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Middle School Online Application Form

Please complete this online form to submit your application form to Middle School online.

Date of birth

Name

(Last) (First) (Middle)

Address

(Street) (City) (Zip)

Home Phone

Cell Phone

Email

Parent/Guardian

(Last) (First) (Middle)

Address

(if different from student)

Home Phone

(If different from student)

Cell phone

Name of emergency contact

(other than a parent/Guardian)

Address

(Street) (City) (Zip)

Emergency contact home phone

Emergency contact cell phone

Gender

Male

Female

Transgender

Ethnicity

African American

Hispanic

American Indian

Asian

Bi-Racial

white

Other

What is your Grade Point Average

Is the student receiving Special Education Services?

Yes

No

If the answer is "yes", what is your disability and what is your IEP setting

Is the student currently receiving 504 services

Yes

No

Is the student being assessed/re-evaluated for services?

Yes

No

Has the student received Special Education services but services were terminated in the past calendar year

Yes

No

If the answer to the previous question is yes, what was your disability and IEP setting?

Are you currently enrolled in school?

Yes

No

If you are currently enrolled in a school, what is the name of the school and what school district is it in

If you are currently enrolled in a school, do you attend at least 75% of the time?

Yes

No

Does the student have an open truancy case?

Yes

No

If the answer to the previous question is yes, in what county do you have your truancy case?

If you are not enrolled in a school or are enrolled in a school and not attending, what is the reason why you are not attending?

What is the least favorite thing about school?

What is your favorite thing about school, and breifly explain why this is your favorite thing?

All middle school students will participate in service learning projects to meet authentic community needs twice a month on the 2nd and 4th Fridays of the month. Think about your community and tell us what problems you see in your community and what thin

The following are roadblocks that might have prevented you from being successful in previous school setting. Please mark all that apply:

Habitually truant

Being bullied

Physical health issues

Pregnant/parenting

Limited English Proficiency

Limited academic skills

Homelessness

frustrated, the work was too hard

Adjudicated delinquency

Gang involvement

Mental health issues

Physical and/or sexual abused

Substance abuse

Expelled

Didn't like teacher

Frequent arguments with teachers

Physical fights with students

Talked during class

Other: Please describe

Online video URL (address)

In the space below please write an essay to the Admissions Committee describing yourself and why you should be admitted to Vista Academy.

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*Welcome Reception for the Newly Accepted Students *Recepción de Bienvenida para los Nuevos Estudiantes * Hispanic Scholarship Fund

Applying to Vista Academy
- High School Application Applications being accepted now!
- Middle School Application Applications being accepted now!
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Vista Perspective

Mission
Vision
Core Values
Belief Statement
The SWAGGER Journey
Academic Programs and Culture
Vista Academy Programs:

Competency Based Diploma Program
GED
Certified Nursing Assistant (CNA) Program
Culinary Arts Program
Sports Medicine
Computer Aided Design (CAD) STEM
Gateway to Technology Program for Middle School (STEM)
Ms. Juett, Vista Academy Principal
Our Location

VISTA ACADEMY
4800 Telluride Street
Temporary Office:
Student Union, Bldg#1
Denver, Colorado 80249
Tel: 720-423-7601
Fax: 720-423-7699
Principal, Rhonda Juett
Rhonda_Juett@dpsk12.org

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