About Us
Staff
Our Impact
Enroll Now!
I Would Like More Information
Ways to Give
Tax Credits and Donate Now
2024 Birdies for Charity
Student and Family Resources
Handbooks
Student and Family Handbook
Parental Rights Handbook
Prepare for your Future
Calendar & Courses
CVHS 2024-2025 School Calendar
CVHS 2024-2025 Bell Schedule
Student Support
Career Advancement Services and Supports
Health and Wellbeing
Pathways to Success
SNAP Information Letter to Parents
Crew’s N Health Mobile
Online Student Resources
Canvas Online Classroom
Virtual / At-Home Learning Actions
Resources for Learning at Home
Public Notices
City View in the News
Contact Us
About Us
Staff
Our Impact
Enroll Now!
I Would Like More Information
Ways to Give
Tax Credits and Donate Now
2024 Birdies for Charity
Student and Family Resources
Handbooks
Student and Family Handbook
Parental Rights Handbook
Prepare for your Future
Calendar & Courses
CVHS 2024-2025 School Calendar
CVHS 2024-2025 Bell Schedule
Student Support
Career Advancement Services and Supports
Health and Wellbeing
Pathways to Success
SNAP Information Letter to Parents
Crew’s N Health Mobile
Online Student Resources
Canvas Online Classroom
Virtual / At-Home Learning Actions
Resources for Learning at Home
Public Notices
City View in the News
Contact Us
City View Hish School Enrollment Form
Get To Know City View Hish School Enrollment Form
Please enable JavaScript in your browser to complete this form.
1
STUDENT INFORMATION
2
NAME OF PARENT/GUARDIAN
3
ELIGIBILITY FORMS
4
MEDICAL RELEASE
5
MEDIA RELEASE
Date
*
SAIS #
*
Start Date
*
System Input
*
Student Name
*
First
Middle
Last
Address
*
First
Middle
Last
Gender
*
Male
Female
Others
DOB
*
Place Of Birth
Student Cell Phone
*
Student Email
*
Does The Student Have A Probation Officer? If Yes, Please Provide Contact Information.*This Question Is Not A Condition Of Enrollment
*
Yes
No
Probation Officer Name
*
Phone
*
Email
*
RACE/ETHNICITY
Student's Ethnicity: Is The Student Hispanic Or Latino?
*
Yes
No
Prefer Not to say
Race
Please Choose At Least One. Latino Is An Ethnic Background, Not A Race. (Please Check All That Apply)
NA
Asian or Indian Subcontinent
Black/African American
White: European, North African, Middle East
Native Hawaiian/Other Pacific Islander
American Indian/Alaskan Native
Prefer not to say
Tribe
*
EDUCATIONAL INFORMATION
Last School Attended
*
How Many Credits Does The Student Have?
*
School Type
*
High School
8TH
Others
Expelled From Any School Or District?
*
Yes
No
Is Pending A Due Process Hearing For Expulsion
*
Yes
No
Please Check Any Special Services Previously Received (This Information Is For Continuation Of Services)
*
Special Education
504 Accommodation
Gifted/Talented
Title 1
English Language Learner (ELL)
Next
NAME OF PARENT/GUARDIAN
Name
*
Relationship
*
Home Phone
*
Work Phone
*
Cell Phone
*
Email Address
*
Address
*
Address Line 1
City
State / Province / Region
Postal Code
Do You Have A Different Mailing Address?
*
Yes
No
Mailing Address:
*
Active Military
*
Yes
No
Name
Relationship
*
Home Phone
*
Work Phone
Cell Phone
*
Email Address
*
Address
*
First
Middle
Last
Do You Have A Different Mailing Address?
*
Yes
No
Mailing Address
*
Active Military
*
Yes
No
If legal guardian is other than Mother and/or Father, you must present legal court documentation of guardianship with your enrollment application.
EMERGENCY CONTACT INFORMATION
In the event that I cannot be contacted, I authorize ACYR City View High School to contact and/or release my child to any one of the following people. Please provide at least one emergency contact.
1) Name
*
Relationship To Student
*
Phone
*
Work Phone
*
2) Name
Relationship To Student
Phone
Work Phone
3) Name
Relationship To Student
Phone
Work Phone
Parent/Legal Guardian Signature
*
Date
*
Enrollment Representative
Date
*
The responses to this Home Language Survey (HLS) are used by the school to provide the most appropriate instructional programs and services for the student. The answers below will determine if a student will take the Arizona English Language Learner Assessment (AZELLA). Please respond to each of the three questions as accurately as possible. If you need to correct any of your responses, this must be done before the student takes the AZELLA Placement Test.
What Language Do People Speak In The Home Most Of The Time?
What Language Does The Student Speak Most Of The Time?
*
What Language Did The Student First Speak Or Understand?
Student Name
*
District Student ID
*
Date Of Birth
*
SSID
*
Parent/Guardian Signature
Student Name
*
Date
District or Charter: Arizona Center for Youth Resources (ACYR) School: City View High School Please provide a copy of the Home Language Survey to the EL Coordinator/Main Contact on site. In AzEDS, please enter all three HLS responses. These HLS questions are in compliance with Arizona Administrative Code (R7-2-306(B)(1),(2)(a-c). (Revised 01-2020) Office of English Language Acquisition Services 1535 West Jefferson Street • Phoenix, Arizona 85007 • (602) 542-0753 • www.azed.gov/oelas
Previous
Next
ELIGIBILITY FORMS
Date Of Birth
*
The McKinney-Vento Homeless Assistance Act (Title X, Part C, of the No Child Left Behind Act) defines “homeless” as “individuals who lack a fixed, regular, and adequate nighttime residence.” This includes children who “are temporarily sharing the housing of other persons due to the loss of housing or economic hardship.” The information provided below is not a condition of enrollment and is optional.
Student Is Not Homeless
Does not apply; student is not homeless Please check one of the following statements if your family is experiencing temporary homelessness
Including Transitional Housing Shelters
Please provide Living in a shelter, including transitional housing shelters (i.e. UMOM, Catholic Charities); awaiting foster care, etc.–
Name Of Shelter
*
Address
*
Living On The Streets, Abandoned Buildings, In Cars, Trailers, Campgrounds, Public Places, Housing Not Fit For Habitation-
Living on the streets, abandoned buildings, in cars, trailers, campgrounds, public places, housing not fit for habitation-
Please Provide Information Regarding Area In Which Student Is Living
Living In Hotels/Motels For Lack Of Other Suitable Housing –
Living in hotels/motels for lack of other suitable housing –
Name
Address
*
Doubled-Up; Temporarily Living With Family Or Friends Due To Lack Of Adequate Housing Or Financial Conditions.
Doubled-up; Temporarily living with family or friends due to lack of adequate housing or financial conditions.
Please Provide Address Of Where Student Is Living
*
Please answer the following if you checked one of the four boxes above:
How Long Do You Expect To Be At This Address?
Are You Seeking Permanent Housing?
Date Student Moved To This Address
Is A Parent Living In The Home With The Student?
Relationship
The School Social Worker may be in contact with you if clarification or bus transportation is needed. We have read the information provided and indicated our living circumstances above with regard to the McKinney-Vento Act:
Signature Of Parent/Guardian/Unaccompanied Youth
*
Date
*
Office Use Only:
Does Qualify Under McKinney-Vento Act
Does Qualify under McKinney-Vento Act
Does NOT Qualify
McKinney-Vento Liaison/Appointee Signature
Date
Arizona Department of Education Arizona Residency Documentation Form
Student
School City View High School School District or Charter Holder Arizona Center for Youth Resources (ACYR)
Parent/Legal Guardian
As The Parent/Legal Guardian Of The Student, I Attest* That I Am A Resident Of The State Of Arizona And Submit In Support Of This Attestation A Copy Of The Following Document That Displays My Name And Residential Address Or Physical Description Of The Property Where The Student Resides:
Valid Arizona driver’s license, Arizona identification card or motor vehicle registration
Valid Arizona Address Confidentiality Program authorization card
Real estate deed or mortgage documents
Property tax bill
Residential lease or rental agreement
Water, electric, gas, cable, or phone bill
Bank or credit card statement
W-2 wage statement
Payroll stub
Certificate of tribal enrollment (506 Form) or other identification issued by a recognized Indian tribe in Arizona
Documentation from a state, tribal or federal government agency (Social Security Administration, Veteran’s Administration, Arizona Department of Economic Security)
Temporary on-base billeting facility (for military families)
I am currently unable to provide any of the foregoing documents. Therefore, I have provided an original affidavit signed and notarized by an Arizona resident who attests that I have established residence in Arizona with the person signing the affidavit.
Signature Of Parent/Legal Guardian
Date
*For members of the armed services, the provision of verifiable documentation does not serve as a declaration of official residency forincome tax or other legal purposes. Armed service members may utilize a temporary on- base billeting facility as the address for proof of residency. State of Arizona Affidavit of Shared Residence
Student Name:
Parent/Legal Guardian Name
School City View High School School District or Charter Holder Arizona Call A Teen (ACYR)
Name Of Arizona Resident
I, (Resident Name)
swear or affirm that I am a resident of the State of Arizona and that the persons listed below reside with me at my residence, described as follows:
Persons Who Reside With Me
Location Of My Residence
I Submit In Support Of This Attestation A Copy Of The Following Document That Displays My Name And Current Residence Address Or Physical Description Of My Property:
Valid Arizona driver’s license, Arizona identification card or motor vehicle registration
Valid Arizona Address Confidentiality Program authorization card
Real estate deed or mortgage documents
Property tax bill
Residential lease or rental agreement
Water, electric, gas, cable, or phone bill
Bank or credit card statement
W-2 wage statement
Payroll stub
Certificate of tribal enrollment (506 Form) or other identification issued by a recognized Indian tribe inArizona
Documentation from a state, tribal or federal government agency (Social Security Administration,Veteran’s Administration, Arizona Department of Economic Security)
Printed Name Of Affiant:
Signature Of Affiant
State Of Arizona County Of
My Commission Expires
The Foregoing Was Acknowledged Before Me This Day Of
By
Notary Public
Previous
Next
MEDICAL RELEASE
I Give Permission For Myself Or My Child Named
to be taken to the nearest medical facility for emergency medical care while he/she is attending City View High School.It will be my responsibility to contact the hospital or medical facility and arrange for the payment of emergency services provided to my child.
Student/Parent/Guardian Name (Must Be Parent Or Guardian If Under The Age Of 18)
Date
Please List Any Known Medical Conditions Or Allergies To Food And/Or Medication:
Does The Student Take Medication Daily?
Yes
No
List The Name Of Medication (S), Dosage And Time
Should your child take medication, she/he will be required to check their medication into the school office. It is their responsibility to use properly (i.e. time/dosage). Students are NOT allowed to carry medication on their person on school campus
Does The Student Wear Glasses?
*
Yes
No
Contacts?
*
Yes
No
Hospital Preference (Optional)
Health Insurance Carrier (Optional)
Policy No.
I.D. No.
City View High School Does Not Employ A School Nurse; Therefore, School Staff And/Or Other Students Cannot Administer Medication. We Maintain A Basic First Aid Supply Cabinet At The School. Please Indicate Which Item(S), If Any, That You Will Allow Your Child To Use.
Student/Parent/Guardian Signature (Must Be Parent Or Guardian If Under The Age Of 18)
The Family Educational Rights and Privacy Act (FERPA), a Federal law, requires that ACYR, with certain exceptions, obtain your written consent prior to the disclosure of personally identifiable information from your child's educational records. However, City View High School may disclose appropriately designated "directory information" without written consent, unless you have advised the District to the contrary in accordance with District procedures. The primary purpose of directory information is to allow City View High School to include this type of information from your child's educational records in certain school publications. Examples include: •A playbill, showing your student's role in a drama production; •The annual yearbook; •Honor roll or other recognition lists; •Graduation programs; and •Sports activities, such as for wrestling, showing weight and height of team members. Directory information, which is information that is generally not considered harmful or an invasion of privacy if released, can be disclosed to outside organizations without a parent's prior written permission. Outside organizations include, but are not limited to companies that manufacture class rings or publish yearbooks. In addition, two federal laws require local educational agencies (LEAs) receiving assistance under the Elementary and Secondary Education Act of 1965 (ESEA) to provide military recruiters, upon request, with three directory information categories - names, addresses, and telephone listings - unless parents have advised the LEA that they do not want their student's information disclosed without their prior written consent. If you do not want City View High School to disclose directory information from your child's education records without your prior written consent, you must notify the District in writing. Directory Information Includes But Is Not Limited To: •Student's Name •Grade level •Address •Honors and awards received •Telephone Listing •Enrollment status (full or part-time) •Electronic Mailing Address (Email) •Participation in officially recognized •Photographactivities/sports •Date and place of birth •Most recent educational agency or institution •Major field of studyattended •Dates of attendance
Directory Information Includes
I do
I do not
Give My Written Permission To Release Directory Information On
Parent/Legal Guardian Signature
Student Signature
Date
Previous
Next
MEDIA RELEASE
I give my consent for Arizona Center for Youth Resources, Inc. (ACYR) staff or designee to take photographs, audio recordings, and/or video recordings of me/my minor child and to depict my/my minor child's work products. I understand that any such photographs, audio recordings, and/or video recordings, as well as any work products, become the property of ACYR and may be used by ACYR for educational, instructional, or promotional purposes determined by the organization in broadcast and electronic media formats now existing or in the future created.
Please Check One Of The Options Below
*
Yes, I give my consent
No, I do not give my consent
Consent Is For (Check One)
*
me (I am 18 years of age or older)
my minor child.
Name
*
Name Of Child
*
Name Of Parent/Guardian
*
I certify that I have full power to give this consent and understand the meaning and effect of this authorization. This authorization will remain in effect until I revoke permission.
Signature of Student/Parent/Guardian
Date
I understand that: All students attending City View High School will be required to use an individual logon ID and password combination to access any computer on the school's campus. In most cases, a version of the individual user ID and password given to you during enrollment to access the student level of the Synergy web site will be used to log on to any school computer. This includes any station in the computer labs, classroom desktop computers, and any portable computer available on the school campus. It will be the responsibility of each student to log on to the computers when directed by a teacher or other school staff using your ID and password combination. It will also be your responsibility to log off or shutdown that computer when directed. The student is expected to learn and memorize this logon information within the first week of class. This procedure is being implemented to protect your individual work and to assist in the prevention of unauthorized access to our computer system. The use of City View High School's computer equipment is a privilege, NOT a right. Students are to use ONLY their assigned logon credentials when accessing computers or any electronic media. Students are NOT to use another student's logon information or provide their credentials to any other student. Abuse of the rules may result in the restriction or cancellation of a student's account. Repeated abuse may also lead to disciplinary action for both students, including suspension or expulsion. City View High School reserves the right to monitor users' online activities and to access, review, copy, store, and delete any electronic communication or files accessed on City View High School's computers and disclose them to others, including police, as it deems necessary. Users should have no expectation of privacy regarding their use of computer or internet access at City View High School. property, network, and/or internet access or files, including email. City View High School employs a computer monitoring system that monitors student computer activity real time, records all keystrokes, and allows teachers and staff to copy, control, or shutdown the student's workstation at any time. In addition, the following rules apply to ALL City View High School computers at all times. 1. NO personal storage devices, cell phones, or music players may be connected to ANY ACYR computer at any time. Not even for charging, as such devices may contain harmful viruses that can be transferred to the network simple by plugging them in. 2. Do NOT change the background or screen saver settings unless instructed to do so by the CTE instructor for the purposes of learning how to manage a computer's settings and they may ONLY be changed to OS provided pictures. 3. Use of proxy servers is STRICTLY prohibited. At no time should you ever attempt to subvert the firewall settings in place at ACYR. 4. No streaming or downloading of music. This means you cannot listen to music online, watch music videos on YouTube, or in any other way access music on the internet from your computer. All music put onto ACYR computer must have prior approval of the CTE instructor, must be legally obtained, and is to be used only for meeting the requirements of a classroom assignment. 5. No downloading of images for personal use. ONLY images needed for coursework and that do not violate copyright laws may be put on school computers. 6. Only class related videos may be viewed and only when instructed to do so as part of an assignment. NO other videos, music or otherwise may be viewed at any time while using ACYR computers or networks. 7. No accessing of Facebook, Flickr, Twitter, Tumblr, or any other type of social media unless specifically directed to do so by CTE instructor for educational purposes only. 8. No using the internet to search for information related to drugs, gangs, violence, sex, fighting (human or animal), or weapons at any time, unless specifically approved by classroom teachers for research for educational projects, presentations, and papers ONLY. 9. Do NOT change the password assigned to any user account at ANY time. This includes your personal access sign on. 10. All computers MUST be logged off at the end of class and shut down at the end of the school day. All laptops must be shut down before being returned to the cart. 11. All computer usage at ACYR is monitored, and all computers in the CTE lab are enabled with software to track keystrokes, websites and programs accessed, and the ability to screenshot what is being accessed at any time. Access to personal e-mail is allowed, however, ACYR staff can view anything that is accessed. Inappropriate e-mails and pictures accessed may be subject to disciplinary action. 12. No use of any instant messaging or chat service is allowed on any ACYR computer, unless specifically approved by CTE instructor for educational use only. 13. Access to computers and the internet is a privilege and not a right. This privilege may be suspended or completely taken away at any time for violation of any computer and internet policy rules. Class performance will be negatively impacted by loss of computer privileges. I understand and agree to abide by the above rules, as well as all computer rules in the student handbook. I understand that violation of these rules may result in disciplinary action, up to and including expulsion, in accordance with the student/parent handbook.
Name
Student Signature
Date
Submit
About Us
Staff
Our Impact
Enroll Now!
I Would Like More Information
Ways to Give
Tax Credits and Donate Now
2024 Birdies for Charity
Student and Family Resources
Handbooks
Student and Family Handbook
Parental Rights Handbook
Prepare for your Future
Calendar & Courses
CVHS 2024-2025 School Calendar
CVHS 2024-2025 Bell Schedule
Student Support
Career Advancement Services and Supports
Health and Wellbeing
Pathways to Success
Crew’s N Health Mobile
Online Student Resources
Canvas Online Classroom
Virtual / At-Home Learning Actions
Resources for Learning at Home
Public Notices
City View in the News
Contact Us
About Us
Staff
Our Impact
Enroll Now!
I Would Like More Information
Ways to Give
Tax Credits and Donate Now
2024 Birdies for Charity
Student and Family Resources
Handbooks
Student and Family Handbook
Parental Rights Handbook
Prepare for your Future
Calendar & Courses
CVHS 2024-2025 School Calendar
CVHS 2024-2025 Bell Schedule
Student Support
Career Advancement Services and Supports
Health and Wellbeing
Pathways to Success
Crew’s N Health Mobile
Online Student Resources
Canvas Online Classroom
Virtual / At-Home Learning Actions
Resources for Learning at Home
Public Notices
City View in the News
Contact Us