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ATTACHMENT A
OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITION
Current Information in Charter School Tracking System
Charter Holder Name TEXAS BOYS CHOIR
Charter School Name FORT WORTH ACADEMY OF FINE ARTS
Charter School CountyDistrict 220-809
Generation 06 bull
Maximum Approved Enrollment 1000 |
Grades Approved Kl2345678910ll12 I
Campuses
220809001 220809101 FORT WORTH ACADEMY OF FINE ARTS FORT WORTH ACADEMY OF FINE ARTS ELEMENTARY 3901 SHULENST 3901 SHULENST FORT WORTH TX 76109 FORT WORTH TX 76109
Grade Levels Currently Served Grade Levels Currently Served 789101112 3456
Geographical Boundary The original charter application and amendment history reflects that the following district(s) comprise the charter schools geographic boundary
ALEDO ISO CLEBURNE ISD GODLEY ISD LAKE WORTH ISD
ALVARADO ISO COPPELL ISD GRANBURY ISD MANSFIELD ISD
ARLINGTON ISO CROWLEY ISD GRAND PRAIRIE ISD NORTHWEST ISD
AZLE ISD DALLAS ISO GRAPEVINE-COLLEYVILLE ISD PEASTER ISD BIRDVILLC ISD DESOTO SD HURST-EULESS-BEDFORD ISD SPRINGTOWN ISD
BURLESON ISD DUNCANVILLE ISD JOSHUA ISD WEATHERFORD ISD
CARROLL ISD EAGLE MT-SAGINAW ISD KEENE ISD WHITE SETTLEMENT ISD CASTLEBERRY fSD EVERMAN ISD KELLER ISD CEDAR HILL ISD FORT WORTH ISD KENNEDALE ISD
Section I
Coversheet
ATTACHMENT A OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL
The enclosed document entitled OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL will serve as the coversheet when the application is completed and submitted and includes current information in the Charter School Tracking System Verify the accuracy of the information on the coversheet and if updates to the information are needed create a separate sheet detailing your corrections and label the sheet Update to Data Provided by TEA and include it in the renewal packet immediately following the preprinted coversheet
Page
Section II
Contact Information
The persons listed below will be contacted by agency staffif there are issues to be resolved in any of the renewal application sections Note that any contact information including email addresses provided with the renewal application will be public information
Superintendent Contact Information
Superintendents Name Clint Riley
Telephone Number 817-924-1482 ext 106
Fax Number 817-926-9932
E-mail Address cliatrileyfwafaorg
Charter Holder Board Chair Contact Information
Board Chairs Name Bill Lamkin
Telephone Number 817-924-1482
Fax Number 817-926-9932
E-mail Address presidenttexasboyschoirorg
Application Preparers Contact Information S Same as Superintendent D Same as Board Chair
Contact Name Clint Riley
Telephone Number 817-924-1482 ext 106
Fax Number 817-926-9932
E-mail Address clintrileyfwafaorg
Charter School Website
Web address wwwfwafaorg
PageS
Section HI
Website Postings
In accordance with the requirements of TEC sect121211 an open-enrollment charter school shall list the names of the members of the governing body on the home page of the schools internet website Provide the internet URL address where the names of the members of the governing body are listed
wwwfwafaorg
In accordance with the requirements of TEC sect12136 an open-enrollment charter school shall post the salary of the schools superintendent or CEO on the schools internet website Provide the internet URL address where the superintendents salary is posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
In accordance with Local Government Code sect140006 an open-enrollment charter school shall post continuously on the schools internet website the annual financials of the school Provide the internet URL address where the annual financial statements of the charter school are continuously posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
Page 9
Section IV
Organizational Charts
Submit as Attachment 1 the organizational chart for the charter school that specifies the administrative positions including the title and name of the individual currently in each position
Submit as Attachment 2 a chart that identifies all other entities under the direction of the charter holder This would include entities andor programs that the charter holder governsmanages in addition to the charter school
Page 10
ATTACHMENT 1
Coversheet
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ATTACHMENT 2
Coversheet
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
Section I
Coversheet
ATTACHMENT A OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL
The enclosed document entitled OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL will serve as the coversheet when the application is completed and submitted and includes current information in the Charter School Tracking System Verify the accuracy of the information on the coversheet and if updates to the information are needed create a separate sheet detailing your corrections and label the sheet Update to Data Provided by TEA and include it in the renewal packet immediately following the preprinted coversheet
Page
Section II
Contact Information
The persons listed below will be contacted by agency staffif there are issues to be resolved in any of the renewal application sections Note that any contact information including email addresses provided with the renewal application will be public information
Superintendent Contact Information
Superintendents Name Clint Riley
Telephone Number 817-924-1482 ext 106
Fax Number 817-926-9932
E-mail Address cliatrileyfwafaorg
Charter Holder Board Chair Contact Information
Board Chairs Name Bill Lamkin
Telephone Number 817-924-1482
Fax Number 817-926-9932
E-mail Address presidenttexasboyschoirorg
Application Preparers Contact Information S Same as Superintendent D Same as Board Chair
Contact Name Clint Riley
Telephone Number 817-924-1482 ext 106
Fax Number 817-926-9932
E-mail Address clintrileyfwafaorg
Charter School Website
Web address wwwfwafaorg
PageS
Section HI
Website Postings
In accordance with the requirements of TEC sect121211 an open-enrollment charter school shall list the names of the members of the governing body on the home page of the schools internet website Provide the internet URL address where the names of the members of the governing body are listed
wwwfwafaorg
In accordance with the requirements of TEC sect12136 an open-enrollment charter school shall post the salary of the schools superintendent or CEO on the schools internet website Provide the internet URL address where the superintendents salary is posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
In accordance with Local Government Code sect140006 an open-enrollment charter school shall post continuously on the schools internet website the annual financials of the school Provide the internet URL address where the annual financial statements of the charter school are continuously posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
Page 9
Section IV
Organizational Charts
Submit as Attachment 1 the organizational chart for the charter school that specifies the administrative positions including the title and name of the individual currently in each position
Submit as Attachment 2 a chart that identifies all other entities under the direction of the charter holder This would include entities andor programs that the charter holder governsmanages in addition to the charter school
Page 10
ATTACHMENT 1
Coversheet
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
Section II
Contact Information
The persons listed below will be contacted by agency staffif there are issues to be resolved in any of the renewal application sections Note that any contact information including email addresses provided with the renewal application will be public information
Superintendent Contact Information
Superintendents Name Clint Riley
Telephone Number 817-924-1482 ext 106
Fax Number 817-926-9932
E-mail Address cliatrileyfwafaorg
Charter Holder Board Chair Contact Information
Board Chairs Name Bill Lamkin
Telephone Number 817-924-1482
Fax Number 817-926-9932
E-mail Address presidenttexasboyschoirorg
Application Preparers Contact Information S Same as Superintendent D Same as Board Chair
Contact Name Clint Riley
Telephone Number 817-924-1482 ext 106
Fax Number 817-926-9932
E-mail Address clintrileyfwafaorg
Charter School Website
Web address wwwfwafaorg
PageS
Section HI
Website Postings
In accordance with the requirements of TEC sect121211 an open-enrollment charter school shall list the names of the members of the governing body on the home page of the schools internet website Provide the internet URL address where the names of the members of the governing body are listed
wwwfwafaorg
In accordance with the requirements of TEC sect12136 an open-enrollment charter school shall post the salary of the schools superintendent or CEO on the schools internet website Provide the internet URL address where the superintendents salary is posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
In accordance with Local Government Code sect140006 an open-enrollment charter school shall post continuously on the schools internet website the annual financials of the school Provide the internet URL address where the annual financial statements of the charter school are continuously posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
Page 9
Section IV
Organizational Charts
Submit as Attachment 1 the organizational chart for the charter school that specifies the administrative positions including the title and name of the individual currently in each position
Submit as Attachment 2 a chart that identifies all other entities under the direction of the charter holder This would include entities andor programs that the charter holder governsmanages in addition to the charter school
Page 10
ATTACHMENT 1
Coversheet
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
Section HI
Website Postings
In accordance with the requirements of TEC sect121211 an open-enrollment charter school shall list the names of the members of the governing body on the home page of the schools internet website Provide the internet URL address where the names of the members of the governing body are listed
wwwfwafaorg
In accordance with the requirements of TEC sect12136 an open-enrollment charter school shall post the salary of the schools superintendent or CEO on the schools internet website Provide the internet URL address where the superintendents salary is posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
In accordance with Local Government Code sect140006 an open-enrollment charter school shall post continuously on the schools internet website the annual financials of the school Provide the internet URL address where the annual financial statements of the charter school are continuously posted
httpwwwfwafaorgfwafaresourcesfwafa-governance-documents
Page 9
Section IV
Organizational Charts
Submit as Attachment 1 the organizational chart for the charter school that specifies the administrative positions including the title and name of the individual currently in each position
Submit as Attachment 2 a chart that identifies all other entities under the direction of the charter holder This would include entities andor programs that the charter holder governsmanages in addition to the charter school
Page 10
ATTACHMENT 1
Coversheet
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
Section IV
Organizational Charts
Submit as Attachment 1 the organizational chart for the charter school that specifies the administrative positions including the title and name of the individual currently in each position
Submit as Attachment 2 a chart that identifies all other entities under the direction of the charter holder This would include entities andor programs that the charter holder governsmanages in addition to the charter school
Page 10
ATTACHMENT 1
Coversheet
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
ATTACHMENT 1
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
ATTACHMENT 2
Coversheet
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
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Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
Section V
Admission Policy
Please be aware that any change to the terms of an open-enrollment charter that relates to the following subjects
bull grade levels bull maximum enrollment bull geographic boundaries bull approved campus(es) bull approved sites bull relocation of campus bull charter holder name bull charter school (district) name bull charter campus name bull charter holder governance bull articles of incorporation raquocorporate bylaws bull management company bull admission policy or bull the educational program of the school
requires the commissioner of educations approval of an amendment (See sect1001033(b) Types of amendments 19 TAC Chapter 100)
A Specify the period during which applications for admission are accepted TEC sect12117 requires that a charter school establish a reasonable application deadline for the submission of applications for admission
Beginning of Period (MonthDay) End of Period (MonthDay)
15 26
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
Not applicable applicants audition for admission
C If the school utilizes a lottery when oversubscribed are any categories of applicants exempted from the lottery
OYes
ONO copy Not applicable (because lotteries are not utilized)
If Yes was indicated in C above state the categories of applicants that are exempted
Page 11
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
__
Section V (Continued)
Admission Policy
D If the school utilizes a lottery when oversubscribed specify the approximate date on which a lottery will be conducted
Approximate Date of Lottery (MonthDay)
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 (ie 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 sect12117 requires a charter school that uses a first-come first-served admission process when oversubscribed to publish a notice in a newspaper of general circulation not later than the seventh day before the application deadline
Not Applicable All students are placed on a waiting list through an audition based application process
F If the school has a separate process for re-enrollment state the process and the timeline to be used
For students returning or re-enrolling for the next school year at the end of the open enrollment period all current students are sent an Intent to Return Form allowing them the opportunity to verify their intent to return or not return for the upcoming school year Students are given 30 calendar days for submission to return the form back to the school Reminder notices to return the forms are sent out to parents one week prior to the deadline
G State the procedures for processing applications received once the application deadline has passed
Once applications are received an audition is scheduled Auditions are scored based on a rubric found on the schools website Students are notified of acceptance or wait list placement Applications received after the open enrollment period are date stamped by the front office and placed on a secondary wait-list in the order they are received Families are contacted from the secondary wait-list when there is a grade-level opening and the primary wait-list (applications received during the open enrollment period) is exhausted late applications are accepted and maintained through the school year When an opening occurs with no eligible student on the primary wait-list families are contacted by phone and e-mail in the order the applications were received These students are invited to audition and then placed in order based on their scores
H Describe the information that an applicant must provide in order to be considered for admission Applicants may not be required to provide copies of transcripts or other academic records until after they are offered admission and are enrolling Furthermore a student may not be precluded from enrolling due to the charter schools failure to receive information required for enrollment from the sIndents parent or guardian or previous school See TEC sect25002
The application for admission requires the applicants full name age date of birth gender home public school districtISO current grade enrollment and the name of current school attending In addition the applicant selects audition area(s) Parent contact information is required with parent or guardian signature
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
Section V (Continued)
Admission Policy
I The charter holder certifies that the non-discrimination statement required by TEC sect12111 (a)(5) is printed in the schools admission policy TEC sect12111 (a)(5) requires that a charter schools admission policy include a statement that the school will not discriminate in admissions based on gender national origin ethnicity religion disability academic artistic or athletic ability or the district the child would othenvise attend
copyYes
ONo
J Does the admission policy either require or permit the school to exclude from admission all students with documented histories of a criminal offense a juvenile court adjudication or discipline problems under TEC Chapter 37 Subchapter A as authorized by TEC sect 12111 (a)(5)(B)l
O Yes (The school excludes such students or reserves the right to exclude such students from admissions)
copy No (The school does not deny admission to such students based on their documented histories of misconduct)
Submit
bull A current copy of the admission policy that incorporates the information provided in the above answers to questions
A through H and any other relevant information (Attachment 3)
bull A blank copy of the current admission application ie the information requested when the student first seeks
admission (Attachment 4) and
bull A blank copy of the current enrollment form(s) ie the information required once an applicant has been offered
admission and is registering for enrollment (Attachment 5)
Page 13
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
ATTACHMENT 3
Coversheet
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH ACADEMY ADMISSION PROCESS OF FINE ARTS 2015-2016
In order to apply for enrollment at the Fort Worth Academy of Fine Arts (FWAFA) students must submit an
application AND successfully complete the audition process Students whose parentguardian currently resides in any
of the following TEA-approved ISDs are eligible to apply
Aledo ISO
Alvarado ISO
Arlington ISO
Azte ISO
Birdville ISO
Burleson ISO
Carroll ISO
Castleberry ISO
Cedar Hill ISD
Cleburne ISD
Coppell ISD
Crowley ISD
Dallas ISD
DeSoto ISD
Duncanville ISD
Eagle Mt-Saginaw ISD
Everman ISD
Fort Worth ISD
Godley ISD
Granbury ISD
Grand Prairie ISD
Grapevine-Colleyville ISD
Hurst-Euless-Bedford ISD
Joshua ISD
Keene ISD
Keller ISD
Kennedale ISD
Lake Worth ISD
Mansfield ISD
Northwest ISD
Peaster ISD
Springtown ISD
Weatherford ISD
White Settlement ISD
The entire process for application includes the following steps
1 Submit an application in person by Friday February 6 2015
2 You will be assigned an audition date and time upon submission of the application Due to the large volume
of applicants we are unable to honor special requests for audition times which are assigned on a first come-
first serve basis
3 Arrive to your audition at the appointed time
4 Receive notification by mail letters will be mailed the week of March 9 2015 regarding the status of
applicants acceptance Some will be placed on a wait-list when there are more eligible applicants than
available openings Applicants will be offered enrollment based on their ranking and FWAFAs availability at
the appropriate grade level
Students will receive one of the following
bull Acceptance Letter Scores were acceptable for admission and an opening is available
bull Wait-List Letter Scores were acceptable for admission but there are no openings
bull Non-Acceptance Letter Scores did not meet the minimum standards for admission
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORTWORTH ADMISSION PROCESS ACADEMY 2015-2016 OF FINE ARTS
Prepare for your audition by following the audition guidelines as on our website (wwwfwafaorg)
Applicants must be prepared to audition as early as January 20 2015
Auditions will begin January 20 2015 and continue through March 1 2015 by appointment only
In the case of illness an audition may be rescheduled by contacting stephenmadridfwafaorg prior to the original
appointment A doctors note must be submitted at the time of the new appointment The school will assign a new
audition date and time which shall be within 10 days of the originally scheduled audition
Auditions are held on the FWAFA campus ParentsGuardians may bring their auditioning child on the scheduled
date however parents may not accompany the child into the audition room
Auditions are scored using the related rubric (download available from the website) An incomplete audition
presentation will result in a loss of points
Scores are tallied and ranked within each grade level regardless of audition area
The audition rubric will be used to rank each child with minimum score requirements within hisher grade level
Ranking determines childs position on the acceptance and wait lists
Resumes academic standings and letters of recommendation are not considered for admission only audition scores
are considered for admission
Acceptance for admission is contingent upon successful completion of the students current grade level
Students will not receive a copy of the completed rubric or score
Requirements and rubrics available online httpwwwfwafaorgfwafaabout-usadmission
For audition questions please call 8179241482 ext 109 or send email to stephenmadridfwafaorg
(Email preferred)
FWAFA Open House for elementary January 132015 at 630 pm to 800 pm
FWAFA Open House for middle and high school January 152015 at 630 pm to 800 pm
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH Elementary Audition Requirements ACADEMY 3rd - Gth graders audition in two (2) fine art areas listed below OF FINE ARTS Information at httpwwwfwafaorgfwafaabout-U5admission
VISUAL ARTS (3 Audition Evaluation Elementary students auditioning for the Department of Use of space Visual Arts should be prepared to
1 Participate in a hands-on activity designed to Awareness of light source
assess a students level of visualspatial Three dimensional forms awareness
2 Participate in a 20 minute group drawing Rectangular and square composition
session
Last modified 11262013
Audition Students will be expected to sing a memorized prepared song which demonstrates the singers best musical attributes
Please do not audition with popcontemporary (radio) music or gospelcontemporary Christian All audition selections must be age appropriate
As an option students may choose the following for their audition found on our website
Elementary-Choir-Option
Boys need to be prepared with sheet music
Girls can sing from sheet music a CD with no words or a cappella
J3^ arfe] Audition They will be auditioning in groups with other students their age They will learn and perform separate ballet and jazz technique combinations
Evaluation bull Pitch Intonation
bull Tonal Production
bull DictionArticulation
bull Musicality
bull General Presentation
Familiarity with solfege recommended
but not required
Evaluation Coordination
Body alignment
Dance technique
Performance skills
Attire Regular clothes or if they have a dance audition before or after they can stay in their dance clothes
No costumes or props are necessary
Last modified 12182014
Attire Girls Leotard tights ballet or jazz shoes Hair secured back
Boys Form fitting t-shirt dance pants and ballet or jazz shoes
Last modified 11262013 Elem Audition page 1
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
THEATER Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
3rd and 4th grades 3rd amp 4th graders may select a monologue or poem that is thoroughly prepared and memorized It should be a minimum of 30 seconds and no more than one (1) minute in length
Optional poems and monologues can be found on our website Students may select one of these downloadable options
Poem Options for 3r - 4th Grade Elementary Girls Monologue Elementary Boys Monologue
if you would like to select your own poem we recommend authors such as Jack Prelutsky Shel Silverstein or Dr Seuss an animated actable story is preferred
5th amp 6th grades 5th amp 6th graders will perform a monologue that is thoroughly prepared and memorized it should be a minimum of one (1) minute and no more than 1 minutes in length
Optional monologues can be found on our website Students may select one of these downloadable options
Elementary Girls Monologue Elementary Boys Monologue
If you would like to select your own monologue students should choose monologues from published plays found at your local library bookstores or publishing companies such as
Samuel French (wwvsamuejfrenchcom) Dramatists Play Service
(_www dra mati sts_ co m) Dramatics Publishing
(httpvwwdram aticoubNshinacomA PlayscriptS (wvjwplayscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age Students should avoid original material or monologues from movies found online
bull introduction
bull Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
If students have a dance audition before or after they can stay in their dance attire
No costumes or props are necessary
Last modified 12092014
Eiem Audition ptigc 2
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH ACADEMY Middle School Audition Requirements OF FINE ARTS 7th - 8th graders audition in two (2) fine art areas listed below
Audition Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students should be prepared to participate in an on-site still-life drawing session The test administrator will set a time limit for this portion of the audition (Usually 30 minutes)
CHOIR (7tn - 8in grade) Audition Students should be prepared to perform the following
A prepared song to be sung from memory which demonstrates the singers best musical attributes This selection should be from the Class II or ill University interschoiastic League Prescribed Music List or a comparable selection fhttpswwwutexaseduuilpmlbrowse)
The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
Short sight-reading examples may be included as part of the audition
Students should bring 2 copies of the song they are singing One copy will be used by the judge and the other will be used by the accompanist An accompanist will be provided CD accompaniment will not be permitted
Evaluation Composition
Value
Balance
Proportion
Space
Last modified 11262013
Evaluation
bull Pitch Intonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 1212013
MS Audition page I
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
DANCE (7^-8 grade) Audition Applicants will learn and perform combinations in the following genres
bull Ballet - barre work adagio petite allegro grande allegro and turns across the floor
bull Modern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bull Jazz -progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
Students will participate in an ensemble audition setting which will include theater-related activities and games
7th amp 8th graders will perform a monologue that is thoroughly prepared and memorized It should be a minimum of one (1) minute and no more than VA minutes in length
Students will be asked to cold read a script
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
Samuel French fwwwgSamuejjrench com) Dramatists Play Service (wwwdramatist5com) Dramatics Publishing
Playscripts (wwwpiayscriptscQm)
When choosing material for these auditions students should choose characters that are close to themselves in age Middle School aged students should avoid poetry original material or monologues from movies found online
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance Skills
Evaluation bull Introduction
Stage Presence
Believability
Expression
Vocal Variety
Diction
Preparation
Physical
Characterization
Age Appropriate
Material
Cold Reading Ability
Attire Girls solid-colored leotard tights ballet and jazz shoes Hair secured back
Boys form fitting t-shirt dance pants ballet and jazz shoes
For the modern dance portion of the audition all
applicants must be barefoot
Last modified 11262013
Attire Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
MS Audition page 2
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH ACADEMY High School Audition Requirements OF FINE ARTS 9th - 12th graders audition in one CU fine art area listed below
[yisuAir Audition Evaluation High Schools-10th grade Composition Students should be prepared to participate in an on-site drawing session
Value The test administrator wil set a time limit for this portion of the audition (about 20 minutes) Balance
Proportion Students should present a portfolio containing the following bull Five (5) drawingspaintings indicating the applicants ability to draw Space
based on observation (not from photographs but from actual subjects (ie still-life portrait landscape etc)
bull In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
High School 11lh - 12th grade only Students should be prepared to participate in an on-site drawing session The test administrator will set a time limit for this portion of the audition (about 20 minutes)
Students will also participate in a Spatial Awareness Skills Assessment where they will construct an image from pre-cut shapes and designs All materials for this part of the assessment will be provided
Portfolio Concentration All 11th and 12th grade applicants are required to present evidence of work in a specific area of concentration containing the following
bull If concentration is in 2-D art applicants are required to present five (5) drawingspaintingsphotographs in chosen area of concentration 2-D concentrations can include painting in any wet media printmaking drawing and mixed media collage as well as photography
bull If concentration is in 3-D art applicants are required to present three (3) actual works and three (3) color photographs of completed works Photographs need to indicate the size and materials used 3-D concentrations include sculpture ceramics metals etc
Last modified 1222013
VIS Audition page
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
[CHpiRX9m-12 grade) Audition Students should be prepared to perform the following
raquo Two prepared songs to be sung from memory which demonstrates the singers best musical attributes One selection may be in English while the other must be in Italian French or German This selection should be from the Class i ii or II University inter5chgiajtIc_Leag_ue Prescribed Music List or a comparable selection (httgsj www utexas ed uu i Jpm 1b rowse)
bull The student will be asked to sing vocalizes to determine vocal range ability to match pitch and tune intervals
bull Short sight-reading examples may be included as part of the audition
Students should bring two copies of the song(s) they are singing The judge will use one copy and the accompanist will use the other An accompanist will be provided CD accompaniment will not be permitted
DANCE (9in-12tn grade) Audition Applicants will learn and perform combinations in the following genres
bullBallet - barre work adagio petite allegro grande allegro and turns across the floor
bullModern dance - center floor and progressions including a variety of body isolations turns traveling steps jumps and leaps
bullJazz-progressions across the floor involving basic movements performed in classical jazz including turns jumps and leaps
High School Dance applicants must also come to the audition with a self-choreographed solo in the style of ballet jazz or modern dance which is 1 to 1 minutes in length
Music selection should be appropriate to the chosen style of dance
Evaluation bull Body alignment
bull Dance technique
bull Musicality
bull Performance skills
bull Talent and potential
as a performer
bull An openness to
assimilate corrections
bull A willingness to learn
in the various styles
bull Level and quality of
training
Evaluation
bull PitchIntonation
bull Tonal
Production
bull Diction
Articulation
bull Musicality
bull General
Presentation
Last modified 11262013
Attire Women solid colored leotard pink or black tights (that can be rolled up for modern dance) ballet shoes and jazz shoes Pointe shoes are not necessary unless you need them for your audition piece Hair secured back Men black tights or dance pants form fitting t-shirt ballet shoes and jazz shoes
Please DO NOT wear leg warmers sweaters or jewelry
For the modern dance portion of the audition the applicants must be barefoot
Last modified 11262013
HS Audition page 2
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
THEATER (9th - 12tfl grade) Audition Evaluation Attire Students will participate in an ensemble audition setting which will include theater-related activities and games
Students will perform two (2) thoroughly prepared memorized contrasting monologues no more than a total of two (2) minutes in length
Students will be asked to cold read a script
Students may choose bull A classical or contemporary monologue bull Classical Any Greek or Roman playwright Shakespeare Christopher Marlowe Ben Johnson Richard Brinsley Sheridan Moliere Carlo Goldoni Jean Racine etc
Ibsen Chekov Noel Coward Samuel Beckett Thornton Wilder Samuel Beckett or any modern day playwright
Students should choose monologues from published plays
Sources may be obtained from your local library the internet bookstores or play publishing companies such as
bull Samuel French fV^Wsamueifrenchcgm) Dramatists Play Service (wwwdramatJstscom) Dramatics Publishing (wwwdxarr^^^^ Playscripts fwwwpJavscriptscom)
When choosing material for these auditions students should choose characters that are close to themselves in age
bull Introduction
Stage Presence
bull Believability
bull Expression
bull Vocal Variety
bull Diction
bull Preparation
bull Physical
Characterization
bull Age Appropriate
Material
bull Cold Reading Ability
Nice casual comfortable clothing in which you can move
If students have a dance audition before or after they can stay in their dance clothes
Hair out of face and secured back Closed toed shoes no sandals flip flops or high heel shoes
No costumes or props are necessary
Last modified 11262013
HS Audition page 3
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH Choir Audition Elementary ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons YD ND If so how long ___ with
Have you ever taken voice lessons YD ND If so how long ____ with
Audition Selection 1
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality
General Presentation (20)
Total (100)
Additional Comments
Last modified 11212013
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH ACADEMY
Choir Audition MSHS
OF FINE ARTS Audition Date
Staff Initials
Name Current Grade
Previous choir experience YD ND If yes where
Have you ever used the solfege system of sightreading (do re mi etc) Y D N D
Have you ever taken piano lessons
Have you ever taken voice lessons
All-StateAll-Region
Audition Selection 1
Audition Selection 2
Range
Additional Comments
Sight-Reading
Y D N D If so how long _____ with
YD N D If so how long _____ with
Scoring (80 is passing)
Pitch Intonation (20)
Tonal Production (20)
Diction Articulation (20)
Musicality (20)
General Presentation (20)
Total (100)
Last modified 11212013
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH Elementary Dance ACADEMY OF FINE ARTS Number Audition Date ___
Overall Score Staff Initials
Name
Current Grade
Ballet 1
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Ballet
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazzl
Knowledge o f Combination 1 2 3 4 5
Technical Ability 1 2 3 4 5
Jazz 2
Knowledge o f Combination 1 2 3 4
Technical Ability 1 2 3 4 5
Overall Professionalism amp Potential
7 8 10
Total
Last modified 12212012
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTHACADEMY OF FINE ARTS Number
Middle School Dance
Overall Score ___ Staff Initials
Name Current Grade
Ballet- Barre (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Ballet- Barre (Placement amp Use of rotation)
1 2 3 4 5 6 7 8 9 1 0
Ballet-Center 1
1 2 3 4 5 6 7 8 9 1 0
Ballet - Center 2
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7 8 9 1 0
Modern shy Center (Technical Ability)
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 1
1 2 3 4 5 6 7 8 9 1 0
Jazz shy Across the Floor 2
1 2 3 4 5 6 7 8 9 1 0
Jazz - Across the Floor 3
1 2 3 4 5 6 7 8 9 1 0
Overall Ability amp Performance Skills
1 2 3 4 5 6 7 8 9 1 0 Last modified 12212012
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH ACADEMY OF FINE ARTS Number
Overall Score
Name
Current Grade
Ballet- Barre (Knowledge of Combination)
High School Dance
Audition Date ________
Staff Initials
Ballet-Barre (Placement amp Use of rotation)
Ballet-Center 1
Ballet-Center 2
1 6
7
7
8 10
10
Modern ~~ Center (Technical Ability)
1 2 3 4 5
Modern shy Center (Knowledge of Combination)
1 2 3 4 5 6 7
7 8
10
10
Jazz-Across the Floor 1
1 2 3
Jazz - Across the Floor 2
Jazz - Across the Floor
4
4
5
7
7
7 8
8
8
9 1 0
10
10
Last modified 11192013
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR
FORT WORTH ACADEMY OF FINE ARTS
Name
Current Grade
Number
High School Dance Solo
Audition Date _____
Staff Initials
Choreography amp Performance Quality
4 7 8 10
Technical Ability
7 8 10
Technique Class Total
Solo Total
Final Total
Last modified II192013
FORT WORTH Ensemble ACADEMY OF FINE ARTS
Audition Date
Staff Initials
Student
1
2
3
4
5
6
7
8
9
10
11
12 bullt n13
14
15
16
17
18
19
20
21
22
23
24
Risk-Taking Imagination Listening Takes Ensemble 3 Completely without
reservation 2 Strives to
incorporate risks 1 Seldom takes risks 0 Unwilling to participate
3 Visualizes enacts leads in imaginative play 2 Limited imagination
cliche 1 Tries but has to be
prompted 0 Unimaginative
3 Intently listens and responds
2 Often listens and responds
1 Seldom listens seldom responds
0 Does not listen
Direction 3 Responds immediately
to adjustment 2 Often responds to
adjustment 1 Seldom responds to
adjustment
3 Completely engaged takes the lead
2 Strives to be a part of the group follower
1 Seldom interacts has to be encouraged
0 Alienated separated
Total Points
0 Does not take direction
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
r3 r2 ^1 f 0 3 r A2 1
t 0 3 n laquot
2 1 f
0 3 n it2 1
f 0 3 n A
2 1 r
0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0 3 2 1 0
Last modifiedII262013
FORT WORTH Visual Arts Elementary ACADEMY OF FINE ARTS A ^
Audition Date
Staff Initials
Name Current Grade
Still-life Drawing Session (1-50)
Students will be asked to draw from a still-life set up containing a variety of simple three dimensional shapes Use of space awareness of light source and attempts to convey three dimensional forms will be assessed
Spatial Awareness Skill Assessment (1-50)
Students will be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular and a square composition
Additional Comments
Total
Last modified 1212013
FORT WORTH Visual Arts MSHS ACADEMY OF FINE ARTS A ^
Audition Date
Staif Initials
Name Current Grade
Still-life Gesture Drawing Session (1-40)
Students will be asked to draw from an actual still-life setup Student drawings should demonstrate an understanding of
1 composition 2 value 3 balance 4 proportion 5 space
Spatial Awareness Skill Assessment (1-20)
Students wil l be asked to compose a visual composition by using a series of two dimensional cut paper shapes Each student will be asked to compose both a rectangular composition that will assess their abstract and conceptual spatial skills
Portfolio Assessment (1-40)
Students should present a portfolio containing the following
bull Five (5) drawingspaintings indicating the applicants ability to draw based on observation (not from photographs but from actual subjects ie still-life portrait landscape etc)
In addition applicants may also include photographs of original three dimensional works Photographs need to be in color and indicate the size and materials used
Additional Comments
Total
Last modified 1222013
ATTACHMENT 4
Coversheet
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART0
2015-2016
Date
t Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin icity religion disability academic artistic or athletic ability or the district the child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age Birftj date Gender
Home Public School DistricttSD Grade Currently Enrolled bull
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areasbemy
VHigh School Audition Area (circle one) Chpir Dance Theater Visual Arts
Middle School Audition Area (circle two) ChoirV Dance Theater Visual Arts
Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (print legibly)
Name of ParentGuardian(s) Mailing Addre
Phone Preferred number for contact
Return completed in person Jan 5th- Feb 6th 2015 Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as IV 3 days
Signature (ParentGuardian)
FORT WORTH ACADEMY STUDENT AUDITION APPLICATION OF FINE ART 2015-2016
APPROVED DURING CONTINGENCY PROCESS Date
Fort Worth Academy of Fine Arts will not discriminate in admission on the basis of sex national origin ethnicity religion disability academic artistic or athletic ability orthe district_the_child would otherwise attend
Applicant Information (To be completed by Parent or Guardian)
Applicants Full Name
Age_ Birth date Gender
Home Public School DistrictISO Grade Currently Enrolled
School Currently Attending
High School auditions in one area Middle School amp Elementary audition in two areas Please select audition areas below
bull High School Audition Area (circle one) Choir Dance Theater Visual Arts
bull Middle School Audition Area (circle two) Choir Dance Theater Visual Arts
bull Elementary Audition Area (circle two) Choir Dance Theater Visual Arts
If accepted fine arts coursework will be determined by audition area(s)
Contact Information (Print legibly)
Name of ParentGuardian(s) Mailing Address
Phone Preferred number for contact
Application must be received by Feb 6th 2015 bull Monday - Friday 800 am to 400 pm Auditions will be scheduled upon return of application and may be as soon as 1 - 3 days
Signature (ParentGuardian)
ATTACHMENT 5
Coversheet
FORT WORTH ACADEMY OF FINE ARTS
Thank you for choosing the Fort Worth Academy of Fine Arts We look forward to serving your child Please return the following before the designated dates below
Name
Return by May 1 2015
Enrollment Information (Current Year) Ethnicity and Race Reporting Form Home Language Survey Media Release Form Medication Administration Form Transportation Contract Technology and Internet Usage Form Social Security Card (copy) Birth Certificate (copy)
The return of materials completed forms and information above constitutes acceptance of the FWAFA enrollment opening
bull If the materials above are not received on or before May 1 2015 the
opening for enrollment will be released considered declined
Return on or before June 20th 2015 n Final 2014 Transcript (High School students only)
Return first day of school to home room teacher D Medical CertificateAuthorization Form (notarized)
Summer Reading
Every student who enters FWAFA is expected to complete summer reading The requirements including the number of books and required books as well as turnitincom instructions can be found on the Resources page at wwwfwafaorg website in late May and throughout the summer
Signature Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
STUDENT ENROLLMENT INFORMATION FOR OFFICE USE
Todays Date For Grade
School Year 2015-2016
Fort Worth Academy of Fine Arts will nol discriminate in admission on (he basis of sex national origin ^ ethnicity religion disabilityacademic artistic or athletic ability or the district the child would otherwise attend
Student Information (To be completed by Parent or Guardian)
Information you provide will be kept confidential Providing incomplete or false information may result in termination of enrollment
Students Legal Name Age Birthdate
Preferred First Name Social Security Number
Address City State Zip
Phone Student Email Sex DMale D Female
Neighborhood Public Schoo the child would attend
Home School District
Family Information ParentGuardian ParentGuardian
Name Name
Address Address
Home Phone Home Phone
Cell Phone Cell Phone
Email Email
Employer Employer
Work Phone Fax Work Phone Fax
Check if appropriate D Father Deceased D Mother Deceased D Parents Divorced D Parents Separated
D Both Parents D Mother D Father D Female Guardian D Male Guardian Student Lives with
D Stepmother D Stepfather
Revised 12172014
Please list other children in your family
Name
Name
Name
Name
Age School
Age School
Age School
Age School
Grade
Grade
Grade
Grade
Schools Attended
Current School
Grades Attended
Address
D
PrincipalDirector
ates Attended
City
Phone
State Zip
Previous Schools (List most recent first)
School City
School City
State Dates Attended
State Dates Attended
Why do you want your sondaughter to attend Fort Worth Academy of Fine Arts
Is your child receiving or has your child received Special Education services If yes explain
Has your sondaughter ever been identified Gifted and Talented If so which school district
Signature of Parent or Guardian Date
Signature of Student Date
Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS
Ethnicity and Race Reporting Form
In October 200T the United States Department of Education (USDE) issued their final guidance to educational institutions on the adoption of new federal standards for collecting and reporting ethnicity and race data for students Due to these changes we are asking all parents and guardians to report their childs ethnicity and race under the new standards Please fill out this form in order that we can record your childs information correctly
Students Name
1 The USDE requires that ethnicity and race be collected separately using a specific two-part question presented in a specific order Both parts of the question must be answered
Parti Ethnicity Is your child HispanicLatino Choose only one
HispanicLatino
Not HispanicLatino
Part 2 Race What is your childs race Choose one or more regardless of ethnicity
a American Indian or Alaska Native
b Asian
c Black or African American
d Native HawaiianOther Pacific Islander
e White
2 Respondents may select only one category for ethnicity but may select multiple designations for race
3 The categories for ethnicity are HispanicLatino and Not HispanicLatino Regardless of the category selected for ethnicity respondents must still select one or more categories for race
4 One of the major changes is the recognition that members of Hispanic populations can be of different races The federal government would like to afford HispanicLatino populations the opportunity to better describe themselves according to their culture and heritage
Revised 03202013
5 An additional category for race was created by separating Asian or Pacific Islander into two separate categories The categories for race include American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander and White Note that HispanicLatino is not a racial category
6 The categories to be used when reporting aggregate data to the USDE differ from the categories to be used for data collection Each student or staff member is associated with only one of the seven aggregate reporting categories listed below Use of these seven categories for aggregate reporting eliminates the possibility of counting an individual twice
bull HispanicLatino bull American Indian or Alaska Native Asian bull Black or African American Native Hawaiian or Other Pacific Islander
White Two or More Races
Respondents who select HispanicLatino for ethnicity will be counted in this category for aggregate reporting to the USDE regardless of the responses provided to the question on race
Respondents who select Not HispanicLatino for ethnicity and select more than one category for race will be counted in the category Two or More Races for aggregate reporting to the USDE
Respondents who select Not HispanicLatino for ethnicity and select only one category for race will be counted in the single racial category for aggregate reporting to the USDE
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
HOME LANGUAGE SURVEY
Student Name Date
Grade
1 What language is spoken in your home most of the time
English Spanish Other (Specify)
2 What language does your child speak most of the time
English Spanish Other (Specify)
Signature of parentguardian
Nombre Del Alumino Fecha
Grado
1 Cual idioma se habla en su hogar casi siempre
ingles Espanol Otro (Favor de especificar) _
2 Cual idioma habla se hijo casi siempre
Ingles Espanol Otro (Favor de especificar)
Firma de padre(s) o guardian
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
MEDIA RELEASE
hereby grant the Fort Worth Academy of Fine Arts and all related entities fui
and absolute permission and all rights to copyright publish display and use for
any legal purpose any or all photographs video tapes digital recordings and
electronic images together with descriptive text or statements in which my child
may appear Fort Worth Academy of Fine Arts has the right to use these images
at any time in the future for the benefit of the school as they see fit without
compensation to the student or parents This includes but is not limited to print
and digital media audio and video recordings and broadcasts
Printed Student Name Printed Parent or Guardian Name
Signature of Parent or Guardian Date
Revised 04-42014
FORT WORTH ACADEMY OF FINE ARTS
PARENTPHYSICIAN REQUEST FOR ADMINISTRATION OF MEDICATION BY SCHOOL PERSONNAL
Requests for the administration of medications by school personnel may be made as follows
1 A separate request form is to be completed for each medication 2 Only those medications that cannot be given outside school hours will be
administered (Prescriptions can be written so that doses are not necessary during school hours)
3 A written request from a students physician will be required when non-prescription medication must be given longer than 10 consecutive school days
4 Medication must be in the original properly labeled container accompanied by this completed form (Texas Education Code 21914) Please request the pharmacist to dispense two labeled bottles of medication one for home and one for school
5 It is the students responsibility to come to the clinic or office to take hisher medication
6 Please write yes or no if you give your permission for your child to take home hisher medication at the completion of this request Unused medication will be discarded after two weeks
I hereby represent and attest that I am the legal guardian of the below-named student 3 hereby request that the medication specified below be administered to the below-named student beginning on the following date and ending on the following date
As long as a physician authorizes a refill of any prescription set forth above this authorization shall apply to any such refills On behalf of the above-named student myself and our personal representatives family members heirs assigns and successors i also agree and do hereby waive and release all claims for loss damage or injury against The Texas Boys Choir tncFort Worth Academy of Fine Arts and any teachers employee volunteer agent or other person arising directly or indirectly out of any act or omission relating to the receipt administration or execution of this request
Date of Request Students Name __ Grade Level
Condition for which medication is required
Medication Date(s) to be administered Dosage
Precautions side effects of medications for your student
Physicians Name Phone Number
I the undersigned the parentguardian of request that the above medication be administered to my child
Signature (ParentGuardian) (Home Phone) (Work Phone)
Signature (Physician See 3 above) (Date) (Office Phone)
Revised 03202013
ParentGuardian
Medication
Dosage
Prescription Stop Date
Disposition
Prescription Depleted
Medication Discontinued
Medication Returned to ParentGuardian
Medication Destroyed
September M T W TH F
MDecember
T W TH F MJanuary
T W TH F M T W TH F
M TApril
W TH F M TMay W TH F M i T
June W TH F
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION BEHAVIORAL EXPECTATIONS
As a student of Fort Worth Academy of Fine Arts I will follow the rules stated below concerning transportation I understand that these rules are for my safety and for the safety of others After reading the rules thoroughly I will sign and return the TRANSPORTATION CONTRACT signifying my understanding of the expectations listed below
bull will sit in my assigned seat bull will wear my seat belt in the proper manner at all times bull will honor code one while vehicle is maneuvering such as parking
backing or in inclement weather bull will talk only to those seated next to me in a soft voice when talking
is allowed laquo w7 respecf the vehicle in which I am riding as we as the other riders
and their property bull I understand that I may study read sleep listen to music with
headphones or play electronic games that can be muted or used with headphones while in the vehicle I will keep the headphone volume at a level that does not disturb others
bull I will control my behavior at all times to ensure the safety of myself the driver and the other passengers
bull I understand that my inability to follow the rules as stated in this document or by verbal instruction from the driver will result in disciplinary action
Consequences
bull First offense verbal warning will be given bull Second offense detention will be assigned bull If behavior does not improve immediately a conference with the student
parent driver or school representative will be called bull Riding privileges may be temporarily suspended or permanently
revoked if behavior continues to be a problem
Keep this page for your information Return the contract to school
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
TRANSPORTATION CONTRACT
We understand that transportation provided by Fort Worth Academy of Fine Arts is not required by law and that it is provided as a convenience to the parents Riding privileges can and will be suspended or revoked if it is deemed necessary by FWAFA and its affiliates
We have read and understand the information contained in the Transportation Behavioral Expectations sheet We have discussed these expectations and possible consequences for failure to abide by them
Date
Student Name
Student Signature
Parent Signature_
Parent Signature
Revised 03202013
FORT WORTH ACADEMY OF FINE ARTS
Technology and Internet User Agreement Form
We are pleased to offer students of the Fort Worth Academy of Fine Arts access to our electronic resources Our
goal in providing this service is to promote educational excellence in our system by facilitating resource sharing
innovation and communication Electronic resources provide students with access to vast amounts of information
and numerous opportunities for communication
Our intent is to make Internet access available to further educational goals and objectives However
parentsguardians should be warned that if students disregard the guidelines of the school andor system they
may find ways to access other materials via the Internet which may contain items that are illegal defamatory
inaccurate or potentially offensive to some people We believe that the benefits to students from access to the
Internet in the form of information resources and opportunities for collaboration exceed any disadvantages
Ultimately parents and guardians of minors are responsible for setting and conveying the standards that their
children should follow when using media and information sources To that end the Fort Worth Academy of Fine
Arts supports and respects each familys right to decide whether or not to approve independent Internet access
and communication To gain access to the Internet all students under the age of 18 must obtain
parentalguardian permission and must sign and return the attached form to your English teacher or to Mrs
Maddox Students 18 and over may sign their own forms
Student Responsibilities Electronic resources are provided for students to enhance the learning experience Access to services is given to
students who agree to act in a responsible manner Student use must be consistent with the educational
objectives of Fort Worth Academy of Fine Arts
Students are responsible for good behavior on school computer network just as they are in a classroom or a
school hallway Communications on the network are often public in nature General school rules for behavior and
communications apply
Internet access is provided primarily for educational purposes under the direction of FWAFA staff Nonshy
educational use may be limited at any time by supervising teachers
Network storage areas will be treated like school lockers Network andor school administrators and teachers may
review files bookmarks and communications under the same standards set for school lockers to insure the
integrity of the electronic media Privacy is not guaranteed for files stored on school district servers nor will files
be maintained indefinitely Students should also be advised that they should have no expectation of privacy for
any information created or communicated using Fort Worth Academy of Fine Arts electronic resources
School and Parent Responsibility Within reason freedom of speech and access to information will be honored During school teachers will guide
students toward appropriate materials Outside of school and with independent access parentsguardians bear
the same responsibility for such guidance as they exercise with information sources such as television telephones
movies and other potentially offensive media
Page 1 Revised 12172014
FWAFA will insure that procedures for access and standards of conduct regarding Internet use are communicated to students It is presumed that students given access will comply with FWAFA standards and will honor the agreements they have signed The school cannot be responsible for ideas and concepts that a student may gain by his or her inappropriate use of the Internet
FWAFA does not warrant that the functions of the system will meet any specific requirements you may have or that It will be error-free or un-interrupted nor shall it be liable for any direct or indirect incidental or consequential damages (including lost data information or profits) sustained or incurred in connection with the use operation or inability to use the system
Security Security on any computer system is a high priority especially when the system involves many users If you can identify a security problem on the network quietly notify your teacher the system administrator or the principal You are not permitted to use another individuals account and you should never allow anyone else to access your account If at any time you feel that your password may have been compromised ask your teacher how you can change your password You are responsible for all activity that occurs with your account Attempts to login to the network as a system administrator or gain unauthorized access will result In the cancellation of your computer privileges
Electronic Access and Internet Rules The following uses of the Fort Worth Academy of Fine Arts electronic resources are not permitted and may result in disciplinary action
bull open drinks andor food in any computer area bull running outside software bull downloading storing installing or modifying software on any computer bull moving or disconnection any computer or peripheral device or piecepart of any equipment bull violating copyright laws bull printing documents without absolute necessity bull using electronic resources for non-instructional purposes bull using obscene language bull sending or displaying offensive messages or pictures bull harassing insulting or attacking others bull intentionally spreading viruses or malicious software bull deletion examination copying or modification of files andor data belonging to other users without their
prior consent bull publishing personal information (name address photographs) without teacherparent approval bull accessing and using an email account at school other without expressed permission bull using personal electronic devices at school without appropriate permission bull attempting to bypass network security to gain unauthorized access to information bull intentionally wasting limited resources or bull any unauthorized deliberate action which damages or disrupts a computing system (including the willful
introduction of computer viruses or other disruptivedestructive programs) alters its normal performance or causes it to malfunction
Sanctions The use of Fort Worth Academy of Fine Arts electronic resources is a privilege not a right and inappropriate use will result In cancellation of privileges Access entails responsibility FWAFA administration and faculty will deem what is inappropriate use and their decision is final Additional disciplinary action may be determined at the local school level in keeping with existing procedures and practices regarding inappropriate language or behavior When applicable law enforcement agencies or legal action may be involved
Page 2 Revised 12172014
STUDENT COMPUTERINTERNET USAGE AGREEMENT
I have read the Fort Worth Academy of Fine Arts Technology and Internet User Agreement understand It and agree to adhere to the principles and procedures listed within I understand that until this agreement is signed and returned cannot access the FWAFA computer network I also understand that additional rules and regulations may be added from time to time and that they become a part of this agreement Should I break this agreement I understand that I may lose all computerInternet privileges
Date Student Name Student Signature grade
PARENT COMPUTERINTERNET USAGE AGREEMENT
I understand that some objectionable materials may be accessed even with content filtering in place I understand that individuals and families may be held liable for violations will accept responsibility for guidance of Internet use by setting and conveying standards for my sondaughter to follow when exploring on-line information and media on an independent basis The Fort Worth Academy of Fine Arts cannot be responsible for ideas and concepts that my child may gain by his or her inappropriate use of the Internet
I also understand and accept the conditions stated and agree to release indemnify and hold harmless the Fort Worth Academy of Fine Arts the Fort Worth Academy of Fine Arts Board of Education andor their employees or agents from any and all claims and liability associated with or arising from the above students independent use andor access to the Internet
ParentGuardian Name ParentGuardian Signature
Page 3 Revised 12172014
FORT WORTH ACADEMY OF FINE ARTS MEDICAL CERTIFICATE (REQUIRED ANNUALLY) Due first day of school to
homeroom teacher This Section to be completed by ParentGuardian
Student Name Date of Birth Grade in Fal
AddressStreet
Last First Middle
City Zip
Month Day Year Home Telephone
incPleasPleasee include area code with all phone numbers
ParentGuardian
ParentGuardian
Work Phone (
Work Phone (
)
)
Ceil Phone (
Ceil Phone
)
1 Immunizations A Copy of Immunization Record is required each year Must indicate the Month Dayamp Yearof Series and Boosters as required by Texas Department of Health Ai immunizations must be current or attendance will be denied
2 Health History Todays Date Food Allergies Drug Allergies Environmental Allergies Asthma Heart Conditions Seizure Disorder Orthopedic Conditions Diabetes EmotionalPsychologicaiBehavioral Concerns Attention Deficit Bed Wetting Other Previous Injuries Illnesses Surgeries List all medications taken for the above conditions
This is to verify that had varicella disease (chickenpox) on or about And does not need the varicella vaccine monthdayyear This student may be administered the following medications (or their generic equivalent) during the school day
Advil Tylenol Neosoorin Benadrvl Cream Parent Siqnature
This section to be completed bvPhysician
3 Physical Examination Date (Must be within 3 months prior to start of new school year)
Height Weiaht Blood Pressure Vision Right Left
Negative Positive Negative Positive Skin Abdomen Head Genitalia Eves Ears Nose Extremities Mouth Throat Joint Function Neck Spine-Scoliosis Lungs and Chest Kvohosis Heart Lordosis Hearinq Vision
Date of first menstrua period Date of last menstrual period
Explain any abnormal findings I certify that on this date I have examined the above student as indicated by items checked and I recommend himas being physically able to participate in those supervised activities checked below
Trips Campouts All Sports Swimminq Exceptions (List)
( I Printed Name of Physician Signature of Examining Physician Area Code Phone
Revised 03202013
TRAVEL MEDICAL RELEASE PARENTAL AUTHORIZATION FORM Student Name Grade A Authorization to Consent to Medical Treatment In the event my child becomes ill or injured at school related events and I cannot be reached Texas Boys Choir Inc FWAFA is authorized to take one or more of the following actions a) release my child to either of the people listed below b) take my child to the physician chosen by choir school staff or c) take my child to a hospital and give consent for emergency care Local emergency telephone numbers if parents cannot be reached at above numbers Name Telephone _) Relationship Name Telephone ( ) Relationship Doctors Name Office Phone ( ) Preferred Hospital Telephone ( ) Student is covered by
Insurance Company Certificate Number Name of insured Insureds Employer
Texas Boys Choir Inc FWAFA is not financially responsible for emergency care or transportation B Release and Authorization to Participate in Physical Education and Approved Travel I give my consent for my child to participate in Texas Boys Choir Inc FWAFA approved sports as listed on the Medical Certificate extra-curricular activities and approved travel with transportation being provided by the staff paid carriers other representative of the school or any parent I understand that by participating in physical education and athletics at Texas Boys Choir Inc FWAFA my child will be exposed to the risk of serious injury including but not limited to injuries such as sprains and fractures and injuries that could result in brain damage paralysis or even death I understand that contact sports have a higher risk factor than other sports I understand that Texas Boys Choir Inc FWAFA does not assume any responsibility in case an accident occurs In consideration for my child being permitted to take part in such activities and to make such trips I hereby waive all claims and I release indemnify defend and hold harmless Texas Boys Choir Inc FWAFA its Trustees Directors staff faculty its agents employees and invitees together with all persons including parents of students of Texas Boys Choir Inc FWAFA assisting with any phase of such activities and trips (excluding paid certified carriers) from any and all liability claims suits demands or causes of action including all expenses of litigation andor settlement which may arise in connection with such activities and trips including any accident or injury suffered by my child while involved in such activities and trips C This section applies to off campus extended overnight travel ONLY Authorization of Administration of Medication in the event of extended sponsored activities I give my consent for rny child to be administered (per packaging directions) the following non-prescription medications(s) or its generic equivalent by the school staff athletic director or Directors designee YES NO
Tylenol SOQmg tabs 1 or 2 tabs PO Q4h PRN headache or fever X 1 year Advil 200 mg tabs PO Q4h PRN strain sprain muscle aches or pains menstrual cramps or dental pain X 1 year Hydrogen Peroxide followed by triple antibiotic ointment and a band-aid daily until healed PRN minor cuts and abrasions X 1 year Benadry 25 mg cap 1 PO Q4~6h PRN allergic reaction X 1 year Maalox 2 teaspoonfuls QID PRN upset stomach indigestion or nausea X 1 year Robitussin DM cough syrup 2 teaspoonfuls Q4h PRN cough X 1 year Sudafed 30 mg tabs 2 tabs PO QID PRN nasal congestion X 1 year Calamine lotion applied to affected areas PRN heat rash or insect bites X 1 year Sunscreen SPF 25-30 PRN applied to exposed skin for prolonged exposure to sun X 1 year Ricola lozenges PRN sore throat X 1 year Aloe Vera Gel PRN sunburn or other minor skin irritations X 1 year
Other medications or prescription medication which may be required by the student during school related or extended travel must be supplied by the parents and turned it in the original container properly labeled with the name of the student and identification of the medication the dosage and the time to be administered by the school staff or the Directors designee
(Separate form required -please see Request for Administration of Medication) NOTARIZATION REQUIRED
Subscribed and sworn before me this the day of Signature of Parent
Signature of Notary Date Commission Expires
Revised 03202013
FORT WORTH Student Information Update Form
Please complete this form ONLY if you need to change information
Student Name Student Grade Level
Student Mailing Address
Mailing Address City ST Zip
ParentGuardian Contact Information
1 ParentGuardian Name Phone E-mail
2 ParentGuardian Name Phone E-mail
Student Contact Information
Name Phone E-mail
Additional Contact Information
Relationship to Student Name Phone E-mail
If change of address please complete the following
Campus ID of Residence (This is the school you would attend based on your residence)
School District
Last updated 8132014
Section VI
Special Education Assurances
The charter holder certifies 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 of education rules related to students with disabilities and further certifies any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Chai^^lder Board Chair Date (Must sigti in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 14
Section VII
Serving Students at Residential Facilities Assurances
If the charter school is not currently approved to serve students at residential facilities do not provide a signature and indicate NA on the signature line
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 by signing the assurance that
Compliance with 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 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 campuss 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 home district the child would otherwise attend
School Choice The charter holder assures that parentslegal 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) an external auditor or another entity
Residential Facilities Monitoring (RFM) System The charter holder assures that it understands that pursuant to 19 (TAG) sect971072 there is a specific system for monitoring school districts and charter schools serving students with disabilities who reside in RFs The charter holder further assures that it understands it will be required to report data related to students with disabilities residing in RFs in TEAs data collection system known as RF Tracker and it may be subject to RFM intervention activities and on-site visits based upon a review of the data reported on a random selection or other means of selection
Training The charter holder assures that all personnel involved with serving students with disabilities residing in a RF and personnel involved with reporting data in RF Tracker will receive training on the RFM system Please contact your regional Educational Service Center for information regarding the required RFM system training
Page 15
Section VII (Continued)
Serving Students at Residential Facilities Assurances
The charter holder assures this 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 of education 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
Signature of Charter Holder Board Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Please write NA in the signature line if the charter does not serve students at residential facilities
Page 16
Section VIII
BilingualESL Section 504 and Dyslexia Assurances
Texas Education Code Chapter 29 SubchapterB TECsectJ2 J04(b)(2)(G) and 19 TAC sectsect89120J-89J265 require charter schools to identify 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to limited English proficient students
copyYes
ONo
Section 504 of the Rehabilitation Act of 1973 29 USC sect794 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 it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students protected by Section 504
copyYes
ONo
Texas Education Code sect38003 TEC sect12104(b)(2)(K) 19 TAC sect7428 and Section 504 of the Rehabilitation Act of 1973 29 USC sect794 require charter schools to identify students with dyslexia or related disorders and to provide appropriate educational services
C The charter holder certifies it has policies and procedures in place to ensure it complies with the legal and regulatory requirements concerning identifying and providing appropriate educational services to students with dyslexia or related disorders
copyYes
ONO
I further certify that any future amendments to the laws regulations and rules will be incorporated and implemented
Signature of Charter WaI35rBoard Chair Date (Must sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 17
Section IX
Fingerprinting and Criminal Record Check Assurance
The charter holder certifies it is in compliance with TEC sect12120 and confirms that no individual is serving in any capacity if he or she has been convicted of a misdemeanor involving moral turpitude a felony an offense listed in TEC sect37Q07(a) or an offense listed in Article 62001(5) Code of Criminal Procedures unless the individual is eligible to be employed in a position in a school district under TEC sect12120 (a-1)
Additionally the charter holder confirms all current fingerprinting and criminal record checks are available for all employees including contract employees volunteers who indicated in writing their intention to serve board members and officers of the charter holder who are not on the board in compliance with TEC sectsect121059 220832-220835
^_ Signature of CharteiQSDlder Board Chair Date
(Musi sign in blue ink)
Bill Lamkin
Printed Name of Charter Holder Board Chair
Page 18
Section X
Certificate of Acknowledgement
This section requires at least a majority of the governing body of the charter holder to certify 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
Typed Name Signature (Type name next to corresponding signature) Date (Must sign in blue ink)
Michael Wellbaum
Willa G Dunleavy
Members are to sign the acknowledgement during an open meeting therefore the date next to each signature must reflect the date of the meeting
Page 19
Michael Williams Commissioner of Education
Lizzette C Gonzalez Reynolds Chief Deputy Commissioner
Michael Berry Deputy Commissioner Policy and Programs
Sally Partridge Associate Commissioner Accreditation and School Improvement
Heather Mauze Director Division of Charter School Administration
For further information contact the Division of Charter School Administration at
Texas Education Agency 1701 North Congress Avenue
Austin Texas 78701
(512)463-9575 (512) 463-9732 fax
Email - CharterSchools(S)teastate_tx_us
Or visit the website
httg^teatex_asgovTexas SchoolsCharter SchoolsCharter Schools
Page 20
TEA Texas Education Agency
lidnaei Williams Charter Renewal Commissioner
February 2 2015 FEB 2 3 2015
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR 3901 S Hulen St CharteFschooTs Fort Worth TX 76019
Re Charter Renewal Contract for FORT WORTH ACADEMY OF FINE ARTS ICON 22u809)
Dear Mr Lamkin
I am pleased to inform you that the charter renewal is approved for FORT WORTH ACADEMY OF FINE ARTS with a contract ending date of July 31 2025 After renewal the charter contract shall consist of the following
bull the representations and assurances made by the charter holder in the original request for application under the standard application system including all revisions made during the contingency process
bull the original contract for charter as signed by the charter holder and the State Board of Education
bull any condition amendment modification revision or other change to the charter approved by the State Board of Education or the commissioner of education including any prior renewal documents with revisions based on contingency responses
bull the final renewal application received in spring 2015 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
bull 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
By accepting these renewal terms the charter holder represents that it understands that the charter holder including any and all governance at whatever level whether appointed or elected employees agents and volunteers shall fully cooperate with every Texas Education Agency investigation andor sanction deemed necessary by the commissioner based on authority and responsibility given to the commissioner in state or federal law This means that Texas Education Agency staff may conduct confidential interviews of charter school personnel and contractors outside the presence of representatives of the charter schools administration and board and that failure to timely reply with reasonable requests for access to site personnel documents or other materials andor items is a material violation of the contract for charter
By accepting these renewal terms the charter holder represents that it is understood by all parties that if the charter holder loses its 501(c)(3) tax exempt status for any period of time through action of the Internal Revenue Service or any other action which renders the charter holder no
Mr Billy Lamkin Board Chair TEXAS BOYS CHOIR Page 2
longer an eligible entity within the meaning of TEC sect12101(a) the charter contract shall be rendered void and it shall automatically return to the Texas Education Agency without any other action having to be taken by the commissioner
Note that 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 modify 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
Notwithstanding the granting of this renewal it is understood by the parties that the charter continues to be subject to future actions by the commissioner including but not limited to possible revocation under TEC 12115(c)
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
Michaeljmliiams Commissioner of Education
MWbs
cc Mr Clint Riley Superintendent
I the undersigned hereby certify that the governing body of the crTarler Bolder has accepted and agreed to the charter renewal agreement for FORT WORTH ACADEMY OF FINE ARTS as outlined in the foregoing letter and has authorized me to sign below
Agreed and Accepted
Mr Billy Lamkin Date Board Chair TEXAS BOYS CHOIR