2021/2022 Youth Program Application

TCC PREP Attachments

Report Card

• Report cards must show your semester one final grades and conduct, your name, grade level and academic year. No hand-written or progress reports will be submitted. If you are a home-schooled student, please upload something that outlines current courses.*field type file upload

Essay

• Write at least a 100-word essay answering “Why I want to attend TCC PREP?”
Would you like to upload or type your essay?*field type radio button
Would you like to upload or type your essay?UploadType
Essay Upload*field type file upload
Essay*field type multi line

Teacher Recommendation

• Each student must provide 2
• They must be completed via the form/grid (no letters of recommendation)
• They must come from the school counselor, English, math or science teacher.
Recommendation #1 (Email)*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Recommendation #2 (Email)*field type single line
Input blocked. Maximum character limit of 4000 characters reached.

2021/2022 Youth Program Application

Student Information

SSNfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Colleague IDfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Student's First Name*field type single line
Student's Full Legal First Name
Input blocked. Maximum character limit of 4000 characters reached.
Student's Last Name*field type single line
Student's Full Legal Last Name
Input blocked. Maximum character limit of 4000 characters reached.
Student's Middle Initialfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Student's Date of Birth*field type date
Student's Gender*field type radio button
Student's GenderMaleFemaleOther
Address*field type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
If your student needs accommodations for a documented disability, please contact Student Accessibility Resources on the campus your student will be attending.

School Information

School District*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
School attended this school year*field type single line
Input blocked. Maximum character limit of 4000 characters reached.

Parent Information

Parent Email address*field type email
Used to notify you of the status of your application
Home Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Other Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.

I authorize TCC to allow the following persons to call or come for my child in case of an emergency or early dismissal.

	Name*field type single line	Relationship*field type single line	Telephone*field type single line
Row 1×	Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Relationship*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Telephone*field type single line Input blocked. Maximum character limit of 4000 characters reached.	×

Add

2021/2022 Youth Program Application

First Parent/Guardian Information

This will be the first point of contact utilized throughout the program and in cases of emergency.
Parent/Guardian Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Relationship to student*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Parent/Guardian Physical Address*field type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Main Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Category*field type radio button
CategoryHomeCellWork
Secondary Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Category*field type radio button
CategoryHomeCellWork
Parent/Guardian Email address*field type email
Will be used for all official e-communications
Does the child reside with you?*field type radio button
Does the child reside with you?YesNo
*field type checkbox
I am the parent/legal guardian of the student named above and give permission for my student to attend TCC PREP.

2021/2022 Youth Program Application

Second Parent/Guardian Information

This will be the second point of contact and will only be used if we cannot reach the first during emergencies.
Parent/Guardian Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Relationship to student*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Parent/Guardian Physical Address*field type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Main Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Category*field type radio button
CategoryHomeCellWork
Secondary Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Category*field type radio button
CategoryHomeCellWork
Parent/Guardian Email address*field type email
Will be used for all official e-communications
Does the child reside with you?*field type radio button
Does the child reside with you?YesNo

2021/2022 Youth Program Application

TCC PREP Policies

Please Check:*field type checkbox
Please Check:We understand that the student must strictly follow all TCC PREP and TCC rules.
Please Check:*field type checkbox
Please Check:I have read the Transportation Policy (linked to the website).
Please Check:*field type checkbox
Please Check:I have read and agree with the photographs / video policy.
Please Check:*field type checkbox
Please Check:We (student and parent/legal guardian) understand that TCC PREP is a rigorous and demanding program that requires the ability and motivation to complete complex class work and homework above and beyond standard school instruction. We also understand that she/he will have homework daily.
Please Check:*field type checkbox
Please Check:We understand that attendance is important TCC PREP, that the student must attend every day during the program and that there is a maximum of THREE absences (no absences will be excused).
Please Check:*field type checkbox
Please Check:We understand that TCC PREP has a zero tolerance policy on a student’s noncompliance with all TCC PREP and/or TCC’s rules and policies. In the event of a rule/policy violation, the coordinator may dismiss the child from the program. Some examples of rule violations include: skipping class, cheating, plagiarism, leaving campus without permission, damaging property, physical violence, setting off fire alarms, or repeated patterns of less serious violations.
Please Check:*field type checkbox
Please Check:Disclaimer/Privacy notice - With a few exceptions, you are entitled to be informed about the information U.T. San Antonio collects about you. Under Sections 552.021 and 552.023 of the Texas Government Code, you are entitled to receive and review this information. Under Section 559.004 of the Texas Government Code, you are entitled to have U.T. San Antonio correct information about you that is held by us and that is incorrect, in accordance with the procedures set forth in the University of Texas System Business Procedures Memorandum 32. The information that U.T. San Antonio collects will be retained and maintained as required by Texas records retention laws (Section 441.180 et seq. of the Texas Government Code) and rules. Different types of information are kept for different periods of time.

Upload a copy of the students transcript, report card or letter of recommendation from non-family member (for home schooled students only) here. This document must include the Child's Full Name, School Name, School Year, Grades and Conduct, the grade the child is currently in and a School Seal or Logo:*field type file upload
(Pdf, Word Document, Tiff, etc.)

YOUTH: Please select your t-shirt size.field type radio button
YOUTH: Please select your t-shirt size.SmallMediumLargeX-Large
ADULT: Please select your t-shirt size.field type radio button
ADULT: Please select your t-shirt size.SmallMediumLargeX-Large

Signatures

Student Signature

	Type Name*field type single line	Signature*field type signature	Datefield type date
row 1	Type Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Signature*field type signature	Datefield type date Date will be captured on form submission

Parent Signature

	Type Name*field type single line	Signature*field type signature	Datefield type date
row 1	Type Name*field type single line Input blocked. Maximum character limit of 4000 characters reached.	Signature*field type signature	Datefield type date Date will be captured on form submission

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TCC PREP Attachments

Report Card

Essay

Teacher Recommendation

Student Information

Ethnicity

School Information

Parent Information

I authorize TCC to allow the following persons to call or come for my child in case of an emergency or early dismissal.

First Parent/Guardian Information

Second Parent/Guardian Information

TCC PREP Policies

Signatures

Student Signature

Parent Signature