1. Healthcare

Tyler Independent School District
Early College High School
2015-2016
Admissions Application
Mission Statement
The mission of Tyler ISD Early College High School is to provide all students with a quality education that
blends high school and the first two years of college while exposing students to a rigorous curriculum and
relevant instruction that will produce graduates that will successfully perform in a globally competitive society.
Student Name: ____________________________________
Application Submitted on this date: _______________________________
Received by: ________________________________________________
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Admission Policy:
Tyler ISD Early College High School’s primary focus is on providing students from underrepresented backgrounds; atrisk, low income and/or first generation college goers the opportunity to earn 60+ college credits free of charge while
attending high school. As a designated Early College High School we must target students from underrepresented
backgrounds; however, we encourage students of all backgrounds to apply.
Note: In accordance with the Texas Education Agency rules for ECHS Blueprint Benchmark 1, academics, discipline,
state assessments and/or teacher recommendations cannot be considered in the selection process.
Application criteria:
Students must be enrolled in the Tyler ISD attendance zone. In addition to a completed application, there is an essay and
interview requirement for all applicants.
Application Process:
Students with completed applications submitted by the deadline will be scheduled for an interview. During the interview,
students will be asked to submit a writing sample by completing an essay prompt. Students may submit essay in English
or Spanish. Interviews will be conducted by the Tyler ISD Early College High School Leadership Team.
Items that you must include as part of your application are:
Latest STAAR results and TELPAS results (if applicable)
Current report card
Last school year final report card
Current attendance report
Last school year attendance report.
Immunization Record (for students new to Tyler ISD)
Make sure all required signature forms have been signed.
When all pages of your application are completed, and you have received the
three recommendation forms and campus forms, Hand Deliver your completed application
packet to the office of the Director of Early College High School at the Jim Plyler Instructional
Complex, Student Services Building, 807 West Glenwood Boulevard, Tyler, TX 75701
by the deadline of February 2, 2015.
Incomplete applications will not be reviewed for admission to Tyler ISD ECHS. (Applicants are
responsible for requesting all test scores, grades, and attendance from the counselor.)
After applications are received and reviewed, eligible students will be contacted for parent
and student interviews.
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Admission Application – Student Information
Name
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Last
First
Middle Initial
Male
Female
Current Middle School and District
Tyler ISD or Current District Student ID
Date of Birth (Month/Day/Year)
Social Security Number
Student’s Phone
Student’s Email Address
Name of the person(s) you live with
Relationship to the person(s) you live with
Are you currently an AVID student?
Yes
No
Please check all that apply:
African American
Asian/Pacific Islander
Hispanic
Free/Reduced Lunch
White
Yes
Other (Please specify)
No
Student T-Shirt Size: Check the appropriate size.
XS
S
M
L
XL
XXL
XXXL
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Admission Application – Parent or Guardian Information
Parent/Guardian Name:
Address:
City/Zip Code:
Home Phone:
Email Address:
Work Phone:
Cell Phone:
Alternate Email Address:
Primary Language Spoken at Home:
Please Mark the Highest Level of Education for Parent/Guardian
Mother
Father
Guardian
No GED/Diploma
No GED/Diploma
No GED/Diploma
GED/HS Diploma
GED/HS Diploma
GED/HS Diploma
Some College Work
Some College Work
Some College Work
Associate’s
Associate’s
Associate’s
Degree/Certificate
Degree/Certificate
Degree/Certificate
Bachelor’s Degree
Bachelor’s Degree
Bachelor’s Degree
Master’s Degree
Master’s Degree
Master’s Degree
Ph.D./JD/MD
Ph.D./JD/MD
Ph.D./JD/MD
By submitting this application, you agree to abide by the rules, regulations, and expectations set by Tyler ISD
Early College High School and Tyler Junior College faculty and staff. The Tyler ISD Early College High
School will require commitment and effort. If at the end of any high school year a Tyler ISD Early College
High School student is unable or unwilling to continue studies in the Tyler ISD ECHS, he/she will be
reassigned to their zoned high school. By signing below, I certify that the above information is true and
accurate.
Parent/Guardian Name(s) Printed: _________________________________________________
Parent/Guardian Signature: ______________________________ Date: ____________________
Parent/Guardian Signature: ______________________________ Date: ___________________
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Student Statement
(To be completed in blue ink in the student’s own handwriting)
The Tyler ISD Early College High School Program student is an accomplished individual. The student
possesses the maturity and understanding to accept the challenges of this innovative school and is capable of
advanced academic work and college classes. Tyler ISD Early College High School student is interested in
being an active member of this close community of peers and faculty.
Student Name: _________________________________ ID Number: ____________________
1. Why do you want to attend Tyler ISD Early College High School?
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2. What are you plans for the future?
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Note: Final acceptance depends on designation notification from the Texas Education Agency.
3. What are your strengths?
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4. What type of learning activities do you enjoy most?
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5. Describe what you believe to be the perfect high school where you can be most successful?
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Note: Final acceptance depends on designation notification from the Texas Education Agency.
6. What is your strongest academic subject?
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7. What is your weakest academic subject, and what have you done to overcome this weakness?
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8. List any community service, extra-curricular activities, school clubs and/or hobbies you have been
involved in during the past 2 years.
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Note: Final acceptance depends on designation notification from the Texas Education Agency.
9. Check the characteristics below that best describe you. Check all that apply.
Creative
Work well with peers
Shy
Misunderstood
Friendly
Independent thinker
Flexible
Strong Leadership skills
Loner
Need or seeks attention
Good time-management
skills
Readily accepts authority
Able to walk away from
conflict
Needs help with
organization
Organized
Other characteristics that describe me are:
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Student Essay
Please write an essay responding to the following questions: What are your college and career goals?
How will being a part of the Tyler ISD Early College High School assist you in achieving these goals?
What are some of the challenges you face in school/class, and what are your plans for overcoming these
challenges. Please note that grammar and punctuation count. The essay may be written in English or
Spanish (if Spanish is your native language)
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Note: Final acceptance depends on designation notification from the Texas Education Agency.
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Note: Final acceptance depends on designation notification from the Texas Education Agency.
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Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Parent/Guardian Agreement
(To be completed in blue ink by parent/guardian)
(Para ser completado en tinta azul por el padre / tutor)
Student Name: _______________________________________ Student ID Number: _______________
Parent/Guardian Agreement:
Students are successful in school when there is a collaborative partnership between school and parent. Students
with support from home, will have more confidence and increased academic success. Please sign below if you
agree to the following expectations as parent/guardian.
Acuerdo de padres/tutores:
Los estudiantes son exitosos en la escuela cuando hay una colaboración entre la escuela y los padres. Los
estudiantes tendrán más confianza y mayor éxito académico con apoyo en casa. Por favor firmar a continuación
si está de acuerdo con las siguientes expectativas como padre o tutor.
I will support and make every effort to make sure my child is at school and on time every day. Apoyare
a mi hijo y hare todo lo posible para asegurar que este a tiempo en la escuela todos los días.
I will communicate with my student and staff regularly regarding progress, goals, questions, comments
and concerns. Me comprometo a mantener comunicación con el personal de la escuela y con mi hijo
regularmente acerca del progreso, objetivos, preguntas, comentarios y preocupaciones.
I will ensure there is transportation to and from tutorials and/or Saturday School as needed. Aseguraré
transporte hacia y desde tutoriales o escuela de sábado según sea necesario.
I will maintain accurate contact information with the school by reporting any changes in address or
telephone numbers immediately. Mantendré información de contacto vigente con la escuela al reportar
inmediatamente cualquier cambio en los números de teléfono o dirección.
I agree to attend all mandatory informational sessions each at Tyler ISD ECHS or TJC. Estoy de
acuerdo en asistir a todas las sesiones obligatorias informativas en Tyler ISD ECHS o TJC.
I understand that my child will be required to devote a minimum of two hours each evening to home
work and studying. Entiendo que mi hijo deberá dedicar un mínimo de dos horas cada noche a la tarea
y a estudiar.
I ensure there is a quiet time and place for my child to do homework every night. Garantizo que hay
Note: Final acceptance depends on designation notification from the Texas Education Agency.
un lugar tranquilo para que mi hijo haga tarea cada noche.
I understand my child will be exposed to college level materials and some assignments may require
reading adult college level materials not typically read in high school. Entiendo que mi hijo estará
expuesto a leer materiales de nivel universitario y algunas tareas pueden requerir materiales de nivel
universitario que no suelen ser requeridos en la escuela secundaria.
I will encourage and expect high academic and behavior standards from my child. Motivaré a mi hijo
y esperare altos estándares académicos y de comportamiento de mi hijo.
I understand that when my student is in a class at Tyler Junior College, regardless of location, they
must follow all Tyler ISD and Tyler Junior College policies and procedures. Entiendo que es
necesario que cuando mi estudiante esté en una clase en Tyler Junior College, independientemente de
la ubicación, deben seguir todos los procedimientos y reglas de Tyler ISD y Tyler Junior College.
I understand that my student must commit to completing the entire school year before requesting to
withdraw. Entiendo que mi estudiante debe comprometerse a completar todo el año escolar antes de
solicitar retirarse.
I understand that my student is required to attend the 10 day Summer Bridge Program. Entiendo que es
necesario que mi hijo asista al programa de verano de 10 días.
I understand that if my student breaks a TJC policy and is removed from the class my student’s
continued enrollment at Tyler ISD ECHS may be in jeopardy. Entiendo que si mi estudiante rompe una
regla de TJC y es removido de la clase, su matriculación continua en Tyler ISD ECHS puede estar en
peligro.
Parent/Guardian Signature/Firma del Padre o Tutor: ___________________________________
Date: _________________________________
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Student Agreement
(To be completed in blue ink by student)
(Para ser completado en tinta azul por el estudiante)
Student Agreement:
Our mission at Tyler ISD Early College High School is to produce students that are academically prepared to compete in a
globally competitive society. Below is a list of student expectations. Please read and sign below if you understand and
agree to each expectation.
Acuerdo del estudiante:
Nuestra misión en Tyler ISD Early College High School es producir estudiantes académicamente preparados para
competir en una sociedad competitiva a nivel mundial. Abajo hay una lista de las expectativas del estudiante. Por favor
lea y firme si usted entiende y acepta cada expectativa.
I understand that I will enroll in all Pre-AP, Honors, and Dual Credit courses as appropriate. Entiendo que me
inscribiré en cursos Pre-AP, honores y crédito doble todo según corresponda.
I understand that I am required to attend Tyler ISD ECHS and Tyler Junior College regularly. Entiendo que estoy
obligado a asistir a Tyler ISD ECHS y Tyler Junior College regularmente.
I will set aside time for homework every night to help ensure assignments are completed on time. Reservaré
tiempo para la tarea cada noche para ayudar a garantizar que todo sea completado a tiempo.
I will follow the Tyler ISD Student Code of Conduct and the Tyler Junior College Student Code of Conduct.
Seguiré el código de conducta del estudiante de TISD y Tyler Junior College.
I will come to class prepared every day and turn in all assignments on time. Iré a clase preparado todos los días y
entregaré todas las tareas a tiempo.
I will ask for personal and academic help in any area that gives me difficulty. Voy a pedir ayuda académica y
personal en cualquier área que me de dificultad.
I will not use drugs or alcohol. No usaré drogas o alcohol.
I understand that I am required to attend the 10 day Summer Bridge Program. Entiendo que estoy obligado a
asistir al programa de verano de 10 días.
I will not bring weapons, drugs, alcohol, or other dangerous or harmful items or substances to the Tyler ISD
ECHS campus or TJC campus. No llevaré armas, drogas, alcohol, u otros artículos peligrosos o sustancias
nocivas a Tyler ISD ECHS o TJC.
I will take school work seriously and do my very best academically to maintain a minimum 2.5 (75) G.P.A.
Tomaré en serio el trabajo de la escuela y mantendré un promedio mínimo de 75 (2.5 G.P.A).
I will maintain a 75 average in all subjects in order to participate in extra-curricular activities at my zoned school.
Mantendré un promedio de 75 en todas las clases para poder participar en actividades extracurriculares en mi
escuela.
I understand that I am ultimately responsible for my success. I will be given resources and support, but I am
responsible for using these resources and asking for help. Entiendo que soy responsable por mi éxito. Se me dará
apoyo y recursos, pero yo soy responsable de utilizar tales recursos y pedir ayuda.
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I understand that I must complete an entire school year at ECHS, unless I moved out of the Tyler ISD attendance
zone. Entiendo que estoy obligado a completar el ciclo escolar en ECHS, a menos que me cambie a vivir fuera de
la zona de asistencia de Tyler ISD.
Student Signature/Firma del Estudiante: ___________________________________ Date _________________________
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Permission for Students under the Age of 18 to take Dual Credit Courses
Tyler Junior College affirms that the following student has been counseled about the rigors of college level
classes, the academic freedom of college instructors, and the overall demands on time and effort that are
required to be successful in higher education. This student has been advised that there not be any changes in
curriculum to accommodate any student under the age of 18.
Student Name: _______________________________________ Student ID Number: ______________
(Please print)
By the signature below, the student agrees to abide by this agreement:
Student Signature: _____________________________________________ Date: _______________
By the signature below the student’s parent/guardian agrees to abide by this agreement:
Parent/Guardian Signature: ____________________________________ Date: _________________
I give permission for this student to enroll in dual credit classes:
Administrator/Counselor Signature: ______________________________ Date: ______________
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Parent/Guardian Photo/Video Release Form
(To be completed in blue ink by parent/guardian)
Student Name: _________________________________________ Student ID Number: ____________
I give my permission _____________ I do not give my permission ___________ for Tyler Independent School
District and Tyler Junior College to use my child’s photo(s) and video(s) for publicity. This publicity may include,
but is not limited to newspapers, brochures, websites, videos, and yearbooks.
Parent/Guardian Name(s) Printed: _________________________________________________________
Parent/ Guardian Signature: _________________________________________ Date: ______________
Parent/ Guardian Signature: _________________________________________ Date: ______________
Tyler Independent School District
Early College High School
Student Photo/Video Release Form
(To be completed in blue ink by student)
Student Name: _________________________________________ Student ID Number: ____________
I give my permission _____________ I do not give my permission ___________ for Tyler Independent School
District and Tyler Junior College to use my child’s photo(s) and video(s) for publicity. This publicity may include,
but is not limited to newspapers, brochures, websites, videos, and yearbooks.
Student Signature: ________________________________________________ Date: ______________
Note: Final acceptance depends on designation notification from the Texas Education Agency.
Tyler Independent School District
Early College High School
Recommendation for Potential Student
8th Math Teacher Recommendation
The following student is asking for a recommendation as part of the application process for the Tyler ISD
Early College High School. Please complete the information requested to the best of your ability. Place
the completed form in an envelope and seal the envelope. Then write your name across the seal before
returning it to the applicant.
Student Name: ______________________________ How long have you known the applicant? ______
Please rate the above-name student on the following personal characteristics by circling the appropriate
“points” on the scale below:
Characteristics
Attendance
Attitude
Communication Skills
Creativity
Leadership
Quality of work submitted
Responsibility
Work Ethic (Effort)
1 = lowest point value and 4 = highest point value
Your Overall recommendation for admission:
____ I recommend the applicant for admission. Please comment:
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____ I recommend the applicant for admission with reservation. Please comment:
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____ I do not recommend the applicant. Please comment:
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Person completing the form: ___________________________________________ Date: ____________
(Please print)
Signature of person completing the form: __________________________________________________
School: __________________________________________Phone Number: _______________________
Tyler Independent School District
Early College High School
Recommendation for Potential Student
8th Science Teacher Recommendation
The following student is asking for a recommendation as part of the application process for the Tyler ISD
Early College High School. Please complete the information requested to the best of your ability. Place
the completed form in an envelope and seal the envelope. Then write your name across the seal before
returning it to the applicant.
Student Name: ______________________________ How long have you known the applicant? ______
Please rate the above-name student on the following personal characteristics by circling the appropriate
“points” on the scale below:
Characteristics
Attendance
Attitude
Communication Skills
Creativity
Leadership
Quality of work submitted
Responsibility
Work Ethic (Effort)
1 = lowest point value and 4 = highest point value
Your Overall recommendation for admission:
____ I recommend the applicant for admission. Please comment:
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____ I recommend the applicant for admission with reservation. Please comment:
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____ I do not recommend the applicant. Please comment:
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Person completing the form: ___________________________________________ Date: ____________
(Please print)
Signature of person completing the form: __________________________________________________
School: __________________________________________Phone Number: _______________________
Tyler Independent School District
Early College High School
Recommendation for Potential Student
English Teacher or Community (non-family member) Recommendation:
The following student is asking for a recommendation as part of the application process for the Tyler ISD
Early College High School. Please complete the information requested to the best of your ability. Place
the completed form in an envelope and seal the envelope. Then write your name across the seal before
returning it to the applicant.
Student Name: ______________________________ How long have you known the applicant? ______
Please rate the above-name student on the following personal characteristics by circling the appropriate
“points” on the scale below:
Characteristics
Attendance
Attitude
Communication Skills
Creativity
Leadership
Quality of work submitted
Responsibility
Work Ethic (Effort)
1 = lowest point value and 4 = highest point value
Your Overall recommendation for admission:
____ I recommend the applicant for admission. Please comment:
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____ I recommend the applicant for admission with reservation. Please comment:
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____ I do not recommend the applicant. Please comment:
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Person completing the form: ___________________________________________ Date: ____________
(Please print)
Signature of person completing the form: __________________________________________________
Address/Organization: ___________________________Phone Number: _________________________