Skip to main content
To apply to Open Doors please fill in the form below and click submit. For questions please email kfuega@cloverpark.k12.wa.us
CPSD Logo

Release to Enroll in Open Doors Reengagement Program 2018-2019

Student Information

Full Name:
Birthdate:
Address:
City:
Zip:
Parent/Guardian Name(s):
Home/Guardian Phone:
Parent/Guardian Email:
Student Phone:
Current or Last School Attended:
In the what school district
Location of Last School: City
State
Last year attended:
Last Grade attended:

Program information

Is the student currently suspended or expelled from a previous school?
 
Is the student enrolled or has the student been previously been in Special Education?
 
Has the student had a 504 Plan?
 
Has that student ever had an IEP?
 
Is the student currently on probation?

Schedule Preference (select a first and second choice):

AM Part Time: M-F 7:25am - 10:30 am (morning transportation only)
PM Part Time: M-F 11:00am - 2:10pm (afternoon transportation only)
Less than Part Time/Special Schedule (special circumstances)
Days: Times:
Online Only. (No transportation, enrolled with Graduation Alliance)

Additional Information or special circumstances


It is understood that we as parents/guardians/adult student I 1). Will assume responsibility for adequate transportation and supervision to and from the Open Doors Program, and 2) Retain the right for the student to re-enroll in a traditional high school within the district per district guidelines, thus voiding this release. District guidelines state that once a student has been in the program for more than ten (10) days, they may not be eligible to enroll in a traditional CPSD program until the next semester window.

Captcha

Enter Above Code: