haas hall academy in loco parentis printed name parent/guardian/persons in loco parentis ... haas...
TRANSCRIPT
HAAS HALL ACADEMYS T A R R S C H O L A R C E N T E R
3 8 8 0 N O R T H F R O N T S T R E E T
F A Y E T T E V I L L E , A R 7 2 7 0 3 . 5 1 3 0
( 4 7 9 ) 9 6 6 . 4 9 3 0 | ( 4 7 9 ) 9 6 6 . 4 9 3 2 – F A X | H A A S H A L L . O R G
E V E R Y S C H O L A R , E V E R Y D A Y – C O L L E G E B O U N D
H A A S H A L L A C A D E M Y D O E S N O T D I S C R I M I N A T E O N T H E B A S I S O F S E X , N A T I O N A L O R I G I N , R A C E ,
E T H N I C I T Y , R E L I G I O N , D I S A B I L I T Y O R A T H L E T I C E L I G I B I L I T Y .
Tuesday, Feb. 21, 2017
Congratulations and thank you for choosing Haas Hall Academy, recognized as one of the
nation’s premiere schools, as the next step in your scholar’s academic career! You are joining
an exceptional group of individuals who have made the decision to focus on preparing for
college.
I welcome you to the Haas Hall Academy community. Classes for the fall will commence on
Thursday, August 10, 2017.
Haas Hall Academy is a multiple national award-winning model of how a charter school can
strengthen communities, inspire innovation, and be a catalyst for the renewal of expectations
for public education. Haas Hall Academy is the accelerated, rigorous, college-preparatory
open-enrollment charter high school located in Fayetteville, Bentonville, Springdale and Rogers. Haas Hall Academy is the number one ranked high school in the state of Arkansas,
for the fifth consecutive year, according to U.S. News and World Report. Haas Hall Academy
is listed as the 19th
highest ranked public high school in the nation by Newsweek.
You will be receiving more information from us in the coming months. For now, please fill out the paperwork in this Registration Packet and return it by 3 p.m. Friday, Feb. 24. Paperwork may be hand delivered, faxed to (479) 966.4932 or emailed to [email protected]. Failure to submit the required paperwork by the deadline will result in your scholar losing their seat. We do not want that to happen.
Please do not hesitate to contact the school at (479) 966-4930 so that we may immediately
address your questions or concerns. I hope this becomes routine for you, as continual
communication is the key to success in educating your scholar.
Again, congratulations! We look forward to working with you to ensure your scholar’s future
academic success!
Sincerely,
Dr. Martin W. Schoppmeyer, Jr.
Founder and Superintendent of Schools
MWS/hpt
HAAS HALL ACADEMYS T A R R S C H O L A R C E N T E R
3 8 8 0 N O R T H F R O N T S T R E E T
F A Y E T T E V I L L E , A R 7 2 7 0 3 . 5 1 3 0
( 4 7 9 ) 9 6 6 . 4 9 3 0 | ( 4 7 9 ) 9 6 6 . 4 9 3 2 – F A X | H A A S H A L L . O R G
E V E R Y S C H O L A R , E V E R Y D A Y – C O L L E G E B O U N D
H A A S H A L L A C A D E M Y D O E S N O T D I S C R I M I N A T E O N T H E B A S I S O F S E X , N A T I O N A L O R I G I N , R A C E ,
E T H N I C I T Y , R E L I G I O N , D I S A B I L I T Y O R A T H L E T I C E L I G I B I L I T Y .
Additional Races: (Check all that apply)
□ American Indian/Alaska Native
□ Asian
□ Black
□ Native Hawaiian/Other Pacific Islander
□ White
ARKANSAS DEPARTMENT OF EDUCATION RACE AND ETHNICITY FORM 2017.2018
Dear Parent or Guardian:
Every school district in Arkansas is required to report to the Arkansas Dept of Education each year student data with race and ethnicity categories that are set by the federal government. The ADE does not report individual student data to the federal government but does report aggregate data for each race/ethnic group.
These reports help us to keep track of changes in student enrollments and ensure that all students receive the educational programs and services to which they are entitled. All schools are required to report to the ADE using these new categories.
The federal government recently changed the reporting categories for student race data. As a result, you have the opportunity to update the student data on your child if you wish to do so. With the new reporting categories you may now identify your child by ethnic group (either Hispanic/Latino or non-Hispanic/Latino) and by one or more racial groups. The list below gives a description of each of the ethnic and racial groups:
Primary Race: (Please select only one)
□ American Indian/Alaska Native
□ Asian
□ Black
□ Native Hawaiian/Other Pacific Islander
□ White
Hispanic/Latino Ethnicity: (Check one)
□ Yes
□ No
SCHOLAR’S NAME
HAAS HALL ACADEMY
S T A R R S C H O L A R C E N T E R 3 8 8 0 N O R T H F R O N T S T R E E T
F A Y E T T E V I L L E , A R 7 2 7 0 3 . 5 1 3 0
( 4 7 9 ) 9 6 6 . 4 9 3 0 | ( 4 7 9 ) 9 6 6 . 4 9 3 2 – F A X | H A A S H A L L . O R G
E V E R Y S C H O L A R , E V E R Y D A Y – C O L L E G E B O U N D
H A A S H A L L A C A D E M Y D O E S N O T D I S C R I M I N A T E O N T H E B A S I S O F S E X , N A T I O N A L O R I G I N , R A C E ,
E T H N I C I T Y , R E L I G I O N , D I S A B I L I T Y O R A T H L E T I C E L I G I B I L I T Y .
HAAS HALL ACADEMY OFFICIAL RECORDS, ATTENDANCE HISTORY AND TRANSCRIPT REQUEST
Requests a copy of their official records, attendance history and transcripts from:
Please mail or fax to:
Haas Hall Academy
C/o Dr. Martin W. Schoppmeyer, Jr. 3880 North Front Street Fayetteville, AR 72703
(479) 966.4932 – fax
___________________________________________ _______________________________________ Parent/Guardian/Persons in Loco Parentis Printed Name Parent/Guardian/Persons in Loco Parentis Signature
__________________
Date
SCHOLAR’S NAME
SCHOOL NAME
_____________________________________________________________________ CITY STATE ZIP CODE
SCHOLAR'S LAST NAME:
SSN:Gender:
Grade:
RACE Please answer the following in accordance with standards issued by the US Department of Education.
PRIMARY RACE (Please select only ONE)
ADDITIONAL RACES (check all that apply):
American Indian/Alaska Native Asian BlackNative Hawaiian/Other Pacific Islander White
F
Hispanic/Latino Ethnicity:
HAAS HALL ACADEMY Enrollment Form
GENERAL SCHOLAR INFORMATION
PARENT/GUARDIAN CONTACT
American Indian or Alaska Native (A person having origins in any of the original peoples of North and South America, including Central America, and who maintains tribal affiliation or community attachment)
Asian (A person having origins in any of the original peoples of Far East, Southeast Asia, or the Indian subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam)
Black or African American (A person having origins in any of the black racial groups of Africa)
Native Hawaiian or Other Pacific Islander (A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands)
White (A person having origins in any of the original peoples of Europe, Middle East or North Africa)
M
Mailing Address is same as Physical/911 Address
Scholar Primarily Resides with this Guardian. Scholar Primarily Resides with this Guardian.
Yes NoCampus:
Language Spoken At Home:
Address:City: State: Zip Code:
Name:Relationship to Scholar:Language of Correspondence:Mailing Address:City:State:Email:Home Phone:Work Phone:
Entry Date:Entry Code:Curriculum:
Meal ST:M/V Act:504:
ESL:SP:MIG:
IMMG:GT:Homeroom:
Residency:Choice LEA:P/T ADM %:
Address:City: State: Zip Code:
Scholar's Email Address:
Scholar Home Phone: Scholar Cell Phone:
Birthdate: Nickname:/ / / /
SCHOLAR'S FIRST NAME: SCHOLAR'S MIDDLE NAME:
OFFICE USE ONLY
Scholar Physical/911 Address Scholar Mailing Address
Parent/Guardian 1 Parent/Guardian 2
Zip Code:
Cell Phone:Employer:
Name:Relationship to Scholar:Language of Correspondence:Mailing Address:City:State:Email:Home Phone:Work Phone:
Zip Code:
Cell Phone:Employer:
(479) 966-4930 (479) 966-4932
Name: Email:Relationship to Scholar: Home Phone: Cell Phone:Language of Correspondence: Work Phone: *Alert Phone:Mailing Address: *Alert Phone is used by the district's automated phone message system.
City: Employer:State: Zip Code: Scholar Primarily Resides with this Guardian.
Physician: Physician:Physician Phone: Physician Phone:Please list any medical concerns and/or medications for this child:
Last School Attended: Phone #:Address:Is this child currently expelled from any other school district or is the child a party to an expulsion proceeding?Has this child been retained?Has this child met the requirements of the Arkansas State Health laws necessary to enter school?Please list the names of anyone who IS NOT ALLOWED to check out/pick up this child from school:
Yes No
HAAS HALL ACADEMY Enrollment Form
ADDITIONAL SCHOLAR INFORMATION
ADDITIONAL CONTACT INFORMATIONAdditional Guardian Contact
Emergency Information
Emergency Contact Information (Contacts Other Than Guardians to be Called in Case of an Emergency)
(479) 966-4930 (479) 966-4932
Is this child a dependent of an active or reserve member of a branch of the United States Armed Services?
Yes No
Yes NoYes No
Yes No
Is this Scholar a twin (or a triplet, quadruplet, etc.)?
Active Duty – US Army
Active Duty – US Coast Guard
Reserves – US Marines
Active Duty – US Air Force
Reserves – US Army
National Guard – US Army
Active Duty – US Navy
Reserves – US Air Force
National Guard – US Air Force
Active Duty – US Marines
Reserves – US Navy
Parents serve in multiple branches
If this child resides in a household with an active or reserve member of a branch of the United States Armed Services, please select the branch below.
ContactOrder Name Relationship to Child Phone #
Phone Type (ex: Home, Cell, Work)
Parent/Guardian Signature Date
APELLIDO PATERNO:
Número de seguro social-opcional:
Genero: Grado:
RAZA Por favor conteste lo siguiente de acuerdo con los normas emitidas por el Departamento de Educación de U.S.
RAZA PRINCIPAL (Por favor seleccione sólo UNA)
RAZAS ADICIONALES (marque las que correspondan):
Asiático Negro o Afro AmericanoIndio Americano o Nativo de Alaska Hawaiano Nativo u Otro Isleño Pacifico Blanco
M Etnicidad hispana:
Formulario de Inscripción para "HAAS HALL ACADEMY"
INFORMACIÓN GENERAL DEL ACADÊMICO
INFORMACIÓN DE CONTACTO DEL PADRE/TUTOR
Indio Americano o Nativo de Alaska (Una persona que tiene origines de cualquier gente original del Norte o Sur América, incluyendo Centro América, y los que mantienen afiliación tribunal o lazo comunitario)
Asiático (Persona con origen de cualquier gente original de Medio Oriente, Asia Sureste, o del sub- continente Indio incluyendo, por ejemplo Camboya, China, India, Japón, Corea, Malasia, Pakistán, las Islas Filipinas, Tailandia, y Vietnam)
Negro o Afro Americano (Persona con origen de cualquier grupo de raza negra Africana)
Hawaiano Nativo u Otro Isleño Pacifico (Persona con origen de cualquier gente de Hawái, Guam, Samoa, u otra Isla Pacifica)
Blanco (Persona con origen de cualquier gente original de Europa, o del Medio Oriente o África del Norte)
H
Igual a la dirección física
Residencia principal con este tutor. (Living With)
Si NoCampus:
Idioma principal hablado en casa:
Dirección:Cuidad: Estado: Código postal:
Nombre:Relación al Acadêmico:Idioma de la correspondencia:Dirección de correspondencia:Cuidad:Estado:Correo electrónico:Número de casa:Número del trabajo:
Entry Date:Entry Code:Curriculum:
ESL:SP:MIG:
IMMG:GT:Homeroom:
Residency:Choice LEA:P/T ADM %:
Meal ST:M/V Act:504:
Dirección:Cuidad: Estado: Código postal:
Correo electrónico del Acadêmico:
Numero de la casa de Acadêmico: Numero de celular de Acadêmico:
Fecha de nacimiento: Apodo:/ / / /
NOMBRE: 2DO NOMBRE:
USO DE LA OFICINA SOLAMENTE
Dirección física de Acadêmico (911) Dirección de Correspondencia del Acadêmico
Padre/Tutor 1 Padre/Tutor 2
Código postal:
Numero celular:Empleador:
Residencia principal con este tutor. (Living With)
Nombre:Relación al Acadêmico:Idioma de la correspondencia:Dirección de correspondencia:Cuidad:Estado:Correo electrónico:Número de casa:Número del trabajo:
Código postal:
Numero celular:Empleador:
(479) 966-4930 (479) 966-4932
Nombre: Correo electrónico:Relación al Acadêmico: Número de casa: Numero celular:Idioma de correspondencia: Numero de trabajo: *Numero de alerta:Dirección de correspondencia: *El número del alerta se usa por el sistema automatizado de mensajes del distrito.
Cuidad: Empleador:Estado: Código postal: El Acadêmico reside principalmente con este tutor. (Living With)
Medico:Número telefónico del médico:Por favor liste cualquier inquietud médica o medicamentos de su hijo:
Última escuela asistida: Teléfono:Dirección:¿Este estudiante ha sido expulsado o ha sido parte de un proceso de expulsión escolar en cualquier otro distrito escolar?¿Este niño ha sido retenido? (Retained) ¿Este niño llena los requisitos de la ley de Salud Estatal de Arkansas necesaria para ingresar a la escuela? (Met state health laws)Por favor liste los nombres de cualquiera que NO está permitido para registrar salida/llevarse a este niño de la escuela:
Si No
Medico:Número telefónico del médico:
Formulario de Inscripción para "HAAS HALL ACADEMY"
INFORMACIÓN ESTUDIANTIL ADICIONAL
INFORMACIÓN ESTUDIANTIL ADICIONALAdicional Guardián Contacto
Información de Emergencia
Información de Contacto en una emergencia (Contactos u otros tutores para comunicación en caso de emergencia)
(479) 966-4930 (479) 966-4932
¿Este es niño dependiente de miembro activo o en reserva de una rama de los Servicios Armados de los Estados Unidos?
Si No
Si No
Si NoSi No
Este Acadêmico es gemelo, trillizo, cuádruple, etc. (Twin, Triplet, etc.)
Servicio Activo – US Army
Servicio Activo – US Coast Guard
Reservas – US Marines
Servicio Activo – US Air Force
Reservas – US Army
Guardia Nacional – US Army
Servicio Activo – US Navy
Reservas – US Air Force
Guardia Nacional – US Air Force
Servicio Activo – US Marines
Reservas – US Navy
Padres sirven en varias ramas (Multiple Branches)
Si este niño reside en un hogar con un miembro activo o en las reservas deuna rama de los Servicios Armados de los EEUU, elija la rama abajo.
Orden deContacto Nombre Relación al Estudiante Teléfono
Tipo de Teléfono (Casa, Celular, Trabajo)
Firma del Padre/Tutor Fecha
HAAS HALL ACADEMYS T A R R S C H O L A R C E N T E R
3 8 8 0 N O R T H F R O N T S T R E E T
F A Y E T T E V I L L E , A R 7 2 7 0 3 . 5 1 3 0
( 4 7 9 ) 9 6 6 . 4 9 3 0 | ( 4 7 9 ) 9 6 6 . 4 9 3 2 – F A X | H A A S H A L L . O R G
E V E R Y S C H O L A R , E V E R Y D A Y – C O L L E G E B O U N D
H A A S H A L L A C A D E M Y D O E S N O T D I S C R I M I N A T E O N T H E B A S I S O F S E X , N A T I O N A L O R I G I N , R A C E ,
E T H N I C I T Y , R E L I G I O N , D I S A B I L I T Y O R A T H L E T I C E L I G I B I L I T Y .
M E M O R A N D U M
TO:
DATE:
FROM:
RE:
New Haas Hall Academy Families
Tuesday, Feb. 21, 2017
Dr. Martin W. Schoppmeyer, Jr.
Checklist for Orientation
Welcome to the Haas Hall Academy family. We are glad you are here!
Please make plans to attend new scholar orientation at 5:15 p.m. Tuesday, March 7 at our Fayetteville campus and at 5:15 p.m. Thursday, March 9 at our Bentonville campus. New scholars who will attend our Springdale and Rogers campuses may attend either the Fayetteville or the Bentonville session.
This checklist for the evening of orientation should help you to maximize your time.
Welcome
□ Pick up your Information Packet at the Front Desk. This packet will have information about math placement tests, uniforms and parent resourses.
□ Quick presentation by Dr. Schoppmeyer in the Commons beginning at 5:20 p.m.
Pictures
□ Classroom 1: Your scholar will have his/her picture taken so we can learn their faces, not just their names. These pictures will be on display at the beginning of the school year.
Uniforms
□ Classroom 2: Check out deals on gently used uniforms and learn about ordering uniforms.
Tour Campus
□ Classrooms 3 and 4: Visit with faculty and members of our various clubs.
□ Classroom 5: Visit with members of our athletic teams.
Again, welcome to the Haas Hall Academy family! If you have any questions, do not hesitate to call the school (479) 966.4930.