South Broward Alumnae Chapter Delta Sigma Theta Sorority, Inc. Achievers Academy
Student Information
Student Name
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First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Grade: / School:
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Test Score and Readiness Level
Which test have you taken?
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SAT
ACT
Both
Neither
Test Date:
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Was this your first time taking this test?
Please Select
Yes
No
2nd Test Date:
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Overall Composite Score and Section Scores for test taken (include scores for previous test):
What area improved the most? What area(s) do you need to improve?
Score report attached/provided
Score report attached/provided
Score self-reported
Upload your score report.
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Upload your score report.
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My SAT/ACT target score is:
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How would you describe your current level of readiness for the college, university, trade school, training program, or career you are exploring?
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Level 1 – I am Beginning to Explore: I am beginning to think about my future, but I have not decided on a college, trade school, training program, or career. I still need to meet with my school counselor and learn what I need to do to prepare.
Level 2 – I am Exploring and Planning: I have identified some colleges, trade schools, programs, or careers that interest me. I have talked with my school counselor about my options and graduation requirements. My parent/guardian knows about my plans, and we are beginning to discuss my next steps.
Level 3 – I am Getting Prepared: I have narrowed down my choices and understand many of the requirements. I am on track to meet my high school graduation requirements. I am working on my SAT/ACT scores if needed, personal statement or essay, résumé, and a list of people who may write recommendation letters. My parent/guardian understands my plans and is involved in helping me prepare.
Level 4 – I am Ready to Apply or Take Action: I have met with my school counselor and confirmed that I am on track for graduation. I know the requirements and deadlines for my top choices. My personal statement or essay is ready or nearly complete. I have identified or requested recommendation letters. My parent/guardian understands the application, financial aid, scholarship, enrollment, or career process and is actively involved.
Level 5 – I am Taking My Next Steps: I am on track for graduation with my required courses and credits completed or in progress. My applications, personal statement, recommendation letters, test scores, résumé, and other required documents are ready or have been submitted. I am completing financial aid, scholarship, enrollment, interview, apprenticeship, or employment steps. My parent/guardian and school counselor are aware of my plans and supporting my transition after high school.
What do you need the most help with as you prepare for college, trade school, a training program, or a career?
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Graduation Planning – Understanding graduation requirements and meeting with my high school counselor/Brace Advisor
SAT/ACT & Entrance Testing – Preparing for, registering for, or improving my test scores
Choosing My Next Step – Identifying colleges, universities, trade schools, training programs, or careers that fit my goals
Application Materials – Applications, personal statements/essays, résumés, and recommendation letters
Scholarships & Financial Aid – Finding scholarships and understanding FAFSA, financial aid, and paying for school or training
Family Planning & Next Steps – Helping my parent/guardian understand deadlines, requirements, and the process
All of the Above
What is your top academic goal this semester?
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List three actions you will take reach your goals, and/or improve your performance at high school, and preparing for college/trade school. How do you think Achievers Academy can help you reach your goals?
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People/resources that can support me:
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Parent/Guardian Contact Information
Parent/Guardian Name:
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Relationship:
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Primary Phone:
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Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
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example@example.com
Alternate Phone:
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method:
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Email
Text
Phone
Best Time to Contact:
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Emergency Contact:
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Relationship:
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Email:
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example@example.com
STUDENT COMMITMENT & ACCOUNTABILITY AGREEMENT
Student Name
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Student Signature / Date-by signing you agree to adhere to the student expectations listed above
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Parent/Guardian Name
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Parent/Guardian Signature / Date-by signing you agree to discuss and ensure that your child adheres to the student expectations listed above
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Media Release & Permission
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I GIVE permission for photographs, video, audio, and/or student work featuring my child to be used for Achievers Academy and chapter-related educational, promotional, reporting, and program communication purposes.
I DO NOT GIVE permission for photographs, video, audio, and/or student work featuring my child to be used for these purposes.
Parent/Guardian Signature / Date
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Student Signature (if applicable) / Date
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