Alexander Central High School

AP Academy
2018 19 Application

Dear Student and Family,

Thank you for your interest in the Alexander Central High School AP Academy at ACHS. We
are excited to offer this program for the 2018-19 school year. This 21st century program focuses
on preparation for future success not only in college, but also in the workforce. There are many
aspects of our program that are unique to the Academy and ACHS that we are excited to present.

Mission Statement:
The ACHS AP Academy makes AP courses available to a larger and more diverse group of
students by promoting rigorous coursework and preparation, providing individualized
support and academic counseling to AP students, and maximizing each students access to
and ability to achieve success in AP courses in a wide variety of disciplines.

Requirements:
Meet all graduation requirements as specified by the district and the state.
Meet the requirements set by the ACHS AP Academy:
o A minimum of 7 AP classes during students four years.
o 40 hours of community service during high school years (10 hours/year), as determined
by Academy standards and regulations.

Be sure to include the following information in your application packet:

Student information: Parts A, B, and C

Parent/Guardian Questionnaire
Student and Parent Statement of Intent and contract signatures

Return the entire packet to Alexander Central High School, by hand delivery or mail, no
later than Friday, March 2, 2018.

Alexander Central High School AP Academy

c/o Andrea Robinette
223 School Drive
Taylorsville, NC 28681

You may email any questions to:

Andrea Robinette, AP Academy Administrator Contact: arobinette@alexander.k12.nc.us
Tiffany Botkins, AP Academy Counselor Contact: tbotkins@alexander.k12.nc.us
Part A: Demographic Information

Student: ________________________________________ Gender: Male Female

Last First Middle

Date of Birth: __________________________ Age: _______

Home Address: _________________________________________________________________

Street City State Zip

Mailing Address (if different from above): ___________________________________________

Home Phone: ______________________________________ Race: ____________________

Current Middle School: ________________________________

Father/Guardian Name: _________________________________ Cell Phone: _______________

Work Phone: ___________________________ Place of Employment:_____________________

Email Address: _____________________________________________

Mother/Guardian Name: ________________________________ Cell Phone: _______________

Work Phone: ___________________________ Place of Employment:_____________________

Email Address: _____________________________________________

Student resides with: ___________________________ (Communications will go to this person.)

Parent Question: (Question is optional - to be completed by parent)

Why do you feel your child is ready for this advanced curriculum? (You may use back of page.)
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STATEMENT OF PARENT INTENT/RELEASE: As parent/guardian of the above named
student, I understand the rigor inherent in AP courses and grant permission for my childs middle
school records to be released to ACHS.

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Parent name (please print) Signature Date
Part B: Activities
Please list your school, community, or extracurricular activities and any offices held. Also, list
any community service or volunteer activities in which youve been involved. List only activities
and volunteerism from the last two years.
School, Community, Extracurricular Activities (include Offices held)
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Community Service/Volunteer Activities: (include hours served)

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Have you had any discipline referrals in the last year? ______ If yes, please explain:
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How many days were you absent this school year? ______ If over 5, please explain:
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Recommendations: List the teachers below from whom you have requested recommendations:

Science Teacher: _______________________________________________________________

English Teacher: _______________________________________________________________

Math Teacher: _________________________________________________________________

Social Studies Teacher: __________________________________________________________

Part C: Student Essay:

Please respond to the prompt in the space below, using specific details or examples to clarify
your comments. Respond in your own handwriting. Length should not exceed the pages
provided.
Explain why you are applying to the Alexander Central AP Academy. Be sure to include:
Skills you possess that will aid in your academic success (Be sure to tell how you
understand and will meet the academic challenges).
Any information about your own learning experiences (How do you learn best?
What are your favorite subjects- in or out of school?)
How do you think this program will help you achieve high school and post-
secondary goals?
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Statement of Intent: I understand that this is an advanced curriculum and that I will be expected to do an appropriate
amount of work to be successful in the program. Therefore, I accept my responsibility to fulfill the requirements of
the Alexander Central AP Academy.

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Printed Name Signature Date
 The Alexander Central AP Academy
Applicant: Please fill out the information in the box below and give to your CURRENT English teacher.
Student Name: _________________________________________________________________________________
Last First Middle

Student phone number: _____________________ Current school: _____________________________________

I waive my right to see this confidential recommendation: _____________________________________________

(signature)

To the teacher: The student named above is applying for admission to the Alexander Central AP Academy. Please use this form to
share his/her academic performance and promise as well as your perceptions of how this student will meet the requirements of this
rigorous program. Return the completed recommendation to the student in a sealed envelope, to ACHS via courier, or mail to ACHS
AP Academy, Andrea Robinette, 223 School Drive, Taylorsville, NC 28681.
Teacher name: __________________________ Email: __________________________________________
How long have you known the applicant? _________________
Please use the following scale in rating the traits listed:
5- Always exhibits this trait in an exceptional manner.
4- Always exhibits this trait.
3- Often exhibits this trait.
2- Seldom exhibits this trait.
1- Never exhibits this trait.

Learns quickly, with good retention. 5 4 3 2 1

Is a keen and alert observer. 5 4 3 2 1

Is sensitive to deadlines. 5 4 3 2 1

Is a self-starter. 5 4 3 2 1

Works well in groups. 5 4 3 2 1

Is highly motivated. 5 4 3 2 1

Is prepared for class. 5 4 3 2 1

Participates in class. 5 4 3 2 1

Is responsible, dependable, and honest. 5 4 3 2 1

Please circle one of the following as summary:

Heartily recommend Recommend Recommend with reservations Do not recommend
Comments: (You may attach a separate sheet of paper or continue on the back if necessary.)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
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Signature and Date: ___________________________________________________________________________________________
 The Alexander Central AP Academy
Applicant: Please fill out the information in the box below and give to your CURRENT Math teacher.
Student Name: _________________________________________________________________________________
Last First Middle

Student phone number: _____________________ Current school: _____________________________________

I waive my right to see this confidential recommendation: _____________________________________________

(signature)

To the teacher: The student named above is applying for admission to the Alexander Central AP Academy. Please use this form to
share his/her academic performance and promise as well as your perceptions of how this student will meet the requirements of this
rigorous program. Return the completed recommendation to the student in a sealed envelope, to ACHS via courier, or mail to ACHS
AP Academy, Andrea Robinette, 223 School Drive, Taylorsville, NC 28681.
Teacher name: __________________________ Email: __________________________________________
How long have you known the applicant? _________________
Please use the following scale in rating the traits listed:
5- Always exhibits this trait in an exceptional manner.
4- Always exhibits this trait.
3- Often exhibits this trait.
2- Seldom exhibits this trait.
1- Never exhibits this trait.

Learns quickly, with good retention. 5 4 3 2 1

Is a keen and alert observer. 5 4 3 2 1

Is sensitive to deadlines. 5 4 3 2 1

Is a self-starter. 5 4 3 2 1

Works well in groups. 5 4 3 2 1

Is highly motivated. 5 4 3 2 1

Is prepared for class. 5 4 3 2 1

Participates in class. 5 4 3 2 1

Is responsible, dependable, and honest. 5 4 3 2 1

Please circle one of the following as summary:

Heartily recommend Recommend Recommend with reservations Do not recommend
Comments: (You may attach a separate sheet of paper or continue on the back if necessary.)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Signature and Date: ___________________________________________________________________________________________
 The Alexander Central AP Academy
Applicant: Please fill out the information in the box below and give to your CURRENT Science teacher.
Student Name: _________________________________________________________________________________
Last First Middle

Student phone number: _____________________ Current school: _____________________________________

I waive my right to see this confidential recommendation: _____________________________________________

(signature)

To the teacher: The student named above is applying for admission to the Alexander Central AP Academy. Please use this form to
share his/her academic performance and promise as well as your perceptions of how this student will meet the requirements of this
rigorous program. Return the completed recommendation to the student in a sealed envelope, to ACHS via courier, or mail to ACHS
AP Academy, Andrea Robinette, 223 School Drive, Taylorsville, NC 28681.
Teacher name: __________________________ Email: __________________________________________
How long have you known the applicant? _________________
Please use the following scale in rating the traits listed:
5- Always exhibits this trait in an exceptional manner.
4- Always exhibits this trait.
3- Often exhibits this trait.
2- Seldom exhibits this trait.
1- Never exhibits this trait.

Learns quickly, with good retention. 5 4 3 2 1

Is a keen and alert observer. 5 4 3 2 1

Is sensitive to deadlines. 5 4 3 2 1

Is a self-starter. 5 4 3 2 1

Works well in groups. 5 4 3 2 1

Is highly motivated. 5 4 3 2 1

Is prepared for class. 5 4 3 2 1

Participates in class. 5 4 3 2 1

Is responsible, dependable, and honest. 5 4 3 2 1

Please circle one of the following as summary:

Heartily recommend Recommend Recommend with reservations Do not recommend
Comments: (You may attach a separate sheet of paper or continue on the back if necessary.)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Signature and Date: ___________________________________________________________________________________________
 The Alexander Central AP Academy
Applicant: Please fill out the information in the box below and give to your CURRENT Social Studies teacher.
Student Name: _________________________________________________________________________________
Last First Middle

Student phone number: _____________________ Current school: _____________________________________

I waive my right to see this confidential recommendation: _____________________________________________

(signature)

To the teacher: The student named above is applying for admission to the Alexander Central AP Academy. Please use this form to
share his/her academic performance and promise as well as your perceptions of how this student will meet the requirements of this
rigorous program. Return the completed recommendation to the student in a sealed envelope, to ACHS via courier, or mail to ACHS
AP Academy, Andrea Robinette. 223 School Drive, Taylorsville, NC 28681.
Teacher name: __________________________ Email: __________________________________________
How long have you known the applicant? _________________
Please use the following scale in rating the traits listed:
5- Always exhibits this trait in an exceptional manner.
4- Always exhibits this trait.
3- Often exhibits this trait.
2- Seldom exhibits this trait.
1- Never exhibits this trait.

Learns quickly, with good retention. 5 4 3 2 1

Is a keen and alert observer. 5 4 3 2 1

Is sensitive to deadlines. 5 4 3 2 1

Is a self-starter. 5 4 3 2 1

Works well in groups. 5 4 3 2 1

Is highly motivated. 5 4 3 2 1

Is prepared for class. 5 4 3 2 1

Participates in class. 5 4 3 2 1

Is responsible, dependable, and honest. 5 4 3 2 1

Please circle one of the following as summary:

Heartily recommend Recommend Recommend with reservations Do not recommend
Comments: (You may attach a separate sheet of paper or continue on the back if necessary.)
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Signature and Date: ___________________________________________________________________________________________
 The Alexander Central AP Academy
Applicant: Please fill out the information below and give to your guidance counselor.
Student Name: _________________________________________________________________________________
Last First Middle

Student phone number: _____________________ Current school: _____________________________________

I waive my right to see this confidential recommendation: _____________________________________________

(signature)
To the counselor: The student named above is applying for admission to the ACHS AP Academy. Please use this form to share
his/her academic performance and promise as well as your perceptions of how this student will meet the requirements of this rigorous
program. Return the completed recommendation to the student in a sealed envelope, to ACHS via courier, or mail to ACHS AP
Academy, Andrea Robinette, 223 School Drive, Taylorsville, NC 28681.

Academic Achievement:
Name the most recent achievement test: _______________________________
When was this test administered? ____________________________________
Indicate the type of score: composite: _________ or subtest (specify) _________
or EOC (specify): ______________.
Comments: (You may attach a separate sheet of paper or continue on the back if necessary.)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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Please circle one of the following as summary:
Heartily recommend Recommend Recommend with reservations Do not recommend
 The Alexander Central AP Academy
Student/Parent Contract:
The Alexander Central Advanced Placement Academy is designed as a rigorous program
to challenge and to prepare students for college success. The classes and extracurricular
expectations help students not only develop writing and thinking skills, but they also help in time
management and self-discipline.

Furthermore, as stated by the College Board, AP classes help students earn college credit and
advanced placement [and also] stand out in the admission process. Recognizing this rigor,
Alexander Central High School rewards students with an extra quality point beyond the half of
one allotted for honors level classes.

In order to receive the added benefits, students and parents must subscribe to the following
tenets:
Academic rigor and teacher expectations will be higher in AP classes than in Honors.
Since AP classes lead to possible college credits, the course work must parallel college
work.
Enrolling in an AP class requires increased student independence and a high degree of
responsibility.
The rigorous curriculum requires more effort and homework. (There can be hours of
homework per AP class.) The pace of the class is faster, covering more content and
covering it in greater depth. Students must complete all assignments at assigned times to
reap the educational benefits of the class. (Plagiarizing or submitting work not personally
completed is considered cheating.)
Meetings beyond the normal class meetings are often required of an AP student. These
meetings may be tutorial or collaborative in nature.
Service hours are required and must be completed at each grade level.
Field trip opportunities are available, but not required.
Students are required to take and pay for all AP exams for classes in which they are
enrolled, if not paid by the state.
A total of seven AP classes must be taken.

We, the undersigned student and parent/guardian(s), understand, and have carefully read and
discussed the requirements, the accelerated pace, and the rigorous expectations of enrolling in an
intensive/accelerated AP curriculum and agree to honor this contract.

Student printed name: _________________________________________

Student printed name: _________________________________________ Date: ____________

Parent/Guardian printed name:___________________________________

Parent/Guardian printed name:___________________________________ Date: ____________