Hope Elementary Charter School

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School Year _____________

1116 N. Blount Street Raleigh, NC 27604 Phone: (919) 834-0941 Fax: (919) 834-9338

Hope Elementary Charter School Admissions Procedure Thank you for your interest in Hope Elementary Charter School. We trust this admissions packet will answer your questions and guide you as you consider Hope Elementary Charter School for your child. In order for the admissions committee to consider your application, we must have all of the elements that are listed below completed and on file. 1. Application and Photo Complete the Application for Admission and return it to the school office (attention: Principal) Please provide a recent photo, a copy of physical, shot records, and birth certificate for your child. 2. Previous School Records Please include a copy of the latest report card and end of grade test scores from the previous year for your child. If your child has an IEP report attach a copy to the application. Kindergarten Students Parents must provide a copy childs physical and shot record. To enter kindergarten, a child must turn 5 on or before August 31st.

Completed Application Check List: Application Photo Copy of Birth Certificate Copy of Shot Records Copy of Last Report Card Emergency contact information (telephone & address) All IEP records

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Hope Elementary 2011-2012 Staff and Classroom Extensions Richard Rubin - Principal Annie Singletary - Administrative Assistant Elizabeth Williams - Grants/Charter Compliance Marguerite Brailsford - CN Cashier/Data Entry Gwen Partin - Cafeteria Supervisor Keith Sutherland - Security/ Reception Teacher / Teacher Assistant Kindergarten Classroom - Ruth McClam / Amber Bryant 1st Grade Classroom - Charmelle Mann / Stephanie Muhammad 2nd Grade Classroom - Monica Huband / Irene Cooper 3rd Grade Classroom - Jared Marks /Geraldine Leach 4th Grade Classroom - Zandria Lee / Jared Marks 5th Grade Classroom - Lamonica Chambers / Irene Cooper Terrence Maloney - EC Director Arlene Griffis - Math Resource Teacher Carstoba Byrdsong - Reading Resource Teacher Kathy Eash - EC Teacher Alphonso Hopkins Jr. - Behavior Specialist Brenda Herb - Curriculum Coach Dawnn Breynae Technology Facilitator/Testing Coordinator Ron Williams - Physical Education Teacher/Art Teacher Artura Edwards Spanish Teacher Darlene Coleman Music Teacher 13 10 14 33 33 33 31 17 19 34 20 22 32 27 27 15 32 27 11

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ABCs of School Procedures Adopted: 2009-2010

A (ABSENTEEISM) Student must bring written excuse upon returning to school. B (BEHAVIOR) Students must demonstrate positive and respectful actions at all times C (CAFETERIA) Guidelines must be followed, no talking during first 10 (ten) minutes when seated. Parents may apply for or Free or Reduced Price Meals D (DISCIPLINE) Depending upon the severity i.e. fighting, students will be taken home or parents asked to pickup immediately from school E (EVALUATIONS) Students will be consistently tested for learning through teacher made or standard evaluation as required by SDPI. F (FIELD TRIPS) A blanket written permission form shall be kept on file G (GRADES) Teachers will keep parents abreast of student progress or lack of progress. Report cards will go home quarterly H (HOMEWORK) Students are expected to do homework nightly; can be made up when absent I (INFORMATION) Students will share information with parents through weekly folders sent home on Thursdays J (JUDGEMENT) Students will use good judgement when dealing with conflicts with peer, i.e., tell the teacher K (KIND) Students will be kind and treat others as he/she wish to be treated L (LUNCH) Students may apply for free or reduced lunch, purchase it or bring lunch from home M (MEDICINE) Only prescribed medicine will be given by the secretary and maintained in her office N (NEWSLETTERS) Students will take home bi-monthly newsletters O (OBEY) Students must immediately obey all school personnel P (PROPERTY) School property must be taken care of at all times Q (QUIET) Hallway movement must be quiet R (RESPONSIBLE) Students must be responsible only for themselves S (SNACKS) Students are encouraged to bring healthy snacks if the teacher permits T (TORNADO/FIRE DRILLS) Will be held in accordance with regulations of Fire Marshall U (UNIFORMS) Students must wear clean uniforms on Monday Thursday. On Friday they may wear the school sweatshirt or tee shirt V (VACCINES) Students immunization record must be current W (WEATHER) During inclement weather, students will follow Wake County year-round schools procedures X (XCELLENCY) Students must conform to high standards of excellent social and academic behavior Y (Year-round) Students will attend school for 180 days on the 4th track (9 weeks in 3 weeks out) consecutively Z (ZEROS) No student will make zeros; effort is worth something!

School Year _____________ Hope Elementary Charter School

1116 N. Blount Street Raleigh, NC 27604 Phone: (919) 834-0941 Fax: (919) 834-9338

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School Profile
The mission of Hope is to provide children with the academic, emotional, and social foundation necessary to launch a successful school experience in becoming a productive citizen and lifelong learner. Our goal is to draw out the potential that is placed within every child. Students will be provided with leadership skills that will enable them to become visionaries and agents of change. Location: Enrollment: Grades Principal: Calendar: Instructional Day: Dress Code: Lunch: Transportation: Enrollment: Class Size: Staff:
1116 North Blount Street Raleigh, NC 27604 Students accepted through application. There is no tuition. Contact school office (834-0941) for more information. K-5 Richard Rubin, 35 years of experience Year round4th Track -9 weeks track in period followed by 3 weeks out 8:00 AM-2:45 PM Uniformsnavy bottoms; Carolina blue topspurchased locally Participate in the free and reduced lunch program. Catered by LeCounts Catering Limited Bus transportation 110 students Average of 17-19 students per classroom All teachers licensed by State of NC. Full time teacher and teacher assistant in each classroom. We employ part-time Reading Specialist, Math Resources Teacher, Charter Compliance Consultant and, Exceptional Programs Specialist as well as Spanish, PE, Music and Art teacher. State of the Art computer lab with new computers. Employ a full-time technology specialist. NC Standard Course of Study blended with Marva Collins Educational Program and methodologies. Teaching techniques are based on brain research findings. Participate in state annual assessment program EOG for grades 3-5Writing test (grade 4) Participates in state annual assessment program for grades 3-5 Writing test (grade 4). Mock testing done in preparation for EOG. 2003-2004 School of Progress. Made AYP (Adequate Yearly Progress) Different Ways of Knowinginfusion of the arts to promote student learning cooperative learning etc. Necessary component for schoolwide and student success volunteers; Room Moms and Dads, class meetings, field trips etc. PSG (Parent Support Group) Meets 1st Wednesday of each month. ChairpersonAnna Neal Blanchard Encouraged and appreciated. Partners with SAS, Peace College, Raleigh Charter High School, Meredith College and Artspace. Raleigh Parks and Recreation After-school Program. 7:15 7:50

Specials: Technology: Instruction:

EOG Testing:

Comprehensive Reform Model Parent Involvement: School Board Community Involvement After School: Early Arrivals

School Year _____________ We believe EVERY child is a winner!

School Year _____________

1116 N. Blount Street Raleigh, NC 27604 Phone: (919) 834-0941 Fax: (919) 834-9338

Hope Elementary Charter School

Application for Student Admission
Student Information

Student Name
Last First Middle

Gender _____ Place of Birth Grade Entering:

Birthday
Month Day Year

Address
Street Apt. no. City State Zip

Home Telephone ( ) Family History Parent/Guardian Name

Last First Middle

Cell

Address
Street Apt. # City State Zip

Phone ( ) Employer Phone ( )

Street Apt. # City State Zip

Occupation Address Family Members: Name Age

Relationship to child

Office Use Only Other Household Members:

Orient App Fee Int Acc Enr Asses

School Year _____________ School History Has your child attended school before? School Name School Address
Street City Zip

(Yes/No) Phone ( ) Fax ( )

Why did you choose to apply to Hope Elementary School?

Other Pertinent Information: Insurance Information

Insurance Company Policy Number

Address

City

State

Zip

Doctors name

Telephone

Please Provide Two (2) Contact Persons In Case Of An Emergency 1.

Name Address Telephone

2.
Name Address Telephone

List Any Special Needs Your Child May Have

Disclosure of Information If we find that any of the information you have provided is inaccurate we reserve the right to drop your child from our enrollment. Signature Date: Hope Elementary Charter School Non-discriminatory Policy Towards Students
The Hope Elementary School admits students of any race, color, national or ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national nor ethnic origin in administration of its educational policies, admissions policies, and other school-administered programs.

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Hope Elementary Charter School

1116 N. Blount Street Raleigh, NC 27604 Phone: (919) 834-0941 Fax: (919) 834-9338

Authorization to Release Records

I Hereby Authorize the officials of:
Name of previous School Address Telephone number Fax

To Release All Academic, EOG TEST SCORES, and Health Records. All Confidential information including IEP, Psychological Testing, and Social History to Hope Elementary Charter School Concerning:
Name of Student

Grade Level Last Assigned in 20____ - 20____

Signature of Authorizing person Todays Date

Relationship to Student

Street Address

City

State

Zip

Date Requested From School

By:
Principal 1116 North Blount Street Raleigh, NC 27604

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Student Entrance Questionnaire

(Please Print Legibly)

Date: _______________
Student Name: Students Siblings:
Please mark box to indicate if sibling will attend Hope Elementary Charter School.

Print Names _____________________________ _____________________________ _____________________________ _____________________________ _____________________________

Ages __________ __________ __________ __________ __________

Legal Guardian

______________________________________________ Assoc. Degree

Highest Level of Education: GED/High School BA/BS MA/MS PhD Current Address:

_____________________________________________ Street Address _______________________ _________ __________ City State Zip Home: ________________________ Cell: ________________________

Contact Phone Numbers

Work: ________________________ Email Address: _________________________________________ Insurance Information Insurance Company __________________ Policy Number __________________
(Please provide a copy of current medicaid/insurance card)

Transportation Will you need transportation for your child(ren)? Yes No

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Student Information Student Birth Date: ________________________________Sex______________ Student Entering Grade 2011-2012 School Year: __________________________ Student Former Grade 2010-11 School Year: _____________________________ Last School Student Attended: ________________________________________ Reason for interest in this school: ______________________________________ __________________________________________________________________ Student Hobbies/Interests: ____________________________________________ __________________________________________________________________ __________________________________________________________________ Student Academic Strengths: __________________________________________ __________________________________________________________________ Student Academic Weaknesses: ________________________________________ __________________________________________________________________ Student Social Development (peer relationships, respect of authority, etc.) __________________________________________________________________ __________________________________________________________________ Student Medical Needs (include medications, allergies, etc.) __________________________________________________________________ __________________________________________________________________ Student Emotional/Behavioral Concerns (include physician diagnosis, counseling sessions, special treatment, etc.): _________________________________________________________________

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HOPE ELEMENTARY CHARTER SCHOOL FIELD TRIP FORM

Parental/Guardian Consent Form and Liability Waiver Permission Form for _______________ School Year
This form must be on file. In no case will the student be permitted on any field trip if the form is not on file with the parent/guardian signature.

Students Name: _____________________________________ Birth Date:___________ Parent/Guardians Name: __________________________________________________ Home Address: ________________________________ Home Phone: _______________ Work Phone: _________________________________ Cell Phone: __________________ I, (Parent/Guardian) ____________________________, grant permission for my child, (Childs Name)_____________________________________, to participate in this years (2011-2012) school-sponsored field trip events that require transportation to a location away from the school site. In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical treatment. In the event you are unable to reach me at the above numbers contact: Name: _______________________________________ Relationship_____________________________ Phone: ________________________________ / Cell: _________________________________________ Family Doctor: _________________________Phone:_________________________________________ I will not hold the school or personnel responsible for any costs, expenses and all consequential damage arising from or in connection with my child attending the event or cost of medical treatment in connection with any illness or injury treatment. I agree to compensate the school/school personnel, for any expense that may arise in connection with this Field Trip.

SPECIFIC MEDICAL INFORMATION:

Allergic reactions (medications, foods, plants, insects, etc.)____________________________________________ Does child have a medically prescribed diet? _______________________________________________________ Special medical conditions:

Medications: ____________________________________________________________________________________________ ____________________________________________________________________________________________ Students shall obey all transportation rules while on the trip. Students may be denied future field trips if field trip rules are not observed.

The parent/guardian(s), by acknowledging this field trip authorization, fully understands and recognizes that the students participation in this field trip is strictly voluntary, not required attendance.

School Year _____________

Parent/Guardian Signature___________________________________________ Date_______________________