Central Academy Application

 Listed below are the student qualifications for attending Central Academy.  Please check all those that apply.

    Student has repeated at least one (1) grade.

    Student has absenteeism that is greater than ten percent (10%) during the proceeding semester.

    Student has an overall grade point average that is less than 1.5 (4.0 scale) prior to enrolling in an alternative secondary program.

    Student has failed one (1) or more academic subjects.

    Student is two (2) or more semester credits per year behind the rate required to graduate.

    Student has substance abuse behavior.                                       Student is pregnant or a parent.

    Student is an emancipated youth.                                               Student is a previous dropout.

    Student has serious personal, emotional or medical problems.        Student is a court or agency referral.

    Upon recommendation of the school district as determined by locally developed criteria for disruptive student behavior.

Date:                                        Current Grade:   

Student's Last Name:     First Name:      M/I: 

 Sex:      Date of Birth:  (mm/dd/yy)  Home Phone:  

Address:     City:   Meridian Boise     Zip:  

Live with (Check all who live in the same house): 

                  Father      Mother       Stepparent       Guardian       Self

Father/Stepfather/Guardian:        

                                                     First                                                         Last

Occupation:       Place of Employment: 

Work Phone:        Cell Phone:  

E-mail:   

Mother/Stepmother/Guardian:        

                                                      First                                                    Last

Occupation:       Place of Employment: 

Work Phone:        Cell Phone:  

E-mail:   

Other Emergency Contact:      Phone:  

Last School Attended:     City:    State: 

Number of Credits Earned:  

Are you / have you received special services:     No     Yes:      IEP,    504  

    Please explain: