61
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 County/District #: 220-809 ; Generation: 06 Maximum Approved Enrollment: 1000 | Grades Approved: K,l,2,3,4,5,6,7,8,9,10,ll,12 I Campuses: 220809001 220809101 FORT WORTH ACADEMY OF FINE ARTS FORT WORTH ACADEMYOF FINE ARTS ELEMENTARY 3901 SHULENST 3901 SHULENST FORT WORTH, TX 76109 FORT WORTH, TX 76109 Grade Levels Currently Served: Grade Levels Currently Served: 7,8,9,10,11,12 3,4,5,6 Geographical Boundary: The original charter application and amendment history reflects that the following district(s) comprise the charter school's 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

OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

bullbullbullbull

Aiinaed 100435 Msect[H

bullbullbull

ft] 4^ a ii T tradepound tto C c gt 0) a JM _ u

o ltu

ii ao ^c 5 x V

-uosAuuaieuershy

o 01

a o bulla ID O

poundQ

b O

V i-bgt (y

2 25 S 3 O OJ

-SUOLUIUIS BUUOQshy

Q

saDjuas luapms jo JOPOJIQ jojasunoo

MS

P in

o ow

shy

-pupei|

^jeis saDiuas |epads

Mimed sLMAjeuaiua|3

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 2: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

bullbullbullbull

Aiinaed 100435 Msect[H

bullbullbull

ft] 4^ a ii T tradepound tto C c gt 0) a JM _ u

o ltu

ii ao ^c 5 x V

-uosAuuaieuershy

o 01

a o bulla ID O

poundQ

b O

V i-bgt (y

2 25 S 3 O OJ

-SUOLUIUIS BUUOQshy

Q

saDjuas luapms jo JOPOJIQ jojasunoo

MS

P in

o ow

shy

-pupei|

^jeis saDiuas |epads

Mimed sLMAjeuaiua|3

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 3: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

bullbullbullbull

Aiinaed 100435 Msect[H

bullbullbull

ft] 4^ a ii T tradepound tto C c gt 0) a JM _ u

o ltu

ii ao ^c 5 x V

-uosAuuaieuershy

o 01

a o bulla ID O

poundQ

b O

V i-bgt (y

2 25 S 3 O OJ

-SUOLUIUIS BUUOQshy

Q

saDjuas luapms jo JOPOJIQ jojasunoo

MS

P in

o ow

shy

-pupei|

^jeis saDiuas |epads

Mimed sLMAjeuaiua|3

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 4: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

bullbullbullbull

Aiinaed 100435 Msect[H

bullbullbull

ft] 4^ a ii T tradepound tto C c gt 0) a JM _ u

o ltu

ii ao ^c 5 x V

-uosAuuaieuershy

o 01

a o bulla ID O

poundQ

b O

V i-bgt (y

2 25 S 3 O OJ

-SUOLUIUIS BUUOQshy

Q

saDjuas luapms jo JOPOJIQ jojasunoo

MS

P in

o ow

shy

-pupei|

^jeis saDiuas |epads

Mimed sLMAjeuaiua|3

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 5: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

bullbullbullbull

Aiinaed 100435 Msect[H

bullbullbull

ft] 4^ a ii T tradepound tto C c gt 0) a JM _ u

o ltu

ii ao ^c 5 x V

-uosAuuaieuershy

o 01

a o bulla ID O

poundQ

b O

V i-bgt (y

2 25 S 3 O OJ

-SUOLUIUIS BUUOQshy

Q

saDjuas luapms jo JOPOJIQ jojasunoo

MS

P in

o ow

shy

-pupei|

^jeis saDiuas |epads

Mimed sLMAjeuaiua|3

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 6: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

ATTACHMENT 1

Coversheet

bullbullbullbull

Aiinaed 100435 Msect[H

bullbullbull

ft] 4^ a ii T tradepound tto C c gt 0) a JM _ u

o ltu

ii ao ^c 5 x V

-uosAuuaieuershy

o 01

a o bulla ID O

poundQ

b O

V i-bgt (y

2 25 S 3 O OJ

-SUOLUIUIS BUUOQshy

Q

saDjuas luapms jo JOPOJIQ jojasunoo

MS

P in

o ow

shy

-pupei|

^jeis saDiuas |epads

Mimed sLMAjeuaiua|3

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 7: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

bullbullbullbull

Aiinaed 100435 Msect[H

bullbullbull

ft] 4^ a ii T tradepound tto C c gt 0) a JM _ u

o ltu

ii ao ^c 5 x V

-uosAuuaieuershy

o 01

a o bulla ID O

poundQ

b O

V i-bgt (y

2 25 S 3 O OJ

-SUOLUIUIS BUUOQshy

Q

saDjuas luapms jo JOPOJIQ jojasunoo

MS

P in

o ow

shy

-pupei|

^jeis saDiuas |epads

Mimed sLMAjeuaiua|3

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 8: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

ATTACHMENT 2

Coversheet

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 9: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

capIV S

lid) )|

degH

Ud)

lid) HlaquoS UO|HHN P1PM3 atcuew uoiifJin

0d) VraquoD SWBI

usi euefshy

udiw aA|inraquoig

men

tPr

iH

igh

inci

lo

bullow

--C

rai

ngas

tshy

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

Email

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

Email

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

Page 10: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 11: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

__

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

Email

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

Email

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

Page 12: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 13: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 14: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 15: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 16: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 17: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 18: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 19: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 20: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 21: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

[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

Email

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

Email

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

Page 22: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 23: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 24: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 25: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 26: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 27: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 28: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application

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

Email

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

Email

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

Page 29: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 30: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 31: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 32: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 33: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 34: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 35: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 36: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 37: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 38: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 39: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 40: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 41: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 42: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 43: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 44: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 45: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 46: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 47: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 48: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 49: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 50: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 51: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 52: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 53: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 54: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 55: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 56: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 57: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 58: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 59: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 60: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application
Page 61: OPEN-ENROLLMENT CHARTER CONTRACT RENEWAL PETITIONcastro.tea.state.tx.us/charter_apps/content/downloads/... · 2015. 2. 25. · • A blank cop oyf th currene t admission application