choice programs application school year 2013-2014...pbsd 1537 (rev. 10/27/2016) original -...

PBSD 1537 (Rev. 10/27/2016) ORIGINAL - Department of Choice Programs and School Choice

If yes, submit official current Orders and proof of dependency, such as Student's Military ID card.

EMPLOYEE: If parent/legal guardian is a full-time employee at the school selected as your first choice preference, the Principal must verify this employment by signing below.

SIGNATURE - I have read, understand and agree to the following:

Deadlines: December 2, 2016 for Bak MSOA, The Conservatory School @ North Palm Beach, A.W. Dreyfoos Jr SOA, and Boynton Beach High School Arts Programs. Deadline of January 27, 2017 for all other schools. Incomplete or faxed applications will NOT be accepted.

Online application is preferred. Save time, money, and receive an

immediate confirmation email. Complete the online application at:

www.mypbchoiceapp.com

Race (check at least one)

Read the information on Page 2 before completing application. ONE application per child may be submitted. Parent/legal guardian and student must be full-time residents of Palm Beach County on date of submission. Falsification of information on this application could lead to ineligibility. For more information, call (561) 434-8755. Type or print legibly in blue or black ink and return completed application to: Department of Choice and Career Options, 3300 Forest Hill Blvd., C-124, West Palm Beach, FL 33406.

Gender

Home Phone No.

HOME ADDRESS MUST MATCH ADDRESS ON FILE AT SCHOOL or application will NOT be processed.

THE SCHOOL DISTRICT OF PALM BEACH COUNTY DEPARTMENT OF CHOICE AND CAREER OPTIONS Assigned SAC School

SAC #Choice Programs Application School Year 2017-2018

Signature of Parent/Legal Guardian

Student Name (first, middle, last)

Birth Date (mm/dd/yy) Name of Parent(s)/Legal Guardian(s) Current School

Grade Applying For

Signature of School Principal

Cell Phone No.

Elementary Middle High School

Student ID #

American Indian/Alaskan Native Asian/Pacific IslanderBlack/Non HispanicHispanic or Latino Multiracial White/Non Hispanic

OFFICE USE ONLY

Date

Date

Current Grade

Name of School

CHECK ONE ONLY

NAME OF SIBLING ATTENDING SCHOOL PROGRAM BIRTH DATE GRADE

My signature verifies that I declare, under penalties of perjury, pursuant to Florida Statute, Section 92.525, that I have read this application, including all sections on Page 2, and all the information stated in this application is true and correct.

I understand that ONLY ONE (1) Choice application per student may be submitted and only one application selection change will be allowed if applying online.I understand that I must provide my child's IEP, ELL, or 504 Plan prior to an audition to ensure the accommodations are provided.

1.

2.

SIBLINGS: Siblings are defined as brother, sister, half-brother, half-sister, stepbrother, or stepsister, living in the same household. Name of one (1) sibling who is already attending and will be attending the same Choice school to which this applicant is applying:

I understand that if my child is not selected for the 2017-2018 school year, a new application must be submitted for the following school year.

4.

6.

/ /F M

STRAND: Has the applicant participated in and completed a program in a similar preparatory choice theme in grades 4-5 or grades 7-8?

Yes NoIf yes, provide name of school and program:

Ethnic Origin (check one)

NOT Hispanic or Latino

3.

Parent/Legal Guardian E-mail Address

Acceptance of a Choice program takes the place of all assignments for other programs including but not limited to: Reassignment, Controlled Open Enrollment, and Opportunity Scholarships.

5.

SIBLING(S) APPLYING Name of sibling(s) currently applying to the same Choice school as this applicant:

No Yes

I have read (or had read to me), understand, and had an opportunity to ask questions about the information provided in the 2017-2018 Choice booklet and the "Procedures Manual" for Choice programs, both of which are available online at www.palmbeachschools.org/choiceprograms.

Check if siblings are twins or triplets.

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Home Address City Zip Code

MILITARY: Is the parent or legal guardian a full-time active duty service member?

http://www.mypbchoiceapp.com/site.php

https://www.palmbeachschools.org/choiceprograms/


DIRECTIONS - Current PBCSD students must include Student ID on the application. Students applying for kindergarten must be 5 years old by September 1, 2017. Indicate your first and second program choices by placing a "1" for your first preference and a "2" for your second preference in the columns marked "#". Only two program choices are permitted. Eligibility criteria for Choice programs are indicated in the 2017-2018 Choice booklet located at http://www.palmbeachschools.org/choiceprograms. Review the eligibility criteria prior to selection. Identification of a second choice does not decrease a student's chances of being selected to the first choice. First and second choices do not have equal chances of being selected. Programs may have limited numbers of available seats and may not have any second choice students assigned in the lottery. Completion of this application does not guarantee admission. HOME EDUCATION, VIRTUAL SCHOOLS AND PRIVATE SCHOOLS - Parents must submit transcripts/portfolio to applicant school(s) for determination of eligibility no later than February 3, 2017. Check the eligibility criteria as indicated on pages 6-8 in the 2017-2018 Choice booklet. MONTESSORI - Northboro Elementary and S.D.Spady Elementary accept applications for Pre-K students. D.D. Eisenhower Elementary accepts applications for K-5. For Northboro Elementary and S.D. Spady Elementary Pre-K3, applicants must be 3 years old by September 1, 2017 and Pre-K4, applicants must be 4 years old by September 1, 2017. AUDITIONS - Bak MSOA, The Conservatory School @ North Palm Beach, A.W. Dreyfoos Jr. SOA, and Boynton Beach High School Arts programs In order to be eligible for the Choice lottery, the student must receive an eligible audition score for Bak Middle School of the Arts, The Conservatory School @ North Palm Beach - Symphony Orchestra Program, A.W. Dreyfoos Jr. School of the Arts, and Boynton Beach High School Arts programs. Approved applicants will be notified via email and/or U.S. Mail of the audition procedures and/or time and date of student audition. Applicants who need special accommodations or translations during audition(s) should contact the Choice Coordinator at Bak MSOA, (561) 882-3801/(561) 882-3819, at Dreyfoos SOA (561) 802-6005, at Boynton Beach High School (561) 752-1200, or at The Conservatory School @ North Palm Beach (561) 494-1844. APPEALS - Parents/legal guardians who believe their child was not allowed an equitable opportunity to a Choice program during the audition or eligibility process as a result of a technical problem or inequity, may request an appeal within five (5) days of the audition. An application for an appeal of Choice program eligibility must be submitted to the Director of Choice and Career Options within five (5) school days of the audition. At the time of audition, parents are required to sign a statement acknowledging that they have five days to appeal and no appeal will be available after the five day window following a student's audition. To download the PBSD 2418 Choice Appeals Application, go to www.palmbeachschools.org/ Forms/Documents/2418.pdf. DUPLICATE PROGRAMS - If the student is applying for a Choice program that is offered at his/her zoned school, the zoned school program must be listed as the first choice or the application will not be processed, with limited exceptions. All students may apply for first choice to the following full choice schools: Suncoast Community High School, A.W. Dreyfoos Jr. School of the Arts, Don Estridge High Tech MS, Bak Middle School of the Arts, Morikami Park ES, Northboro ES, Poinciana ES, SD Spady ES, and Village Academy. TRANSPORTATION - Transportation is provided for Choice students in the form of bus stops within the Choice Transportation Zone for each school. Bus stops to Choice schools may be limited and located significantly farther from the student's home than transportation to the student's zoned school. Bus stops for Choice schools may not be within walking distance of a student's home. Additional bus stops for Choice students will not be created. It is the parent's responsibility to safely transport the student to the nearest bus stop or school regardless of where the student resides. Check the existing stops using the “Find My Bus Stop” link on our website: http://www.palmbeachschools.org/choiceprograms. Bus stops are subject to change. PALM BEACH STATE COLLEGIATE HIGH SCHOOL - Only students who will be entering 12th grade for the 2017-2018 school year who meet the criteria listed on page 8 in the 2017-2018 Choice booklet.

Choice Programs Application School Year 2017-2018

Student Name

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Apply online at www.mypbchoiceapp.com


https://www.palmbeachschools.org/forms/formsearch/


http://www.mypbchoiceapp.com/site.php


Pre-K & ELEMENTARY SCHOOLS 2017-2018 Student Name

# PROGRAM SCHOOL LOCATION

Biomedical and Veterinary Technology Acreage Pines Loxahatchee

Health and Wellness Allamanda Palm Beach Gardens

Technology Banyan Creek Delray Beach

Technology Boca Raton Boca Raton

Spanish Dual Language Cholee Lake Greenacres

Science, Technology, Engineering, Arts, and Math (STEAM) Citrus Cove Boynton Beach

Science, Technology, Engineering, and Math (STEM) Crosspointe Boynton Beach

Science, Technology, Engineering, and Math (STEM) Cypress Trails Royal Palm Beach

International Baccalaureate Primary Years Programme Dr. Mary McLeod Bethune Riviera Beach

Montessori (K-5) D.D. Eisenhower Palm Beach Gardens

International Baccalaureate Primary Years Programme Forest Park Boynton Beach

Environmental and Animal Science Frontier Loxahatchee

E3-Energy, Environment, and Engineering Galaxy Boynton Beach

Visual, Performing, and Communication Arts Glade View Belle Glade

Technology Golden Grove West Palm Beach

Spanish Dual Language Gove Belle Glade

Biomedical and Veterinary Technology Grassy Waters West Palm Beach

International Baccalaureate Primary Years Programme Grove Park Palm Beach Gardens

Science, Technology, Engineering, Arts, and Math (STEAM) HL Johnson Royal Palm Beach

Spanish Dual Language Hagen Road Boynton Beach

Science, Technology, Engineering, Arts, and Math (STEAM) Hidden Oaks Lake Worth

Science, Technology, Engineering, Arts, and Math (STEAM) Loxahatchee Loxahatchee

Science, Technology, Engineering, and Math (STEM) Meadow Park West Palm Beach

International Baccalaureate Primary Years Programme Morikami Park Delray Beach

International Spanish Academy (ISA) New Horizons Wellington

Spanish Dual Language North Grade Lake Worth

Montessori (Pre-K3, Pre-K4, K-5) Northboro West Palm Beach

International Baccalaureate Primary Years Programme Pahokee Pahokee

Science, Technology, Engineering, Arts, and Math (STEAM) Palm Beach Gardens Palm Beach Gardens

Orchestral Strings Palm Beach Public Palm Beach

International Baccalaureate Primary Years Programme Palmetto West Palm Beach

Science (Environmental), Technology, Engineering, and Math Pine Jog West Palm Beach

Spanish Dual Language Plumosa School of the Arts (SOA) Delray Beach

Arts (Visual, Performing, and Communications)

Science, Technology, Engineering, and Math (STEM) Poinciana Boynton Beach

Math, Science, and Technology Roosevelt West Palm Beach

Montessori (Pre-K3, Pre-K4, K-5) S.D. Spady Delray Beach

Health and Wellness (Specializing in Medical Sciences) Starlight Cove Lantana

Science, Technology, Engineering, and Math (STEM) Timber Trace Palm Beach Gardens

Children's Orchestra and Performing Arts Project (COPA) The Conservatory School @ North Palm Beach North Palm Beach

Arts (Visual, Performing, and Communications) U.B. Kinsey/Palmview SOA West Palm Beach

Small School Continuum Village Academy Delray Beach

Arts (Visual, Performing, and Communications) Wellington Wellington

International Baccalaureate Primary Years Programme Westward West Palm Beach

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MIDDLE SCHOOLS 2017-2018 Student Name


Communication Arts Bak Middle School of the Arts West Palm Beach

Dance

Music - Band Instrument:

Music - Keyboard/Piano

Music - Orchestral Strings Instrument:

Music - Vocal

Theatre

Visual Arts

Pre-Biotechnology Bear Lakes West Palm Beach

Math Boca Raton Boca Raton

Pre-Medical Sciences

International Baccalaureate Middle Years Programme Carver Delray Beach

Pre-Information Technology

Science, Technology, Engineering, and Math (STEM)

Pre-Information Technology Christa McAuliffe Boynton Beach

Digital Graphic Design Congress Boynton Beach

Digital Video Design

Pre-Engineering


Science, Technology, Engineering, Arts, and Math (STEAM)

International Baccalaureate Middle Years Programme Conniston West Palm Beach

Spanish Dual Language

Multimedia, Music, and Communications Crestwood Royal Palm Beach

Pre-Business/IT

Pre-Engineering

High Technology Don Estridge High Tech Middle Boca Raton

Pre-Engineering (Gateway to Technology) Eagles Landing Boca Raton

International Baccalaureate Middle Years Programme H.L. Watkins Palm Beach Gardens

Math, Science, and Robotics


Pre-Business/IT Independence Jupiter

Pre-Law

Pre-Teacher Education

Pre-Culinary Arts Jeaga West Palm Beach

Pre-Law

International Baccalaureate Middle Years Programme John F. Kennedy Riviera Beach

Pre-Culinary Arts


Multimedia, Music, and Communications Jupiter Jupiter

Pre-Culinary Arts

Pre-Engineering (Gateway to Technology)


Pre-Information Technology L.C. Swain Greenacres

Pre-Law


Pre-Medical Sciences Lake Shore Belle Glade

Biomedical Sciences (FAU College of Medicine) Lake Worth Lake Worth

Pre-Engineering (Gateway to Technology)

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MIDDLE SCHOOLS 2017-2018 Student Name

# PROGRAM SCHOOL LOCATION Band Lantana Lantana

Dance



Pre-Culinary Loggers' Run Boca Raton Pre-Law

Pre-Medical SciencesPre-Engineering Odyssey Boynton Beach


International Spanish Academy (ISA) Okeeheelee GreenacresBiomedical Health Informatics Omni Boca Raton

Multimedia & Television Production Osceola Creek Loxahatchee

Pre-Culinary Arts

Pre-Veterinary

International Baccalaureate Middle Years Programme Pahokee Pahokee Pre-Information Technology and Television

Communications Arts Palm Springs West Palm Beach

Dance

Music - Band

Music - Orchestral Strings

Music - Vocal

Spanish Dual Language

Theatre

Visual Arts

Pre-Information Technology Polo Park Wellington Biomedical Sciences (FAU College of Medicine) Roosevelt West Palm Beach

Environmental Science / GIS Leadership Academy for Young Men

Pre-Engineering


Technology

Symphony Orchestra (Grades 6-8)The Conservatory School @ North Palm Beach North Palm Beach

Pre-Culinary Arts Tradewinds Greenacres


Small School Continuum Village Academy Delray BeachLiterary and Fine Arts - Instrumental Watson B. Duncan Palm Beach GardensLiterary and Fine Arts - Theatre

Literary and Fine Arts - Visual

Literary and Fine Arts - Vocal

Literary and Fine Arts - Writing & Literature

Pre-Finance

Fine Arts Wellington Landings Wellington


Graphic Arts Western Pines Royal Palm Beach



Cambridge Academy Woodlands Lake Worth

Pre-Culinary ArtsPre-Information Technology

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Communication Arts A.W. Dreyfoos Jr. School of the Arts West Palm Beach

Dance

Digital Media


Music - Keyboard/Piano

Music - Strings Instrument:

Music - Vocal

Theatre

Visual Arts

International Baccalaureate Atlantic Delray Beach

International Baccalaureate Medical Sciences

Navy JROTC Boca Raton Boca Raton

Aerospace Science (BASA) Boynton Beach Boynton Beach

Dance

Digital Media

Information Technology

Marine Corps JROTC

Medical Sciences - Pre-Medicine


Music - Vocal

Theatre

Visual Arts

Army JROTC Forest Hill West Palm Beach

Engineering and Technology (PLTW)

Environmental Science and Field Research


International Baccalaureate Diploma Programme

Tourism, Hospitality, and Resort Management

Criminal Justice Glades Central Belle Glade

Engineering and Technology


Computer Technology John I Leonard Greenacres

Finance

International Spanish Academy (ISA)


Engineering and Technology (PLTW) Jupiter Jupiter

Environmental Science and Field Research


Air Force JROTC Lake Worth Lake Worth

Biomedical Sciences (FAU College of Medicine)

Criminal Justice

Culinary Arts

Drafting and Design

Early Childhood Teacher Education


HIGH SCHOOLS 2017-2018 Student Name

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PROGRAM SCHOOL LOCATION#Early Childhood Teacher Education Olympic Heights Boca Raton


Finance

Marine Corps JROTC


Air Force JROTC Pahokee Pahokee


International Baccalaureate

Teacher Education

Culinary Arts Palm Beach Central Wellington


Web and Digital Design Biomedical Sciences (FAU College of Medicine) Palm Beach Gardens Palm Beach GardensCulinary ArtsGlobal Business and Entrepreneurship


Sports Management and Recreation

Television & Film Production Technology


Biotechnology Palm Beach Lakes West Palm Beach

Center for Pre-Law/Law Related Careers


Marine Corps JROTC


Teacher Education

Auto Collision Repair and Refinishing Park Vista Lake Worth

Automotive Service Technology


Air Conditioning, Refrigeration, and Heating Technology Royal Palm Beach Royal Palm Beach

Global Business



Science, Technology, Engineering and Mathematics

Band/Music Industry Santaluces Lantana

Culinary Arts


Visual Arts (Digital Media and Photography)

Biotechnology Seminole Ridge Loxahatchee

Construction Television and Film Production Technology

American History and Law Spanish River Boca Raton

Biotechnology

Entrepreneurship

Computer Science Suncoast Riviera Beach

Innovative Interactive Technology


Mathematics, Science, and Engineering


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# PROGRAM SCHOOL LOCATIONSmall School Continuum Village Academy Delray Beach

Equine/Pre-Veterinary Wellington WellingtonFine Arts

Fire Science

Marketing

Computer Science West Boca Raton Boca Raton

Culinary Arts

Drafting and Design


Performing Arts

Early Childhood Teacher Education William T. Dwyer Palm Beach Gardens

Finance



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Palm Beach State Collegiate High School Palm Beach State College

Palm Beach Gardens Campus Only