The Preuss School UCSD Admissions Application Fall 2016 THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016

Admission to the Preuss School is on a nonsectarian basis, and does not discriminate against any pupil on the basis of ethnicity, special needs, national origin, gender, religion, sexual orientation or disability. Instructions for this application are available in Spanish, Vietnamese, and Tagalog. If you need these instructions, please contact the Admissions Office or print a copy from the Preuss website: http://preuss.ucsd.edu/admissions

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 IMPORTANT DATES EVENTS

DESCRIPTION

DATE/TIME Monday, November 6:00—8:00pm

A workshop to help parents and students complete The Preuss School application.

Application 101*

LOCATION 16th

Barrio Logan College Institute

Tuesday December 1st 6:00—8:00pm

Jackie Robinson Family YMCA

The Preuss School UCSD Open House

A great opportunity for parents and students to learn more about The Preuss School, tour the campus, and meet the teachers!

Saturday, November 7th, 2015

Walton Center 11:30am-1:30pm

Application Deadline

Applications must be postmarked or hand-delivered. No exceptions.

Friday, December 18th, 2015 by 4:00pm.

The Preuss School Main Office

Please visit our website or contact the Admissions Office for additional information on these events. Phone: 858-822-0408

E-mail: [email protected]

Website: http://preuss.ucsd.edu

*Parents and teachers, if you are interested in hosting a presentation or workshop at your student’s current school, please contact the admissions office.

FREQUENTLY ASKED QUESTIONS What is The Preuss School UCSD? The Preuss School UCSD is a unique charter middle and high school for low income, highly motivated students who strive to become the first in their families to graduate from college. Our students come from throughout San Diego County to take advantage of an environment that encourages intellectual risk-taking while offering an array of academic supports. Is transportation available? School bus transportation is not guaranteed. Transportation is currently provided for several areas within the San Diego Unified School District. The parent contribution for transportation is $200 per student. If Preuss cannot provide transportation, the parents need to make arrangements for student transportation to and from school. If you have questions about transportation please contact Patty Villanueva at 858-858-0311. What if I already have a student enrolled at Preuss? There is no guarantee that a sibling of a current Preuss student will be admitted to the school. No preference is extended to the brothers/sisters of current students. Does The Preuss School provide special education services? Yes. Eligible students enrolled at The Preuss School UCSD will receive special education services in accordance with their individualized education programs (I.E.P.) or 504 plans. Contact the Admissions Office with any questions regarding special education. What is the admissions process? Application DUE December 18th

Applications Available October 1st September

Oct./Nov. Preuss Open House November 7th

December

Lottery is Held at the End of March January

February

Applications Reviewed for Completeness

All applications must be postmarked or received by Friday, December 18th, 2015.

March

Enrollment Day April

May/June

Check Income of Provisionally Accepted Students Page 2

THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 ADMISSION CRITERIA The Preuss School accepts applications from students in the San Diego area entering the 6th, 7th, 8th and 9th grades.

Applicants must meet all three requirements in order to be eligible to attend the school, both at the time of application and during enrollment: 1. All families must meet income eligibility criteria as defined by Federal guidelines (found below). 2. The parents or chief guardians are not graduates of a four-year college or university. 3. Applicants must submit a completed application by Friday, December 18th, 2015. Applicants who meet the three requirements will be entered into the admissions lottery. No preference is given to the siblings of current Preuss School students. Students with IEPs or 504 plans may apply.

2015 Federal Guidelines for Income Eligibility # of People in Household Maximum Household Income 1 2 3 4 5 6 7 8

$21,776 $29,472 $37,168 $44,864 $52,560 $60,256 $67,952 $75,648

Families/households with more than 8 persons, add $7,696 for each additional person. Income is defined as before any deductions such as income taxes, insurance premiums, charitable contributions, and bonds. Maximum household income is based on the 185% federal poverty guideline. Parents, please use the following checklist to determine eligibility. You must meet ALL FOUR:

   

I I I I

meet the income eligibility criteria based on my 2014 Income Taxes (before the lottery). will meet the income eligibility criteria based on my 2015 Income Taxes (after the lottery). did NOT graduate from a four-year college/university. will submit my student’s completed application by Friday, December 18th, 2015

Please contact the Admissions Office if you have additional questions regarding your child’s eligibility. Phone: 858-822-0408

E-mail: [email protected]

INSTRUCTIONS FOR PAGES 4 AND 5 OF THE ADMISSIONS APPLICATION Please write in all CAPITAL letters with blue or black ink. See the example below: Last Name:

G A R C I A

Phone Number:

1 2 3 4 5 6 7 8 9

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 1. PERSONAL INFORMATION STUDENT INFORMATION Grade applying for:

 

6th 7th

 

8th 9th

Sex:

 

Male

Birthdate:

Female

M

M

D

D

Y

Y

Y

Y

Last Name: First Name:

Middle Initial:

Current Address:

Apt. Zip Code:

City: Home Phone:

City of Birth:

Current School: School District:





SDUSD



LMSVD



LGSD



NSD

OTHER

PARENT INFORMATION Student Lives With:

 

Both Parents Mother Only

Check If Applicable:

 

Father Only Legal Guardian





Other (specify):

Parents Divorced/Separated

 

Mother Deceased Father Deceased

Father/Guardian LAST Name: Father/Guardian FIRST Name: Address (If different from student’s): Cell Phone:

Work Phone:

Email: Mother/Guardian LAST Name: Mother/Guardian FIRST Name: Address (If different from student’s): Cell Phone:

Work Phone:

Email:

PARENT/GUARDIAN EDUCATION LEVEL Father/Guardian:

   

Elementary/Middle School Some High School High School Graduate AA/AS

Mother/Guardian:

  

2 Year College Graduate Some University 4 Year University Graduate

   

All applications must be postmarked or received by Friday, December 18th, 2015.

Elementary/Middle School Some High School High School Graduate AA/AS

  

2 Year College Graduate Some University 4 Year University Graduate Page 4

THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 PREUSS SCHOOL SIBLINGS No preference is given to the siblings/relatives of current Preuss students. Qualifying applicants will be selected at random through a lottery at the end of March 2016. Sibling information used for reference once admitted.

 

Do you have a student currently enrolled at The Preuss School?

No- Skip to next section Yes- Complete the information below

Sibling #1 LAST Name: Sibling #1 FIRST Name:

Current Grade:

Sibling #2 LAST Name: Sibling #2 FIRST Name:

Current Grade:

Sibling #3 LAST Name: Sibling #3 FIRST Name:

Current Grade:

SCHOOL INFORMATION

How do you prefer to receive admission information from The Preuss School?

 Mail

 Email

In which language do you wish to receive admissions information about The Preuss School UCSD?

 English

 Spanish

 Vietnamese

 Tagalog

SECTION 2. REQUIRED SIGNATURES STUDENT AGREEMENT I certify that all the information provided in this application is accurate. I understand that The Preuss School UCSD can deny or revoke my admission or enrollment if any information is found to be incomplete or inaccurate. I also understand that The Preuss School has a rigorous curriculum and requires a major commitment from all of its students. Student’s Signature:

Date:

PARENT AGREEMENT I certify that all the information provided in this application is accurate. I understand that The Preuss School UCSD can deny or revoke my child’s admission or enrollment if any of the information is incomplete or inaccurate. I also understand that, if admitted, my child is NOT guaranteed transportation. If my child is accepted, I will support him/her in their academic progress and trust The Preuss School administration to make the best decisions for his/her education. Father/Guardian’s Signature:

Date:

Mother/Guardian’s Signature:

Date:

REQUEST FOR RELEASE OF STUDENT INFORMATION I grant permission for The Preuss School UCSD to release my child’s grades 5-12 academic records to the Center for Research on Educational Equity, Assessment, and Teaching Excellence (CREATE) at UCSD. I understand that CREATE may use the information for research and the attainment of The Preuss School’s educational goals. I grant permission for CREATE to contact me to obtain additional records as needed. Student’s Name: Parent/Guardian’s Name:

Current Grade: Parent/Guardian’s Signature:

All applications must be postmarked or received by Friday, December 18th, 2015.

Date:

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 3. STUDENT ESSAY RESPONSE Responses must be written in the space provided with blue or black ink. Students who have an I.E.P., 504 Plan or special needs may utilize the accommodations and modifications that are regularly used in the classroom as outlined in the student’s I.E.P or 504 Plan. The Admissions Committee wants to get to know you. Use the space provided below to write your essay: 

Briefly describe a time in your life (in school or out of school) when you found something challenging, and what you learned from that experience.

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 4. STUDENT SHORT ANSWER QUESTIONS Responses must be written in the space provided with blue or black ink. Students who have an I.E.P., 504 Plan or special needs may utilize the accommodations and modifications that are regularly used in the classroom as outlined in the student’s I.E.P or 504 Plan. 1.

Preuss students attend a school that is sometimes very far from the community in which they live. Discuss the community activities in which you have participated within the last year (ex: Service organizations, recreation centers, community centers). What will you do to maintain a connection with your community?

2.

All students are unique. How do you learn best and what is your best subject?

3.

The Preuss School students have a busy schedule and are required to make a major commitment. They have a possible long bus ride and more than an hour of homework each night. Students are also expected to graduate from The Preuss School UCSD. Please explain in detail how you will adjust to this program.

4.

How did you hear about The Preuss School and why did you choose to apply?

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 5. STUDENT WRITING SAMPLE The Preuss School UCSD students are expected to exhibit their work publicly to show they understand what they have learned. (Please ask your English teacher for help with this section and see example of appropriate work sample on page 9.) 1.

2.

3.

Select a graded Writing Sample from within the past year. a. The Writing Sample should be an essay, book report, reading journal, poem or other writing assignment. b. The Writing Sample should be graded by your current English teacher. It may not be larger than 8.5 X 11 or longer than 5 pages. A copy of the sample must be submitted with the application.

SECTION 6. STUDENT RESPONSE TO WRITING SAMPLE Responses must be written in the space provided with blue or black ink. Students who have an I.E.P., 504 Plan or special needs may utilize the accommodations and modifications that are regularly used in the classroom as outlined in the student’s I.E.P or 504 Plan. The Preuss School UCSD wants students to be able to understand why they are doing their work. Please use the Writing Sample you selected from SECTION 5 to answer the following: 1.

Give the title of the assignment and explain what you were asked to do for the assignment.

2.

What did you learn from this assignment?

3.

Why do you think you received the grade that you did?

4.

If you had more time to work on the assignment, what could you do to improve your work?

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 7. PARENT RESPONSE Please respond to the following questions in the space provided. Responses may be written in English, Spanish, Vietnamese or Tagalog. You may also have a translator complete this section for you. In what language will you be completing your responses?



English



Spanish



Vietnamese



Tagalog

1.

How did you hear about The Preuss School UCSD? Specifically, why do you want your child to attend The Preuss School UCSD?

2.

Describe how your child learns best.

3.

Tell us about your child’s best talents and abilities.

4.

Parents are an important part of a student’s academic success. What will you do to contribute to the academic success of your student at The Preuss School UCSD?

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016

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All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 8 PARENT INCOME Parents, please use the Federal Guidelines to complete the Income Eligibility Chart below:

Federal Guidelines

Persons in family/household

Maximum household income

1

$21,775

2

$29,471

3

$37,167

4

$44,863

5

$52,559

6

$60,255

7

$67,951

8

$75,647 Fill In Information

Income Eligibility Chart People in Household:

#

Annual Income:

$

Name:

Age:

Relationship: PARENT/ LEGAL GUARDIAN

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

Name:

Age:

Relationship:

For families/households with more than 8 persons, add $7,511 for each additional person. Income is defined as before any deductions such as income taxes, insurance premiums, charitable contributions, and bonds. All families must meet income eligibility criteria as defined by Federal Poverty Guidelines. Families with an annual income that falls below 185% of the federal poverty level meet the income eligibility criteria for admissions.

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 8. PARENT INCOME Please complete the IRS Transcript Request Form. Your 2014 income will be verified through this transcript. 1. Go to page 15 of the application. 2. Complete each section of the IRS Transcript Request Form:

     

1a: Parent’s legal name 1b: Parent’s social security number 2a: Parent’s legal name 2b: Parent’s social security number 3: Current address Sign and date the bottom. Write in your phone number.

3. Return the form to the admissions office.



This form will be mailed to the IRS to request information about your 2014 income taxes.  It may take several weeks for the IRS to process this request. The earlier you submit your form, the better. If you did not file taxes, contact The Preuss Admission Office. Example of required sections for page 15:

John Smith

123-45-6789

John Smith. 123 San Diego Dr. Apt. 123, San Diego, CA 92111

John Smith

All applications must be postmarked or received by Friday, December 18th, 2015.

11/10/15

(123) 456-7890

Page 14

All applications must be postmarked or received by Friday, December 18th, 2015.

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All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016

SECTION 9. RECOMMENDATION FORMS Three recommendation forms are required with your application; different people should fill out each recommendation. The forms are located on the following pages. Carefully remove them and distribute them to the appropriate people.

For students applying to the 6th grade, you must submit the following letters of recommendation: 1. 5th Grade Teacher 2. 4th Grade Teacher a. If the 4th grade and 5th grade teacher are the same, ask another teacher for a recommendation b. If 4th grade teacher is no longer at the school, ask another teacher for a recommendation 3. Principal, Vice-Principal, or Counselor 5th Grade Teacher’s Name:

Phone Number:

4th Grade Teacher’s Name:

Phone Number:

Principal’s/Vice-Principal’s/ Counselor’s Name:

Phone Number:

For students applying to the 7th-9th grade, you must submit the following letters of recommendation: 1. Current English Teacher 2. Current Math Teacher (if unavailable, ask a different teacher to complete the recommendation) 3. Current Principal, Vice-Principal, or Counselor English Teacher’s Name:

Phone Number:

Math Teacher’s Name:

Phone Number:

Principal’s/Vice-Principal’s/ Counselor’s Name:

Phone Number:

Note: Parents, if you are unable to submit the three recommendations, please describe what you have done to try to obtain them. Attach your description to the application. For your application to be complete you must submit either the three recommendations or your explanation.

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016

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All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 5TH GRADE OR CURRENT ENGLISH TEACHER RECOMMENDATION FORM To the applicant: Print your name and select the grade you are applying for in the space below. Tear out this form and give it to your 5th grade/Current teacher. Student’s Name: Grade applying for:

Student’s ID #:

 6th

 7th

 8th

 9th

To the teacher:

This student is applying for admission to The Preuss School UCSD. In order to best support students, we ask the professional educators who have worked with them to evaluate their strengths and weaknesses, both as students and as people. Your candid assessment of this student’s potential for success at The Preuss School UCSD is extremely valuable. This recommendation may be returned to the student in a sealed envelope or it may be mailed directly to the: Office of Admissions, The Preuss School UCSD, 9500 Gilman Drive #0536, La Jolla, CA 92093-0536 Note: If you are a San Diego Unified School District employee, you may send the recommendation form via District Mail. Documents must be date stamped by your school clerk before mailing. Teacher’s Name:

Grade Taught:

Teacher’s Signature:

Today’s Date:

School Name:

School Phone #:

Do you recommend the student to The Preuss School UCSD?

 Yes, with enthusiasm

 Yes, without reservations

 Yes, with reservations

 No

For each item below, please check the most accurate description of this student compared to peers.

Academic Performance

Needs Improvement

Emerging

Noticeably Age Developing Appropriate Advanced Exceptional

Academic Ability Academic performance Participation Oral expression Written expression Follows directions Prepared for class Attention span

All recommendations will remain confidential. If you have any questions, please contact The Preuss Admissions Office at 858-822-0408 All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 5TH GRADE OR CURRENT ENGLISH TEACHER RECOMMENDATION FORM For each item below, please check the most accurate description of this student compared to peers.

Personal Characteristics Ability to work in a group Ability to work independently Intellectual Curiosity Motivation/Effort Leadership Potential Classroom Behavior Self-confidence Respect for teachers Reaction to criticism Integrity/Honesty Persistence Self-control Consideration of others Maturity Sense of humor Seeks help when needed

Family Information Has realistic expectations for child Communicates openly and honestly with school Follows rules and policies of school and teachers Follows through with school recommendations Participates in school activities

Needs Improvement

Did not Observe

Emerging

Rarely

Noticeably Age Developing Appropriate Advanced Exceptional

Sometimes Usually

Consistently

Exceptional

What three words come to mind when describing this child? _________________________, _____________________________, ______________________________ In the space below, please provide us with any additional information regarding this child that you find relevant : ___________________________________________________________________________________________ __________________________________________________________________________________________ ___________________________________________________________________________________________

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 4TH GRADE OR CURRENT MATH TEACHER RECOMMENDATION FORM To the applicant: Print your name and select the grade you are applying for in the space below. Tear out this form and give it to your 5th grade/Current teacher. Student’s Name: Grade applying for:

Student’s ID #:

 6th

 7th

 8th

 9th

To the teacher:

This student is applying for admission to The Preuss School UCSD. In order to best support students, we ask the professional educators who have worked with them to evaluate their strengths and weaknesses, both as students and as people. Your candid assessment of this student’s potential for success at The Preuss School UCSD is extremely valuable. This recommendation may be returned to the student in a sealed envelope or it may be mailed directly to the: Office of Admissions, The Preuss School UCSD, 9500 Gilman Drive #0536, La Jolla, CA 92093-0536 Note: If you are a San Diego Unified School District employee, you may send the recommendation form via District Mail. Documents must be date stamped by your school clerk before mailing. Teacher’s Name:

Grade Taught:

Teacher’s Signature:

Today’s Date:

School Name:

School Phone #:

Do you recommend the student to The Preuss School UCSD?

 Yes, with enthusiasm

 Yes, without reservations

 Yes, with reservations

 No

For each item below, please check the most accurate description of this student compared to peers.

Academic Performance

Needs Improvement

Emerging

Noticeably Age Developing Appropriate Advanced Exceptional

Academic Ability Academic performance Participation Oral expression Written expression Follows directions Prepared for class Attention span

All recommendations will remain confidential. If you have any questions, please contact The Preuss Admissions Office at 858-822-0408 All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 4TH GRADE OR CURRENT MATH TEACHER RECOMMENDATION FORM For each item below, please check the most accurate description of this student compared to peers.

Personal Characteristics Ability to work in a group Ability to work independently Intellectual Curiosity Motivation/Effort Leadership Potential Classroom Behavior Self-confidence Respect for teachers Reaction to criticism Integrity/Honesty Persistence Self-control Consideration of others Maturity Sense of humor Seeks help when needed

Family Information Has realistic expectations for child Communicates openly and honestly with school Follows rules and policies of school and teachers Follows through with school recommendations Participates in school activities

Needs Improvement

Did not Observe

Emerging

Rarely

Noticeably Age Developing Appropriate Advanced Exceptional

Sometimes Usually

Consistently

Exceptional

What three words come to mind when describing this child? _________________________, _____________________________, ______________________________ In the space below, please provide us with any additional information regarding this child that you find relevant : ___________________________________________________________________________________________ __________________________________________________________________________________________ ___________________________________________________________________________________________

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 PRINCIPAL, VICE-PRINCIPAL, OR COUNSELOR RECOMMENDATION FORM To the applicant: Print your name and select the grade you are applying for in the space below. Tear out this form and give it to your 5th grade/Current teacher. Student’s Name: Grade applying for:

Student’s ID #:

 6th

 7th

 8th

 9th

To the teacher:

This student is applying for admission to The Preuss School UCSD. In order to best support students, we ask the professional educators who have worked with them to evaluate their strengths and weaknesses, both as students and as people. Your candid assessment of this student’s potential for success at The Preuss School UCSD is extremely valuable. This recommendation may be returned to the student in a sealed envelope or it may be mailed directly to the: Office of Admissions, The Preuss School UCSD, 9500 Gilman Drive #0536, La Jolla, CA 92093-0536 Note: If you are a San Diego Unified School District employee, you may send the recommendation form via District Mail. Documents must be date stamped by your school clerk before mailing. Administrator/Counselor’s Name:

Position:

Administrator/Counselor’s Signature:

Today’s Date:

School Name:

School Phone #:

Do you recommend the student to The Preuss School UCSD?

 Yes, with enthusiasm

 Yes, without reservations

 Yes, with reservations

 No

For each item below, please check the most accurate description of this student compared to peers.

Academic Performance

Needs Improvement

Emerging

Noticeably Age Developing Appropriate Advanced Exceptional

Academic Ability Academic performance Participation Oral expression Written expression Follows directions Prepared for class Attention span

All recommendations will remain confidential. If you have any questions, please contact The Preuss Admissions Office at 858-822-0408 All applications must be postmarked or received by Friday, December 18th, 2015.

Page 23

THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 PRINCIPAL, VICE-PRINCIPAL, OR COUNSELOR RECOMMENDATION FORM For each item below, please check the most accurate description of this student compared to peers.

Personal Characteristics Ability to work in a group Ability to work independently Intellectual Curiosity Motivation/Effort Leadership Potential Classroom Behavior Self-confidence Respect for teachers Reaction to criticism Integrity/Honesty Persistence Self-control Consideration of others Maturity Sense of humor Seeks help when needed

Family Information Has realistic expectations for child Communicates openly and honestly with school Follows rules and policies of school and teachers Follows through with school recommendations Participates in school activities

Needs Improvement

Did not Observe

Emerging

Rarely

Noticeably Age Developing Appropriate Advanced Exceptional

Sometimes Usually

Consistently

Exceptional

What three words come to mind when describing this child? _________________________, _____________________________, ______________________________ In the space below, please provide us with any additional information regarding this child that you find relevant: ___________________________________________________________________________________________ __________________________________________________________________________________________ ___________________________________________________________________________________________

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 SECTION 10. ACADEMIC RECORD REPORT Parents, print your student’s name and birthdate below. Sign the agreement and give this form to your school’s clerk or registrar. I hereby authorize the release of my child’s records (such as, but not limited to, those listed below) to The Preuss School UCSD Office of Admissions. Student’s Last Name:

Student’s First Name:

Parent/Guardian Name:

Parent/Guardian Signature:

Today’s Date:

To the School Clerk or Registrar:

This student is applying for admission to The Preuss School UCSD. In order to best support the student, we ask that you provide the following records. These records will also aid the Center for Research on Educational Equity, Assessment, and Teaching Excellence (CREATE) at UCSD, which may use the information for research and the attainment of The Preuss School’s educational goals. The records may be returned to parent or may be mailed directly to the: Office of Admissions, The Preuss School UCSD, 9500 Gilman Drive #0536, La Jolla, CA 92093-0536 If you are a San Diego Unified School District employee, you may send the recommendation form via District Mail. 





Copy of the current report card:  Fall 2015-First semester grades  You may submit progress reports, but please send final report card when it is available. Copy of two previous final report cards:  2014-2015  2013-2014 Copy of the most recent CASSPP and CELDT results and any other 2014-15 standardized test result.

Student SSID:

Student Birthdate:

Student Permanent ID:

Grade Student First Enrolled:

Clerk/Registrar Name:

Clerk/Registrar Signature:

School Name: School Phone #:

School Fax #: All records will remain confidential. If you have any questions, please contact The Preuss Admissions Office at 858-822-0408

All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016

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All applications must be postmarked or received by Friday, December 18th, 2015.

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THE PREUSS SCHOOL UCSD ADMISSIONS APPLICATION FALL 2016 APPLICATION CHECKLIST Please make sure that all of the following information has been completed and/or attached before submitting your application. We strongly recommend that you make a copy of your application before you submit it. To be submitted by parents:

       

Section 1: Section 2: Section 3: Section 4: Section 5: Section 6: Section 7: Section 8:

Applicant Information Signatures Student Essay Response Student Short Answer Questions Student Writing Sample Student Response to Writing Sample Parent Response Family Income (Contact the Admissions Office if you have any questions regarding income)

To be submitted by parents OR by student’s current school:  Section 9: Recommendations (or parent explanation): 

Applying to the 6th grade:

 5th grade teacher recommendation  4th grade teacher recommendation  Principal/Vice-principal/Counselor recommendation





Applying to the 7th-9th grade:

 English teacher recommendation  Math teacher recommendation  Principal/Vice-principal/Counselor recommendation

Section 10: Academic Record Report:

 Current Fall 2015 Report Card  2014-2015 Final Report Card

 2013-2014 Final Report Card  Standardized Test Result for 2014-15

All applications must be postmarked or received by Friday, December 18th, 2015. Mail to: The Preuss School UCSD Office of Admission 9500 Gilman Dr. #0536 La Jolla, CA 92093

Or submit it in person to: The Preuss School UCSD 3670 Voigt Dr. La Jolla, CA 92037

Directions to The Preuss School UCSD: FROM THE 5: Exit on Genesee Ave. Drive east on Genesee Ave. Turn right on Campus Point Dr. Turn right on Voigt Drive. The Preuss School UCSD is on the right. FROM THE 805: Exit on La Jolla Village Drive. Drive west on La Jolla Village Drive. Turn right on Genesee Ave. Turn left on Campus Point Drive. Turn right on Voigt Drive. The Preuss School UCSD is on the right.

All applications must be postmarked or received by Friday, December 18th, 2015.

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