicaciones deben ser recibidas antes de la fecha de vencimiento y llenada completamente. Los primeros 30 estudiantes serán asignados en un salón. Después de los 60 lugares están llenos, su hijo/a será puesto en una lista de espera. Si tiene preguntas al llenar la forma, por favor llame al Aplicación para la Aplicación Año Escolar Fecha Apellido del Estudiante: Nombre: Estudiante Fecha de Nacimiento: Sexo: F / M Nivel actual de Grado: Dirección: Ciudad: Estado: Código Niño primero Idioma: Por favor marque aquí si su niño es un Estudiante del Idioma Inglés (ELL) 3
4 Idioma que se habla con más frecuencia en el hogar: Su nino/a habla español con fluídez? Sí/No NOTA: Los niños cuales están competentes en Español puede recibir preferencia en la aceptación al programa. Si responde "sí" su hijo/a tendrá que tomar una prueba de competencia lingüística. Esto no aplica a los estudiantes que han recibido clases particulares o clases de Español. Su hijo/a a asistió a un programa de doble inmersión previamente? Si es sí, escriba el nombre de la escuela y el lenguaje: El estudiante tiene hermanos que solicitan un permiso para asistir al programa tradicional? Sí, Cuántos hermanos? Nombres de hermanos: Grados hermanos: (marque todas las que correspondan) TK Kindergarten El estudiante tiene un gemelo / triplete aplicando para el programa:? Nota: Los padres de múltiplos tendrá que llenar una forma por cada niño que solicita. Nombre del alumno (s): Su estudiante vive en los límites del Distrito Escolar de Whittier City? Si / No Escuela a la que asiste: Districto: PARENT/GUARDIAN INFORMATION Padre(s): Nombre: Apellido: Relación: 4
5 Teléfono primario: teléfono secundario: Acuerdo: He leído y acepto las "Condiciones para el Programa de Inmersión en dos idiomas " Condiciones para el Programa de Inmersión Dual en el Distrito de la Cuidad de Whittier. 1. Si el niño/a es aceptado para participar en el programa de inmersión dual, los padres son responsable para el transporte para el estudiante a la escuela. 2. Las investigaciones indican que un programa de inmersión es más eficaz cuando los estudiantes permanecen en el programa durante un período de tiempo sostenido. Los estudiantes deberán continuar con el programa hasta el 5 º grado a menos que una decisión de equipo con los padres, el personal escolar, y los especialistas de distrito que es en el mejor interés del estudiante sea colocado en otro programa. Por favor marque aquí si está de acuerdo con los términos anteriores. Nombre de la persona que llena la solicitud: Firma: 5
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