open-enrollment charter contract renewal application

open-enrollment charter contract renewal application

OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL APPLICATION Section I. Current Information in Charter School Tracking System
Charter Holder Name: LA ACADEMIA DE ESTRELLAS
Charter School Name: LA ACADEMIA DE ESTRELLAS
Charter School County/District II: 057-839
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Maximum Approved Enrollment: Grades Approved: Campuses: 400
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057839101
LA ACADEMIA DE ESTRELLAS
125 Sunset Avenue
D.llas, TX 75208
Grade levels Currently Served:
KG,Ol,02,03,04,05
Geographical Boundary: The ongiRul chnner application and amendment history reflects that the rollowing distric1(S) comprise the chnrtcr school's geographic boundllry: DALLAS ISO
I
Section II. Contact Information
The persons listed below will be contacted by agency staff if there are issues to be resolved in any of the sections.
Superintendent Contact Information:
Superintendent's Name:
ILorraine Mantei
Telephone Number:
1'2-14---94-6--8-9-0-8- - - - - - - - - - - - - - - - - - - - - - - - - ­
Fax Number:
1214-946-8777
E-mail Address:
I'lo-rra-in-e-.m-an-te-i@-.c-a-d-em-ia-de-e-s-tre-l-las-.-o-rg------------------­
Charter Holder Board Chair Contact Information:
Charter Holder Board
Chair's Name:
Telephone Number:
Fax Number:
I'. . .·'·,
214-946-8908
1214-946-8777
E-mail Address:
Application Preparer's Contact Information:
Contact Name:
IRiChard Tuck
Telephone Number:
1214-946-8908
Fax Number:
1214-946-8777
E-mail Address:
[email protected]
Charter School Website:
Web address if available:
Iwww.academiadeestrellas.org
Page 7
2
Section III. Organizational Charts
Submit, as Attacbment 1, the orllanizational chart for the charter school that specifies the administrative positions
including title and name of individual currently in each position.
Submit, as Attacbment 2, a chart that identifies all other entities under the direction of the charter holder. This
would include entities and/or programs that the charter holder governs/manages in addition to the charter school.
PageS
:)
Attachment 1 - La Academia de Estrellas Charter School Organizational Chart
Business Manager
Richard Tuck
i
Office Mgr./ Parent Coordinato Hilda Duarte Assistant Principal Ivelisse Centeno I
Curriculum Coordinator Kate Ozmun ,
Intervention Coordinator Amber Lira y
Attachment 2 - All entities under direction of La Academia de Estrellas, the
charter holder
La Academia de Estrellas, the charter holder, has no other entities or programs besides its
operation of the La Academia de Estrellas School District.
5
Section IV. Admission Policy
A. Specii)' the period during which applications for admission are accepted. TEC. §12.117. requires that a charter school
establish a reasonable application deadline for the submission ofapplications for admission.
Beginning of Period
End of Period
(MonthlDay)
(Month/Day)
IFebruary I
B. If the school admits students by lottery when the number of admissions applications received exceeds the number of
available spaces, describe the procedures followed in conducting the lottery.
Type Below:
Please see Attachment 3 (Admission Policy), Section 5 (Lottery) for the procedures followed in conducting the lottery.
C. lfthe school utilizes a lottery when oversubscribed, are any categories of applicants exempted from the lottery?
Check One:
(i' Ves
nNo
r
Not applicable (because lotteries are not utilized)
If "Ves" was indicated in C above, state the categories of applicants that are exempted. Type Below: Current students whose parents have stated their intention for the student to return for the next year are exempted from the lottery.
D. If the school utilizes a lottery when oversubscribed, specii)' the approximate date on which a lottery will be conducted.
Approximate Date of Lottery
(Month/Day)
E. If the school does not utilize a lottery when oversubscribed, but rather fills the available positions in the order in which
applications were received before the expiration of the application deadline (i.e., a "first-come, first-served" admission
process), describe the manner in which the school notifies the community of the opportunity to apply for admission. TEC.
§12.117. requires a charter school that uses a first-come. first-served admission process when oversubscribed to publish a
notice in a newspaper ofgeneral circulation not later than the seventh day before the application deadline.
Type Below:
N/A
Page 9
F. If the school has a separate process for re-enrollment, state the process and the timeline to be used.
Typc Below:
REVISED DURING CONTINGENCY
PROCESS - SEE INSERT
'.
G. State the procedures for processing applications received once the application deadline has passed.
Type Below: \
\
Applicants who did not get pic~ed in the lonery are placed first on the wait lists in the order that they applied. All subsequent applications
are put behind these applicants in the order (by date) they apply. As openings occur, they are filled from the wait lists. Thus, it is a first­
come, first-served system.
H. Describe the information that
applicant must provide in order to be considered for admission. Applicants may not be
required to provide copies ofIra cripts or other academic records until ajier they are offered admission and are
enrolling. Furthermore, a student
not be precludedfrom enrolling due to the charter school's failure to receive
information required for enrollmentfr
the student's parent or guardian or previous school. See TEC, §25.002.
TypcBclow:
Per TEe rules, we cannot require any information in order
~ consider
a student for admission. However, if they do provide the information,
the only information that would preclude an applicant from cb ideration is if they are not eligible to enter one ofour grades or if they have
severe disciplinary issues as authorized by TEe rules (see belo .
I. The charter holder certifies that the non-discrimination sta ment required by TEe, § 12.11 I (a)(6) is printed in the school's
admission policy. TEC, §12.111(6) requires that a charter s 1001'S admission policy include a statement that the school
will not discriminate in admissions based on gender, national igin, ethnicity, religion, disability, academic, artistic, or
athletic ability, or the district the child 1V0uid othenvise aI/end.
Cbeck One:
(0 Yes
rNo
J. Does the admission policy either require or permit the school to exclude om admission all students with documented
histories of a criminal offense, a juvenile court adjudication, or discipline oblems under TEC Chapter 37, Subchapter A
as authorized by TEC, § 12.1 I 1(a)(6)?
Chcck One: (0 Yes ( The school excludes such students or reserves the rigH to exclude such students from
• admissions.)
r No (The school does not deny admission to such students based 0
their documented histories of
misconduct.)
Submit
as Attachment 3, a current copy of the admission policy that incorporates the information p ovided in the above answers to
questions A through H and any other relevant information;
as Attacbmcnt 4, a blank copy of the current admission application (i.e., the information re ested when the student first
seeks admission); and
as Attachmcnt 5, a blank copy of the current enrollment form(s) (i.e., the information required nce an applicant has been
offered admission and is registering for enrollment)
Page 10
7
Recel , ed :
-
Sep. 14. 2010 8: llAM
APPROVED DURING
CONTINGENCY PROCESS
F. If the scbool has a separate process for re-enrollment, state the process and the timeline to be used.
Type Belo,,:
The pan:ats of ctl!ml1 srudCl1!S, who .... expected 10 be in • gnde ..hicb lb. school SCIV.S in lb. next yew, will be sent. returning student
fonn III'OUDd Msrch 25th. The pamll must eomplCl. !h. form by May 151b indicatiJIg wbetber or not Ibeir cbild(=) will be returning for the
"ext year. The ",bool should send a second DOli.. IIrOUDd April 25th to parents who bave not yet responded and finaUy call die
nonn.ponden during the week before May 151b.
.. ._.
.• ...
.... ..-. - ..
.•
__
---_ _-----_._--_. __ __
--
0, Stale the procedures for processing applications received once the application deadline bas passed. Type Below: Applicants wb.o did not get picked in the lottery arc placed first 00 the wait lislS in the order Ibat Ibey applied. All subsequCDt applications
Ibe,e applicanlS in the order (by date) they apply. As openings occur, !hey are fiUed from !he wait lists.
OR put behind
------.-----
----_._---------_ .
.
H. Describe the information !hal an applicant must provide in order to be considered for admission. Applicants mqy "ot be
required to provide copies oftranscripts or Olher OI:adtmic reco,ds until ofter they ore offered admissio" and are
errrolltng. Fun~rmore, a ,trlde"t may "ot be precludedfrom enrolli"g due to the charter school's /ailure to receive
i"/ormotio,, required/o, rnrollment from the studmt's parmt 0' guardian OT previous school. See TEC, §25.002.
Type Belo",:
Per TEC rules, we CIIDIlOt require any information in order to consider. stud.nt for admission. However, ifth.y do provide the infonnation, the only infonnmon !hI! would preclude an appUcant from cOll!lid.,.!ion is if th.y OR .ot eligibl. to enter one ofour p.s or if they have sev.re diociplinary is.ues as au!horized by lEC rules (se. b.low). I. The charter bolder certifies that !he non-discrimination stalement required by TEe, §12.111 (8)(6) is printed in the school's admission policy. TEC, § J2. JJ J(6) ,equ;reJ thol Q cilorler schoo/'I adminion policy include a statement that the school will 11(11 di,c,iminate i" admislions based 0" gender, "ati01lO10rigill; I!lh"icity. religio", disability, acQ{/tmic. artistic, or athletic ability, or the district the child would otherwise attend. CbeekO. .:
€ ,Ycs .
OND
1. Does the admission policy .ither require or pennit the school to exclude from admission all students with documented histories of a criminal offense, 8 juv.nile cowt adjudication, or disciplin. problems IDlder lEe Chapter 37, Subehapter A as authorized by lEe, § 12.III(a)(6)? CbeckOnc: @ Yes (The school.xcludes such srudents orreserves the right to exclude such students from
- admissions.)
()No (The school does not deny admission to such students based on their documented histories of
, misconduct.)
SUbmit
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II
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as Altachlnent 3, a current copy of1he admission policy that incorporates the information provided in the above answers to
questiOD' A through H and any other rel.vant information;
as Attacbment 4, a blank copy of the current admission application (i.e., the information requested when the student lint
seeks admission); and
as Att.clunent 5, 8 blank coPy of the current enrollme.t formes) (i.e., the information required ODce an applicant bas been
offered admission and is registering for enrollment)
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La Academia de Estrellas
Where Students Shine!
Student Admissions Policy
As Amended May 18, 2009
1. Applications for the next school year will be accepted between February 1 and May 15 of each
year.
2. The parents of current students, who are expected to be in a grade which the school serves in
the next year, will be sent a returning student form around March 25 th • The parent must
complete the form by May 15 th indicating whether or not their child(ren) will be returning for the
next year. The school should send a second notice around Apri I 25'h to parents who have not yet
responded and finally call the non-responders during the week before May 15th •
3. Siblings of current students, whose parents have stated will be retuming for the next school
year, are given priority over other applicants. A sibling is defined as having at least one common
parent or legal guardian with a current student who is returning.
4. On May 15 th , the list of returning students, their siblings who are applying for a place in the
school and other applicants will be compiled for each grade. If the number of returning students
and applicants exceeds the number of spaces in the grade, a lottery will be held to determine
which applicants will be offered admission.
5. Lottery. The lotteries required by section 4 will be held by May 20th of each year as follows:
a) If the number of siblings applying for a given grade is less than the number of open
spaces, all sibling applicants will be admitted. If the number of sibling applicants
exceeds the number of open spaces, each applicant will be assigned a number which will
be put on a slip of paper. These paper slips will be put in a secure box and slips will be
drawn randomly until the available spaces are filled. All lotteries must be conducted in
the presence of the superintendent or their designee (must be an administrator).
b) If spaces remain after the siblings are admitted, the remainder of the applicants will be
allocated in the same manner as the sibling applicants. All will be admitted if the number
of remaining applicants is less than available spaces. Otherwise, a lottery will be held to
decide who is admitted.
c) If there are more applicants than available spaces in a particular grade, then any applicant
who is not admitted during the lottery will be placed on a wait list for that grade in the
order that they applied for admission.
La Academia de EstTellas WheTe Students Shine! 6. The school district shall infonn the parents of the applicants in writing by May 25 th whether
their child was admitted or wait listed. This written notice shall be followed by a phone call to
the designated parent to confinn admission with the notification rules in section 12 applying.
7. The school will continue to accept applications for admission beyond May 15 th, but these
applicants will not be eligible for the lotteries. If a grade still has places available after May 20th ,
applicants will be admitted on a first come, first serve basis. Once all spaces in a grade are filled,
applicants will be put on the wait list on the same first come, first serve basis. If a grade is full
and has a wait list as a result of the lottery process, new applicants will be added to the list
behind those already on the list. All applicants after May 20th will be infonned of their status at
the time of their application.
8. If the parents of a student accepted for the next school year decide to withdraw their child
from the school district, a space will be created. This space will be filled by the first name on the
wait list for the grade affected, or if the wait list is empty, by the first applicant.
9. In early August of each year, the designated parent of each student admitted for the next
school year will be reminded about their child's admission status and requested to infonn the
district if they have decided not to enroll their child for the upcoming year. To the extent that
these decisions are made not to enroll, spaces will be created and wait listed children will be
admitted in their order on the wait list.
10. Any admitted student who misses the first three days of school without an acceptable reason
will be subject to removal and replacement by a child on the wait list for that grade. The
detennination of what constitutes an acceptable reason will be made by the superintendent.
Acceptable reasons include illness and family emergencies.
11. Around September 15 th of each school year, the parents of students remaining on the wait
lists will be contacted to detennine whether they would like for their child to remain on the wait
list. Those deciding against remaining on the list will have their child removed from the list.
12. Notification Rules. Parents of children being admitted to the district schools must
acknowledge and confinn this admission within 24 hours of being infonned of their child's
admission. If the parent does not provide notice of their intent to enroll their child for the next
year within this time period, the next applicant on the priority list will be given priority. This
requirement will be waived for all applications received within the two weeks before admission.
g
La Academia de EstTellas
WheTe Students Shine!
REVISED DURING CONTINGENCY
PROCESS - SEE INSERT
13. Ex,:lm;io,~ls. The district reserves the right to deny admission to any students with a history of
misconduct
problems as defined by TEe statutes and commissioner's rules.
14. No'n-l)islcriJni~lati~pn Statement. It is the policy of La Academia de Estrellas not to
discriminate in
on the basis of ethnicity, religion, national origin, gender, disability,
academic, artistic, or
or the district the child would otherwise attend. La
Academia de Estrellas will al ensure that lack of English language skills will not be a barrier to
admission and participation in all)aucational programs and services.
10
Received :
ul.
2010 6: 2 PM
Jul 1 2010 06 :06pm
No.
0782
P. 3
La Academia de Estrdlas
WheTe Sttldents Shine!
o OUR\NG
c~~~~O~:NC'{ PROCESS
13. Exclusions. The district reserves the right to deny admission to any students with 8 history of
misconduct or discipline problems as defined by TEe 12.111(8)(6) and commissioner's rules.
14. Non-Discrimination Statement. It is the policy of La Academia de Estrcllas not to
discriminate in admissions on the basis of ethnicity, religion, national origin, gender, disability,
academic, artistic, or athletic ability, or the district the child would othCIWise attend. La
Academia de Estrellas will also ensure that lack of English language skills will not be a bamer to
admission and participation in all educational programs and services.
I() La Academia de Estrellas Charter School
111 S. Beckley Dallas, TX 75203
Phone: 214-946-8908
Fax:
214-946-Sm
Application Form (Forma de aplicacion) 201&-11 School Year
REVISED DURING CONTINGENCY PROCESS - SEE INSERT
\
Student NamelNombre del alumno _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
_ _ _ _ _ _ SexlSexo_ _ __
Last Grade Com letedlultimo grado completado _ _ __
Previous School an \OistrictlEscuela previa y Districto previo,_ _ _ _ _ _ __
Parent(s)/Guardian
N~eINOmbreS de los Padres,_ _ _ _ _ _ _ _ _ _ _ __
\
\~ __________________
Ho= Addre""Dtrttci', '"
\
c~I,-_ _ _ _ _ _ _ _ __ Cellular Phone NumberINlimero del telefO~\lular _ _ _ _ _ _ _ _ __ Home Phone NumberfTelefono de la
\..>.,-__________ Other Contact Number(s)/Otros nlimeros ___
Return tbis form tolRegresar la forma a:
Lorraine Mantei, Principal
La Academia de Estrellas Charter School
III S. Beckley Avenue
Dallas, TX 75203
II 1. 20 0
Received :
6 : 2 I P~
Jui 1 2010 06 :06pm
No.0782
AHo.ch,..,el'lr 4 - Curre.YlT AcJ.... ,'s~ion
P. 4
Aff/;ca.+/Of)
La Academia de Estrellas Charter School
111 S. Beclcley Dallas, TX 75203
Phone: 214-946-8908
Fax:
214-~777
Application Form (Forma de aplicacionl
2010-11 School Year
Student NameINombre del a1umno _ _ _ __
Student Birth DatelFecha de nacimiento _ _ _ _ __ Last Grade Completed/Ultimo grado completado _ _ _ Previous School and DistrictlEscuela previa y Districto previo_ _ _ _ _ __ Psrcnt(s)/Guardian NameINombrcs de los Padres,_ _ _ _ _ _ _ _ _ _ __ Home AddressIDirccci6n de la Casa _ _ _ _ __ _ _ _ _ _ _ __ _ _
Home Phone Numberffelc!fono de]a casa'--_ _ _ _ _ _ _ __
Cellular Phone NumberlNUmero del telefono celular _ _ _ _ _ _ _ __
Other Contact Number(s)/Otros nUmClOs._ _ _ _ _ _ _ _ _ _ __
Return this form tolRe:resar la forma a:
Lorraine Mantei. Principal
La Academia de Estrellas Charter School
11 J S. Beckley Avenue
Dallas. TX 75203
II At+~dl f1~+ 5
EnrOUmentDocuments Needed:
DOcumentos necesarios pua inscribir:
a BirtbCertificate/Actli tie IIllcimkllto
o SliotRecordsIrecorilde VfIC""1lS
C'ParentPhoto ID/Foto 1D tie Padres
[J SQCial Seewily Cfri/Tqrjefll'. n1lllleroMICitIl
,Ol.ast;ReportMUst show "promoted to"/BIJIdIJ . . .
iililestte fllIe el esuuJiIInte "ptIso'1ll. aigllienteliftlJli'j
.' La Academia de EstreIIas j!!lementsry Charter School Health History
Grade:
'- - -
Dear Parent:
We would like for your child to gain the most from hislher school experience. In order for us to assist in
accomplishing this, it is necessary to have a current health history. Please complete this form and return it to the
principal or nurse.
Pupil's Name: _ _ _ _ _ _ _ _ _ _ _ _,Sex ___ Birth Date: _ _ _ _ _ __
Address:
Phone Numlier: _ _ _ _ _ __ Father's Name
Brothers
Mother's Name: _ _ _ _ _ _ _ _ _ _ _ __ This child is Sisters
in the family.
(Birth order number)
no. ifyes, where? _ _ _ _ _ _ __
Has this child ever attended any school? _ _ yes _
Employment insurance 0 I. How is health care provided for this student?
DPrivate Insurance DSocial Security Insurance DMedicaid DOther: _ _ _ _ __ 2. When did your child last have a physical examination? _ _ _ _ _ _ _ _ _ _ _ __ Purpose of examination: DRoutine check up
Dmnessiinjury _ _ _ _ _ _ _ _ _ __ 3. Does your child have a health problem? (cbeck appropriate) Asthma
Diabetes
Vision
Sickle Cell Anemia
Injury _ _
Allergies __ Anemia
Hearing _ _ Seizures/Convulsions
Heart _ __ Please explain: _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ -'-_ _ _ _ _ _ __
4. Does your child take any medication? 0 Yes DNo Ifyes, name ofmedication(s) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 5. Has child been hospitalized for any reason since birth?
6. Does any close relative in your family have a history of:
(check and indicate relationship this child).
Diabetes_
Epilepsy _ _
Heart Disease
Cancer_
High Blood Pressure _ _ Birth Defect_ _ Mental Retardation _ __
Sickle Cell Anemia _ _
Anemia
Learning Problems _ _
Other _ _ _ _ __
7. Are there any problems in the home which might affect your child's learning?
Comment: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
8. Is there anything more about this child's health tlllltyou think is important for us to know?
13 La Academia de EstreIlas Elementary Charter School Health History
Grado Escolar:_ _ __ Estiamdos Padres:
Nos gustarfa que su nino/a tenga en todas sus experiencias con la escuela. Para que nosotros podamos ayudarlo a
lograr esto, es necesario tener una historia cllnica completa al corriente. Por favor, complete esta forma y regresela a
la Directora 0 a la enfermera.
Fecha de
Nombre del alumno: _ _ _ _ _ _ _ _~_ _ _ _ _ _ _Sexo ___ Nacimiento: _ _ _ _ _ __
Domicilio:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Numero de Telt!fono: _ _ _ _ _ _ __
Nombre del Padre
Nombre de la Madre_ _ _ _ _ _ _ _ _ _ __ Hermanos_ _ _ _ _ _ _ Hermanas _ _ _ _ _ _ Este nino es _ _-;-;,--_ _-;-_-;-.,-- en la familia. (el numero de orden)
l,Alguna vez ha estado matriculado en una escuela? _ _ si _ _ no l,D6nde? _ _ _ _ _ _ _ _ __
I . l, Que segura de salud tiene para su nino/a? Seguro de trabajo
OSeguro Privado 0 Seguro Social
0
0
Medicad DOtro: _ _ _ _ _ _ _ _ _ _ _ _ __
2. l,Cuando fue la ultima vez que su niilo/a recibi6 un examen fisico? _ _ _ _ _ _ _ _ _ _ _ _ __
Raz6n de la exanimaci6n:
0
Examen de rulina
0
Enfermadalherido/a _ _ _ _ _ _ _ _ _ _ __
3. l,Tiene su hijolhija problemas de salud? (marque 10 que es propio) Asma
Diabetes
Problemas de Vista _ __
Herido/a
alergias _ _
Anemia _ __
(Dreoabicuti)Sickle Cell _ _ _ __ Problemas del oldo _ _ AtaqueslConvulsiones_ __ Enfermedad del coraz6n _ _ _ _ _ Otra enfermedad: _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Por favor expIique: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 4. l, Toma su hijo/a medicamento? 0 si 0 no Nombre de medicamentos:
5. l,Ha sido su niilo/a admitido en un hospital por alguna raz6n desde su nacimiento?
6. I.Alguna persona en su familia tiene historia de: (indique y marque el paranetesco). Anemia _ __
Diabetes__
Cancer_
Presi6n alta
Epilepsia _ _
Drepanocito _ _ Enfermedad del coraz6n _ _ Problemas para aprender _ _ Otro_ _
Defecto de nacimiento_ _ Retardardaci6n Mental
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7. l,Hay problemas en su cass que podran afectar el progreso para aprender de su niilo/a? _ _ _ _ _ __
Comentario: _,--,--,--_,--_ _,--,--,--_,--,--_ _,--,--_ _ _ _ _,--_ _ _ _ _ _,--~--8. l,Nos puede decir algo de importancia de la salud de su nino/a que nosotros no Ie hayamos preguntado?
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ExpJique
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1'-1 STUDENT ENROLLMENTJREGISTRATION FORM (~:QtO-l1) Date of Enrollment: The completion of the infonnation on the Student Enrolment Registration Fonn does not detennine the parent-:-a""'l-r""'
el;-a""'
tions""'
- - h-:-ip nor
­ does it
affect legal right ofaccess to the student nor the student's records. (Fonn shOllld be completed by parent/guardian.)
SCHOOL
TEA Code: 057839101
Mother's Email:
Father's Email:
La Academia De Estrellas Charter School
Advisory Assignment
Advisory Name
Advisory Room
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Student's Legal Name (Last, Finit, Middle)
o Male
Grade Level
~~~F(g~.QIQfi~I
Student's Sociru Security Number (ifavailable)
Student's Date of Birth (mm-dd-yy)
Ifstudent's birthplace is outside U.S. (t4t~hOI~!Je_en~i;lll,:;;.
Student's Place ofBirth, (City, State, Country)
SEX:
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Q Asian Pacific Islander
0 White
Ethnicity (check one) EiIBlack
Hispanic
American Indian/Alaskan Native
Special Programs (Check all that apply)
Has your child lived out ofthe U.S. for 2 or more consecutive years?
no ffyes, indicate dates: From
Dyes
Special Education
Section 504
Whcll your child lived outsidc lhe U.S. did he/she attend school
Bilingual Education
regularly? 0 yes 0 no
Other
UFemale
o
o
o
o
o
o
Previous School (School Name, City, State)
Reason for leaving Previous School:
Name ofParent/Guardian with whom student lives
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DOB (rnrn,dd,yy)
Student's Address (Street name, building or aplll, City, State & Zip)
Father's Name and Address (if different from above)
DOB (mm,dd,yy)
Relationship to Student
Residence Telephone Number
Plnee ofEmployment
Home Phone
Work Phone
Cell Phone:
Mother's Name and Address (if ditTerent from above)
DOB (mm,dd,yy)
HomoPhone
PI""e ofEmployment
WorkPhooe
Cell Phone:
HAVE YOU DONE ANY WORK INVOLVING SEASONAL AGRICULTURAL OR FlSHING ACTVITIES IN TIlE PAST SIX YEARS DYES DNO
OTHER PERSONS WHO MAY BE CONTACTED IN THE EVENT OF EMERGENCY'
·Person's Name and Relationship
Telephone Number:
Release AUth0'[jtion
Dyes
no
Telephone Number:
Release Authorization
Dyes
Dna
Telephone Number:
Release Authorization
Dyes
Dna
Name of School(s)
·Person's Name and Relationship
·Person'sName and Relationship
Name of Sibling(s) Attending School
I
I
Name ofPhysician
Health Insurance
.
Phone Number
LJ Medicaid
[J CHIP
..
o Commercial
Preferred Hospital
[] Uninsured
( •Please Itst all guardlanshtp or custody arrangements about which school administrators should be aware of~ Attach aU COpies of legal documents.)
I authorize La ACAdemia Dc Estrcllas Charter School 10 conlaclabo\'c named persons, and Authorize the nomed physician to render treatment for the health of my child in an
emergency. Inlhc c\'(,111 parclIl/gunillian Of' ph.\'~it:inn Co1nnol ~ n1lllnClcd. school officials are 'lIullOri7.cd to III"C whatevcr nClioll is cnno;idcrcd neee.mll)' ror fhl': hcnlth of
Illy child. I will nol huld Ihl! school disl,.. itl financinll), IcspunS'iblc JilT Ihe emergency ellr!! nndhlf IranslJOI[alil1Jl for my child.
ParentiGUllldian Signolurc:,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Dale: _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
TEe §2S .002(f) requires thsllhe name, address and dale of birth Orlhe persons enrolling a sludent be provided 10 the school district
Knowingly falsifying irifOimation on this document is a criminal offense punishable: by law. (TX Penal code §37. 1O. I certify that the infonnation contained in this
enrollment/registration form is true and correcL
Parent/Guardian Signature:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
15
INSCRIPCIONIMATRiCULA
Ah.9 , Es~lat29 1.9;t1
Fecha: ..,...,_-;--:---:--:-:-_ _ AI completar la infonnaci6n sobre la forma de registro de la inscripci6n del estudiante no determina la relaci6n parental ni afectani el derecha legal al acceso al estudiante oi a los expedientes del estudiante. (Se debe lIenar el fonnulario por padre/guardian.) ESCUELA
Codigo TEA: 057839101 r Correo electronico de Madre:
Correa electronico de Padre:
La Academia De Estrellas Charter School
Asignaci6n Consultivo
Nombre del Consultor
r Nlimero del Sal6n
1
Nombre legal del estudiante (Apellido, nombre)
Fecha de nacimiento del esrudiante r Numero social del estudinnte (si estJi
disponible)
Lugar de nacimiento del estudiante, (ciudad, estado, pafs)
Si eI estudiante naci6 fuera de los E.U, escrib" la·fech·a_qu~J'D. tro a E.U.
~mmd<f.lr)
SEXO: U Masculino
Pertenencia Elnica (marque uno) U Indio Americano lNativo de Alaska U Blanco
UFemenino
o Negro
NiveilGr;lCfd
".," ' !CI "
r..ala.~/,\flo
l!.!lJQ;.!!
Prograrnns Especialcs (Marque lodo 10 que apliquc.
o Educaci6n Special
o Secci6n 504
o Educaci6n Bilingue
oOtro
o
Asiano de Isla Pacifica
o Hispano
Su nino ha vivido fuera deo los E.U. 2 ailos consecutivos 0 mas?
ono o si - Si marco sf, indique las fechas:
De
a
Cuando si hijO/a Vi6 afuera de los E.U., asisti6 a una escuela
re ufarmente?
I yes 0 no
Raz6n por la cual salio de la escuela anterior:
O
Escuela Anterior (Nombre de Escuel.. domicilio, estado)
Nombre del podrelguardinn con cual en n/lola vive Dctualmente r Focha de nacimiento
Relaci6n con el estudianto:
(mmdd)y)
Domicilio del estudiante (nombre de la culle. cdificio, # de apL. cuidnd. cslado y codigo postal)
Domicilio del Padre (si es diferente a 10 anterior)
Domicilio de In Madre (si es difcrentc a 10 anterior)
Numero del tel.fono de la residencia
Fecha de
nacimiento
(mmddl'Y)
Lugar de empleo
Telc!fono de casa
Telo!fono del trabajo
TelUono Celular:
Fecha de
Lugar de ompleo
TelUono de casa
Telc!fono del trabajo
TelUono Celular:
nacimiento
(mmddl'Y
AHECHO USTED CUALQUIER TRABAJO ESTAOONAL QUE IMPLICA ACTIVIDADES AGRiCOLA 0 DE PESCA EN LOS ULTIMOS SEts AlIos I I,i I I
*Nombre de la Persona y relaci6n con el estudiantc
• Nombre de In Persona y relacion con cl estudiantc
Autorizado para lIevarselo?
osi
ono
Autoff~o para lIetSelO?
51
• Nombrc de 18 Persona y relacion con cl cstudiantc
Nombre del doctor principal
Seguro de salud
LJ Medicaid
Nlimero de telerono:
Nombrc de escuela que nsistc
J Numero de telerono
LJ CHIP
Nlimero de tel_fono:
DO
AutOoZBdO para IIevarselo?
si
ono
Nombrc de hennanoslas del cstudianlc Y la cscucla que asislc(n)
Nlimero de telMono:
Hospital de Preferencia
UComercial
..
J No tiene segura de salud
(·£numcre por favor lodos los amglos de Ie tutela 0 de la custodia sabre que admlmstradores de la escuela debe tstar cnterBdo. Una loda COPI! de documcntosJurldlcos.)
tOri7"';1 lu (,~ f.;Ucfll cle La ACildclIli •• fA: t:slll:llas CII"f!!.:1 I"";' Cnll;I/ ,:n C(\41II1Clr. CHIIII(I ~ lnn( no.uhmdm., y <l ulutilt) ill mtulCil llwllhrado lIlellOlf cllrali'lIniclllO Jl nm fit sulucf
mi nino en unn c:mergencia. En Cll<;O de t:OIergcl1cia sl no se puede contuelar con cl padre/suardian 0 cl medico. sc aulorilJl n los fUlicionnrios de la cscuda lomar la act ion
%Saria para la s<llud de mi nino. No rc:sponsibilizare eJ distrielo de 18 escuela financiernmente responsuble del cuidado ylo deltnmsporte de la cmergeneia para mi niflo.
Fimla de pndrclguardian:
Fecha.
TEe 25.002(0 rc -uiere ue cl nombre. domicilio. fecha de nacimiento de la rsonn uc esla matricu'ando al estudiante sea rovcida al distrilo escotor.
18 falsificaci6n de In informaci6n sobre este documento Con eonocimiento tS una oftnsa criminal castigable par ley. (e6digo penal §37. to de TX. Certifieo
que Js informaci6n contenida en esto fonna de matricuJalinscripci6n t:Sta venbd y cometa.
Firma de Padre! uardian:
fecha:
J(,
La Academia de Estrellas Charter School
Where students shine! Donde rruestros ninos brillan! BOMELANGUAGESURVEY
Grnde ___________________________
SrudentName __________________
~
. Date ________
_____________________
I. What language is spoken at home or inost ofthe time?
Spanish ____
English__
Other (specify) _______
2. What language does your child speak most of the time?
English_ _
Spanish
Other (specify) _ _ _ _ __
Parent or guardian Signature
INQUESTA SOBRE EL IDIOMA DEL BOGAR
Grado __________________________
Fecha
Nombre del Esrudiante
1. CUa! idioma se habla en su hogar casi siempre?
Ingles_ _
Espaiiol _ _
Otro (sea especific6) ____________
2. Cual idiom a es que su hi~o prefiere 0 casi siempre habla en casa?
Ingles_ _
Espaiiol _ _
Otro (sea especific6) ____--'--______
Firma de Padre/Madre 0 GuardiAn
17
-+
For Students who have lived outside the U.S. Para Estudiantes que han estado fuera de los Estados Unidos
~
Su nmO ha vivido fuera deo los E.U. 2 afios
consecutivos 0 mas?
Sl marco si, indique las fechas:
De
a
Dno
Usi
LJ
No, mi hijo/hija no U Si, mi asistia a la
tenia la oportunidad de escuela regularmente
asistir la escuela
Ctiando si hijo/a vivi6 afuera de los E.U., asisti6 a
una escuela regularmente?
Grado(s)
Por favor espisifique los grados, y las fechas, incluyendo el ano. (por ejemplo: 2ndo grado, enero 2005 hasta mayo 2006). No debe incluyir dias feriados ni dias de vacaClOnes. -
00
Fecha(s) La Academia De Estrel/as Charter School
Parent/Guardian Information
Name of Student _ _ _ _ _ _ _ _ _ _ _ _ _ _,Oate of Birth _ _ _ __
Student's Address'--_ _ _ _ _ _ _ _---,:-:-:----:-o_ _ _ _ _ _ _ _ _ _ __
Phone (Home) _ _ _ _ _ _ _ _ _
(Work)
Emergency Contact's Name ____________,Phone________
Information Supplied by -------------Date ---------
1. Please list the name and relationship to the child of all other people living in the household:
Name
Age
Relationship
2. Does your child wear glasses or have a vision problem? No
3.
Does your child have a hearing aid or a hearing problem? No
0
0
YeU
If Yes, please explain:
yesD
If Yes, please explain:
4. Has your child ever repeated a grade? No_ Yes _
If yes, which grade? _ _ _ _ _ _ __
5. What academic and nonacademic concems do you have regarding your child? _ _ _ _ _ _ __
6.
Has anyone in your family diagnosed with a leaming disability or have any trouble learning?
No _Yes__
If Yes, please explain: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
7. How much time does your child spend on homework each night? _ _ _ _ _ _ _ _ _ _ _ __
8. How much assistance do you provide during homework time?'--_ _ _ _ _ _ _ _ _ _ _ _ __
9. What methods of discipline do you use at home?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
10. Does your child have any health problems? No_ Yes _
11. Does your child take any medications? No_
Name
If Yes, explain: _ _ _ _ _ _ _ __
Yes
If Yes, please list names and dosages:
Dosage
12. Please list any traumatic events (deaths, divorce, injuries, etc.) that may be affecting your child's learning:
13. At what age did your child do the following: 14. Birth weight_ Ibs. _oz
Premature: No
0
Yes
0
I9
15. Has the classroom teacher indicated concerns about your child's behavior performance?
DYes
DNo
If YES, please explain:
What classroom behavioral strategies do you think would help your child?
Has your child had any previous evaluations?
If yes, does the school have a copy of that evaluation?
Who did the evaluation?
Please describe any significant factors (developmental, medical or situational) you feel may impact your child's ability
to benefit from current educational program:
PLEASE LIST ANY ADDITIONAL INFORMATION THAT YOU FEEL WOULD HELP ASSIST US IN WORKING
WITH YOUR CHILD.
Signature: Date Received by School: _ _ _ _ _ _ _ _ _ _ _ __ 20
Section V. Special Education Assurances
The charter holder certi fies that it has policies and procedures in place that ensure implementation of all federal laws and
regulations, Texas laws, State Board of Education (SBOE) and commissioner rules related to students with disabilities
and further certifies that any future amendments to the laws, regulations, and rules will be incorporated and implemented.
__ tlhpt?rd&t/ _(J:-b tJ~ !.._______
Signature of Charter ~Chair
(Must sign in blue ink)
~6-.&v7'
______________________W-. _____________________
Date
__~.JI.cJdL!L__;L}3:1.1I______________
Printed Name of Charter Holder Board Chair
Page 11
21
Sect jon VI. Assurances Regarding Charter Schools Serving Students at Residential Facilities If operating a charter school campus on the site of a residential facility (RF) or serving students residing in or receiving
services from an RF, the charter holder chair certifies the following:
Compliance ..ith Special Education Requirements: The charter holder assures that it will comply with all of the
requirements for the provision of educational services to students with disabilities as mandated by the Individuals with
Disabilities Education Act, as amended, the Texas Education Code, and federal and state special education regulations.
The charter holder acknowledges that state and federal special education requirements require, among other things, that
it provide a free and appropriate public education (FAPE) in the least restrictive environment (LRE) to students with
disabilities residing in RFs. The charter holder further assures that it will provide, or seek the provision of, a FAPE to
students with disabilities, which may require it to contract with outside service providers or another local educational
agency to provide necessary services and supports to students with disabilities.
Geographic Boundaries: The charter holder assures that it will accept students who reside in the school district(s) that
are within each new campus's geographic boundaries regardless of the presence or absence of a disability or admission
to or participation in an RF program.
Admissions Criteria: The charter holder assures that its admissions criteria will not be based on the presence or the
absence of a disability or on gender, national origin, ethnicity, religion, academic, artistic or athletic ability, or the
district the child would otherwise attend.
School Choice: The charter holder assures that parents/legal guardians (or adult students) will be advised that they
may choose to enroll their child in either the charter school or the local public school district and that the elected choice
will be documented in writing and filed for purposes of review or audit by the Texas Education Agency (TEA),
external auditor, or other entity.
Residential Facilities Monitoring (RFM) System: The charter holder assures that it understands that the TEA was
required under the Angel G. v. TEA consent decree to develop a separate system for monitoring school districts and
charter schools that serve students with disabilities who reside in RFs. The charter holder further assures that it
understands that it will be required to begin reporting data related to students with disabilities residing in RFs in TEA's
data collection system known as RF Tracker and that it may be subject to RFM onsite visits based upon a review of the
data it reports or on random selection. Finally, the charter holder assures that it understands that the above·referenced
consent decree and the RFM System require that certain sanctions be imposed against a school district or charter school
that has failed to timely correct noncompliance identified during an onsile visit.
Training: The charter holder assures that all personnel involved with serving students with disabilities residing in an
RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system.
Page 12
22
Section VI. (Continued) Assurances Regarding Charter Schools Serving Students at Residential Facilities The charter holder assures that this assurance document has been shared with, and understood by, the RF board and that the RF
board has acknowledged its understanding of all federal laws and regulations, Texas laws, State Board of Education (SBOE) and
commissioner rules related to charter schools serving students at residential facilities and further certifies that any future
amendments to the laws, regulations, and rules will be incorporated and implemented.
______________tlJIi_________________________ _
Date
Signature of Charter Holder Board Chair
(Must sign in blue ink)
Printed Name of Charter Holder Board Chair
If the charter school is not currently approved to serve students at residential facilities, please indicate N/A on the signature line.
Page J3
23
Section VII. BilinguallESL, Section 504, and Dyslexia Assurances
TEC, Chapter 29, Subchapter D, TEC §12.104(b)(2)(G), and 19 TAC §§89. /201-. 1265 require charter schools to identity limited
English proficient students based on state criteria and to provide an appropriate bilingual education or English as a second
language program conducted by teachers certified for such courses.
A. The charter holder certifies that it has policies and procedures in place that ensure that it complies with the legal and
regulatory requirements concerning identitying and providing appropriate educational services to limited English proficient
Ie Yes
students.
Check One:
Section 504 of the Rehabilitation Act of 1973,29 U.S.c. §794, prohibits discrimination on the basis of disability in any program
receiving federal financial assistance. A recipient that operates a public education program or activity shall provide a free,
appropriate public education to qualified individuals.
B. The charter holder certifies that it has policies and procedures in place that ensure that it complies with the legal and
regulatory requirements concerning identi tying and providing appropriate educational services to students protected by
Section 504.
Ie Yes
Check One:
TEC §38.003, TEC §12.104(b)(2)(K), 19 TAC §74.28 and Section 504 of the Rehabilitation Act of 1973,29 U.S.c. §794, require
charter schools to identity students with dyslexia or related disorders and to provide appropriate educational services.
C. The charter holder certifies that it has policies and procedures in place that ensure that it complies with the legal and
regulatory requirements concerning identitying and providing appropriate educational services to students with dyslexia or
related disorders. Ie Yes
Check One:
rNo
1 further certity that any future amendments to the laws, regulations, and rules will be incorporated and implemented.
J2,uI..l_Q./-t2alL____________
Date
jlL~t.aL1d!?L __
;r&L______________
Printed Name of Charter Holder Board Chair
Page 14
Section VIII. Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify that it has had an
opportunity to review the completed renewal application and has authorized, during an open meeting, submission
of the application to the commissioner of education for consideration of renewal of the charter,
CERTIFICATE OF ACKNOWLEDGEMENT
The undersigned members of the governing body of the charter holder hereby acknowledge that they have had an
opportunity to review the completed renewal application and have authorized its submission, during an open
meeting, to the commissioner of education for consideration of the renewal of the charter:
*Members are to sign the acknowledgement during an open meeting; therefore. the date next to each signature
should be the same,
Typed Name
(Type name next to corresponding
signature)
Signature
(Must sign in blue ink)
Date"
M"'-,1:-- /V-' 1f---,.,-----..,
jJ~
~~1s- lkittAJ£?&Vl:r
/ '-:-:::
V
'
r--I
1
G;rCtcie 01/ rvlCies
/I/&'l-tA-Fldra, &//
C o....t~~ O.s+n--Q"Y<.,
~ ~.J
{j).Jj;al;tu.. ;~.i£
~~G~~
Page 15
25
T
.­i <! '
..,"
~.
1701 North Congress Ave.• Austin, Texas 78701 -1494 • 512463-9734 • 512463-9838 FAX· www.tea.state.tx.us
Charter Renewal Contract
January 25. 2011
Ms. Karen R. Davis, Board Chair La Academia de Estrellas 423 Morning Dove Duncanville, Texas 75137 Re: Charter Renewal Contract for La Academia de Estrellas (CON 057839)
Dear Ms. Davis:
I am pleased to inform you that the charter renewal is approved for La Academia de Estrellas
with a contract ending date of July 31.2020 . After renewal, the charter contract shall consist of
the following:
• the representations and assurances made by Ihe charter holder in the original request
for application under the standard application system;
• the original contract for charter, as signed by the charter holder and the State Board of
Education;
• any condition. amendment. modification. revision, or other change to the charter
approved by the State Board of Education or the commissioner of education;
• the final renewal application, on file with the Division of Charter School Administration,
including any revisions required by the agency and any amendments to the charter
made through the renewal application; and
• all statements, assurances, commitments, and representations made by the charter
holder in its application for charter renewal and its attachments or related documents, to
the extent that these documents are consistent with those listed above.
Note Ihat this contract is contingent upon legislative authorization and that the contract and the
funding under state and federal law may be modified or even terminated by future legislative
acts. Furthermore, state and federal laws and rules may periodically be adopted. amended, or
repealed, and all such changes applicable to the charter holder or its charter school(s) may
mod~y this contract, as of the effective date provided in the law or rule. Nothing in the charter
contract shall be construed to entitle the charter holder to any privilege or benefit, including any
funding, but in accordance with state and federal laws in effect and as they may in the future be
amended. A contract term that conflicts with any state or federal law or rule is superseded by
the law or rule to the extent that the law or rule conflicts with the contract term .
Ms. Karen R. Davis, Board Chair La Academia de Estrelias Page 2 To acknowledge acceptance of this renewed contract, the chair of the charter holder board must sign below and return the entire original document to: Texas Education Agency Division of Charter School Administration William B, Travis Building, Room 5-107 1701 North Congress Avenue Austin, Texas 78701-1494 The charter holder should keep a copy of the document for its files. Please contact the Division
of Charter School Administration at (512) 463-9575 with any questions.
Sincerely,
~"'<A. "5.....
Robert Scott Commissioner of Education RS/rs
cc: Lorraine E. Mantei, Superintendent
I the undersigned hereby certify that the governing body of the charter holder has accepted and
agreed to the charter renewal agreement for La Academia de Estrellas as outlined in the
foregoing letter and has authorized me to sign below.
Agreed and Accepted:
Karen R. Davis
Board Chair, La Academia de Estrel/as
Date