Yorktown High School
Yorktown High School Summer School Registration Currently enrolled students, with prior approval from their school principal or guidance counselor, may take summer school courses. Pre-approval shall be granted only if the course is offered by an accredited institution and the student has not received prior credit for an identical course. Earned grade and credit will be recorded on the student’s transcript upon receipt of confirmation from the outside educational institution. It is the student’s responsibility to ensure this information is provided to YHS.
Student Information
8 9 10 11 12 Student Last Name
Student First Name
Current Grade Level
Home Address
City
Student Email
Student Cell Phone #
Date of Birth
Zip Code
Student Signature
Course Requested for Summer School Include the name of the course, session 1 or 2, and time slot taking this course.
Name of Course
Reason for Request
Summer Session ☐ Session 1: June 5-June 30 ☐Session 2: July 10-August 4
M
8am-10am ☐
10am-12pm ☐
Time Slot (pick only one slot) 12pm-2pm 2pm-4pm 4pm-6pm ☐ ☐ ☐
6pm-8pm ☐
8pm-10p ☐
Friday Assessment Slot (pick only one slot) 8am-10am 10am-12pm 12pm-2pm 2pm-4pm ☐ ☐ ☐ ☐ IMPORTANT INFORMATION REGARDING ONLINE COURES: While Yorktown may approve credit for an online course from an educational institution, students and parents should note that such courses might not be approved by the NCAA. Parents should contact the NCAA Eligibility Center or their intended university/college for information regarding approval.
Student File Copy
Student Copy
Outside Institution Copy
Yorktown High School Summer School Registration For non-Yorktown Community Schools Students
Course:____________________________________
School ________________________________________
Signature (Current School Counselor)
Date
Parent/Guardian Information
Parent/Guardian’s Last Name
Parent/Guardian’s First Name
Home Street Address
City
Work Phone Number
Home Phone Number
Zip Code
Parent/Guardian Cell Number
Parent Email
Signature of Parent/Guardian
Date
For Office Use Only Approved by: _____________________________________
Signature
Date
Amount: ____________
Check #__________ Cash ___ Credit Card ____
Student File Copy
Student Copy
Outside Institution Copy
Student Information
8 9 10 11 12 Student Last Name
Student First Name
Current Grade Level
Home Address
City
Student Email
Student Cell Phone #
Date of Birth
Zip Code
Student Signature
Course Requested for Summer School Include the name of the course, session 1 or 2, and time slot taking this course.
Name of Course
Reason for Request
Summer Session ☐ Session 1: June 5-June 30 ☐Session 2: July 10-August 4
M
8am-10am ☐
10am-12pm ☐
Time Slot (pick only one slot) 12pm-2pm 2pm-4pm 4pm-6pm ☐ ☐ ☐
6pm-8pm ☐
8pm-10p ☐
Friday Assessment Slot (pick only one slot) 8am-10am 10am-12pm 12pm-2pm 2pm-4pm ☐ ☐ ☐ ☐ IMPORTANT INFORMATION REGARDING ONLINE COURES: While Yorktown may approve credit for an online course from an educational institution, students and parents should note that such courses might not be approved by the NCAA. Parents should contact the NCAA Eligibility Center or their intended university/college for information regarding approval.
Student File Copy
Student Copy
Outside Institution Copy
Yorktown High School Summer School Registration For non-Yorktown Community Schools Students
Course:____________________________________
School ________________________________________
Signature (Current School Counselor)
Date
Parent/Guardian Information
Parent/Guardian’s Last Name
Parent/Guardian’s First Name
Home Street Address
City
Work Phone Number
Home Phone Number
Zip Code
Parent/Guardian Cell Number
Parent Email
Signature of Parent/Guardian
Date
For Office Use Only Approved by: _____________________________________
Signature
Date
Amount: ____________
Check #__________ Cash ___ Credit Card ____
Student File Copy
Student Copy
Outside Institution Copy
