Rising Aviation Enrollment Packet

Thank you for considering Rising Aviation High School for your student’s educational needs and for allowing us to share with you the benefits and opportunities available at our school. In an effort to review and process your student’s registration packet in an efficient and timely manner and to have our records in compliance, all forms should be submitted to the School’s Director of Administration by the parent or guardian. There are several required documents that will need to be provided along with the completed registration packet. We have provided the following list for your convenience.

Completed Forms Required
-Student Information
-Academic Information
-Exceptional Student Services Information
-Family Information
-Emergency Contact Information
-Medical Information and Emergency
-Medical Treatment Release
-Request to Administer OTC Medication
-Permission for Internet Usage
-Media and Personal Information Release
-Transportation Permission Form
-Request for Release of Student Records

Documents Required
-Birth Certificate
-Transcripts /
-Academic Progress
-Withdraw Form
-Immunization Records

If you have any questions, please contact the Director of Administration.

Melissa Meehan, Director of Administration
momeehan@risingaviation.com
15506 Wright Brothers Dr.
Addison, TX. 75001
469-206-3048 Office

Enrollment Application

Last Name

First Name

Middle Name

Date of Birth

Age:

Gender:

Birth City:

Birth State

Current Mailing Address

Apartment #

City

State

Country

Zip

Student Phone

Student Email

Race & Ethnicity Data Collection
In accordance with federal guidance, a two-part question must be used to collect data about student race and ethnicity. The first part of the question is on ethnicity and the second is on race. The race question can have multiple values.

Part 1: Ethnicity (Is this student Hispanic or Latino?)

No Yes

Part 2: Race

American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White

What was the last grade level completed?

Current or last high school attended?

City

State

Last Day Attended

Is the student behind on credits?

Yes No

Currently on:

Probation Parole NA

Has the student been out of school for:

1-4 Weeks One Semester One Year Two Years

If Yes please exlplain:

What is the student's future job or career goals?

Exceptional Student Services (click all that apply)
In order to provide continuity in the educational environment, it is important that Rising Aviation High School be informed of any special education received by the student.

Does your student have any learning or behavioral needs?

Yes No

Does your student receive Special Education Services?

Yes No

The student has had Special Education testing or evaluations.

Yes No

The student has been enrolled in a special education program at another school.

Yes No

The student is on a 504 plan.

Yes No

The student is involved in an English as a second language program (ELL).

Yes No

Family Information:

Student Lives With:

Both Parents Mother Father Relative Legal Guardian Ward of the State Other

Guardian 1:

Mother Father Legal Guardian

Guardian 1 Full Name

Last/First/Middle

Home Address

City

State

Zip

Home Phone

Cell Phone

Email

Guardian 1 Signature

Clear

Guardian 2:

Mother Father Legal Guardian

Guardian 2 Full Name

Last/First/Middle

Home Address

City

State

Zip

Home Phone

Cell Phone

Email

Guardian 2 Signature

Clear

Emergency Contact Information:

Relationship to Student

Emergency Contact 1 Full Name

Last/First/Middle

Home Address

City

State

Zip

Home Phone

Cell Phone

Email

Emergency Contact 2 Relation to Student

Last/First/Middle

Emergency Contact 2 Full Name

Last/First/Middle

Home Address

City

State

Zip

Home Phone

Cell Phone

Email

Release Forms & Permissions

Medical Information & Emergency Medical Treatment Release
*Please note that there is not a school nurse on campus

Does the student have any medical, physical, or mental health conditions thatthe school should be aware of?

Yes No

If yes, please explain:

Does the student need to take medications during the school day?

Yes No

If yes, please list medications, dosages, and time of day

Is the student allergic to any medications?

Yes No

If yes, please list medication allergies:

Is the student allergic to any foods?

Yes No

If yes, please list food allergies:

Medical Insurance Carrier

Policy Number

Name of Insured

ID Number

Physician Name

Phone Number

Guardian Signature

Clear

Date

Release Forms & Permissions

Request to Administer OTC Medication

For school personnel to administer medication, the following requests are made:
All medication must be in the original properly labeled container.
NOTE: No more than one week of medications are to be held in the school office for students.

Please check all OTC medications you give RAHS permission to administer to your child:

Acetaminophen ibuprofen clear Eyes/Tears hydrocortisone Antihistamine cough drops Midol Tums Pepto Bismol

Please list any additional OTC medications that are to be provided by the parent/guardian:

Request to Administer Prescription Medication
Please list all prescribed medications you give RAHS permission to administer to your child:

Medication 1:

Dosage

Administer Number of pills/tsp:

at day/time:

Medication 2:

Dosage

Administer Number of pills/tsp:

at day/time:

Medication 3:

Dosage

Administer Number of pills/tsp:

at day/time:

Medication 4:

Dosage

Administer Number of pills/tsp:

at day/time:

I/We, the undersigned, give my/our permission for the staff of Rising Aviation High School to administer the medications listed on this sheet (including both over the counter (OTC) and/or prescription) to my/our child,

Child Name

Guardian Signature

Clear

Date

Release Forms & Permissions

Permission for Internet Usage
This authorization does not replace the Technology Policy or imply permission to freely use the school’s Internet services for personal use.

I/We, the undersigned, authorize my/our child, ________________________________________, to use theworld wide web for research & classroom assignments/projects.

Type student name

Signature

Clear

Date

Media & Personal Information Release
Rising Aviation High School, occasionally publishes/posts the first name and/or pictures of students involved in school activities on our website and other forms of media. This form gives Rising Aviation High School permission to include photographs and the name of your student in media publications, television, newspapers, articles, official school websites, brochures and any other form of media.

Choose one of the following to accept or decline:

I, ___________________________________, hereby grant Rising Aviation High School the above mediarelease and permission.

Type Name

I, ___________________________________, DO NOT grant Rising Aviation High School the above mediarelease and permission.

Type Name

Signature

Clear

Date

Transportation Permission Form
It may become necessary for Rising Aviation High School to provide transportation or authorize transportation for your student for the purpose of: emergency medical treatment, school activities, or field trips.

I, ___________________________________, hereby give my permission to Rising Aviation High School

Guardian Name

or it’s authorized employees/agents to transport or authorize transportation my child,___________________________________, for emergency medical treatment, school activities, or field trips.

Student Name

I understand that by allowing Rising Aviation High School to transport my student to/from the above mentioned purposes, I agree to release Rising Aviation High School, its agents and employees, from and against any and all liability, loss, damages, claims or actions to the maximum extent permissible by law, arising out of such transportation.

Guardian Signature

Clear

Date

Request for Release of Student Record

Request for Release of Student Record
Melissa Meehan, Director of Administration
momeehan@risingaviation.com
15506 Wright Brothers Dr.
Addison, TX. 75001
469-206-3048 Office

Please forward the transcript of ___________________________________________,

Student name

Student Date of Birth

Student DOB

Date enrolled at Rising Aviation

Date

Parent Guardian Signature

Clear

Date