Science Cord Application

Name: __________________________________________

_{Instructions: Turn in this completed application and accompanying required documentation listed below to Mr. Fish (room S-101). Students are responsible for acquiring appropriate teacher signatures and printing the required documents}

Academic Standards

^{_{Write and calculate (where needed) the following values and highlight them on your transcript with highest value if done multiple times}}

ACT Science Reasoning Score: ____________
Cumulative GPA: ____________
Science Courses Cumulative GPA: ____________

Required Science Courses	Q1 Grade	Q2 Grade	Q3 Grade	Q4 Grade
Biology/AP Biology
Chemistry/AP Chemistry
Physics/Honors Physics/AP Physics

Additional Science Courses	Q1 Grade	Q2 Grade	Q3 Grade	Q4 Grade
–
–
–

Science Participation Standard

_{Proof of participation must be provided — proof may include certificates of participation, placement awards, signature from advisor, receipt of registration, certification test results, etc.}

Please identify which year/s applicant participated in these categories:

Other(Specify what and where: ______________________________________________________________________

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• Attach a current transcript with science courses highlighted to verify courses and grades
• Copy of ACT scores on transcript or attach a copy of your scores
• Science participation documentation

Date Received: ______________

Notes: ___________

Approved___________ Denied________________