PSI HIGH COMMITMENT FORM Program of Emphasis
Please return to: Derek Jensen or Kimberly Jackson
Email: [email protected] or [email protected] Seminole High School 9th Grade Center Guidance
21 Lakeview Drive Sanford, FL 32773
PSI High Front Desk: (407) 320-9150
Please complete this form to indicate your intent to enroll in the PSI High program at Seminole High School.
STUDENT INFORMATION
Student Name: _______________________________________________ Birth Date: _______________________
Current School: _______________________________________________ Current Grade: ___________________
PARENT/GUARDIAN INFORMATION
I understand the bulleted statements below:
• PSI High is a full-time, project-based program of emphasis. As a PSI High learner, my child will earn course credit through work on authentic personal and real-world projects.
• My student will learn through a combination of core classes, personal learning investigations, and project-based work at school and in the community.
• My student will receive a schedule with least three class periods combined into a project block. • Students enrolled in PSI High full-time must make satisfactory academic progress to remain in the program. • My student will remain in the program for a minimum of one year. • Enrollment may be revoked if attendance, tardiness, or behavior problems develop in the program.
Parent/Guardian Name: ____________________________________ Signature: _________________________________________
Street Address: ____________________________________ City: _______________________________ Zip: _________________
Today’s Date: _______________________ Phone: _____________________ Email: _____________________________________
NEXT STEPS
1. Please return the form to the Guidance Department or PSI High front desk at the Seminole High School 9th grade center. 2. You will be notified of your application decision in early April. 3. If accepted, you will receive a welcome packet including a student guide. You will be contacted to schedule a new student
meeting with your student and the PSI High team.
FOR SHS GUIDANCE USE
Please check the following:
□ The student has a course request for 9999PSI. (If not, please add.)
□ The student is eligible to join the PSI High program as a full-time student.
Processed by: Name: ___________________________________________________________ Date: _____________________________
Guidance: Retain original for your records Please copy or scan and submit to PSI High Front Desk
Derek Jensen, PSI High Program Manager Email: [email protected] Phone: (407) 320-0330