PSI HIGH COMMITMENT FORM Program of Emphasis Please return to: Derek Jensen or Kimberly Jackson Email: [email protected] or [email protected] Seminole High School 9 th Grade Center Guidance 21 Lakeview Drive Sanford, FL 32773 PSI High Front Desk: (407) 320-9150 Please complete this form to indicate your intent to enroll in the PSI High program at Seminole High School. STUDENT INFORMATION Student Name: _______________________________________________ Birth Date: _______________________ Current School: _______________________________________________ Current Grade: ___________________ PARENT/GUARDIAN INFORMATION I understand the bulleted statements below: • PSI High is a full-time, project-based program of emphasis. As a PSI High learner, my child will earn course credit through work on authentic personal and real-world projects. • My student will learn through a combination of core classes, personal learning investigations, and project-based work at school and in the community. • My student will receive a schedule with least three class periods combined into a project block. • Students enrolled in PSI High full-time must make satisfactory academic progress to remain in the program. • My student will remain in the program for a minimum of one year. • Enrollment may be revoked if attendance, tardiness, or behavior problems develop in the program. Parent/Guardian Name: ____________________________________ Signature: _________________________________________ Street Address: ____________________________________ City: _______________________________ Zip: _________________ Today’s Date: _______________________ Phone: _____________________ Email: _____________________________________ NEXT STEPS 1. Please return the form to the Guidance Department or PSI High front desk at the Seminole High School 9 th grade center. 2. You will be notified of your application decision in early April. 3. If accepted, you will receive a welcome packet including a student guide. You will be contacted to schedule a new student meeting with your student and the PSI High team. FOR SHS GUIDANCE USE Please check the following: □ The student has a course request for 9999PSI. (If not, please add.) □ The student is eligible to join the PSI High program as a full-time student. Processed by: Name: ___________________________________________________________ Date: _____________________________ Guidance: Retain original for your records Please copy or scan and submit to PSI High Front Desk Derek Jensen, PSI High Program Manager Email: [email protected] Phone: (407) 320-0330