Caruthersville High School Missouri Option Program · The Missouri Option Program is designed to target students who have the capabilities to complete Missouri High School Graduation

Caruthersville High School

Missouri Option Program

Policy Information Application Student

Agreement

MISSOURI OPTION MISSION The Caruthersville School District has implemented the Missouri Option program for those students

who are unable to graduate with their kindergarten cohort group. The Missouri Option Program is

committed to helping those students who have realized the importance of earning a high school

diploma achieve their dream of being a high school graduate.

CSD Superintendent, Ms. J.J. Bullington

CHS Principal, Dr. Roger Alsup

CHS Guidance Counselor, Mrs. Brittni St. Mary

CSD Drop Out Prevention Coordinator, Mrs. Patricia Newman

CSD College & Careers Coordinator, Mrs. Barbara Hutchison

CSD Missouri Option Program Instructor, Ms. Eleanor Taylor

Caruthersville High School

1708 Ward Avenue

Caruthersville, Missouri 63830

Phone: [573] 333-6110

Fax: [573] 333-6117

www.cps18.org

Adopted by the Caruthersville C18 Board of Education June

2015

Table of Contents Student Eligibility ............................................................................................................................ 1

Enrollment Process ......................................................................................................................... 1

Important Notice ............................................................................................................................ 1

Procedure and Requirements for Graduation ................................................................................ 2

Attendance Procedures .................................................................................................................. 2

Employment / Internship Requirement .......................................................................................... 3

Program Location / Contact Information ....................................................................................... 3

Discipline Procedures ...................................................................................................................... 3

HiSET Information: [5] Subject-areas ............................................................................................. 4

Frequently Asked Questions ........................................................................................................... 6

Missouri Option Program Application ............................................................................................ 9

Appendix:

Missouri Option Agreement ......................................................................................................... 12

Enrollment Form ........................................................................................................................... 13

ICAP - Individual Career & Academic Plan .................................................................................... 14

Employment/Internship Agreement............................................................................................. 15

Internship/Work Form Hours ....................................................................................................... 16

ALS (A⁺nyWhere Learning System) / Credit Completion Form ..................................................... 17

Page 1

Student Eligibility Age - Students must be at least 17-years old, and no more than 20 years of age.

Credits - Students must be at least one year’s credit behind their cohort group (class), or for other significant

reasons identified in the local plan, be unable to complete their diploma with their cohort group. Cohort is

defined as the year that a student enrolled in Kindergarten, “not” the first year the student entered high school.

Students must be officially enrolled in Caruthersville High School to enroll in the Missouri Option Program.

Students must have at least an 8.0 reading and math level. This is identified by administering a locator test

called the Test for Adult Basic Education [TABE]. Students who do not meet the 8.0 criteria may appeal their

placement to Caruthersville School District Administration.

Enrollment Process

Students must complete the Missouri Option Program Application located in the back of this informational

packet.

Both students, and their legal guardian(s), must complete and sign the Missouri Option Agreement.

The Caruthersville High School Principal, Guidance Counselor, Dropout Coordinator, and Missouri

Option Instructor will finalize and sign the Missouri Option Agreement.

After the Missouri Option application is completed, the student will take part in an interview with the

Dropout Prevention Coordinator and/or College & Career Coordinator. The student will then be scheduled

to take a locator test [TABE] over reading, language, and mathematics prior to placement.

If the student has a 504 plan or an IEP [Individualized Education Plan], the 504 plan or IEP must indicate

that Missouri Option is an appropriate placement for the student. Allowable accommodations for the High

School Equivalency Test [HiSET] will be reviewed before placement into the Missouri Option Program.

Approximately ten students from Caruthersville High School may be enrolled in the Missouri Option

Program at one time. As one, or more, students complete the program, another student may be enrolled.

Students enrolled in the Missouri Option Program will remain throughout the semester.

IMPORTANT NOTE

HiSET SCORES RECEIVED WHILE IN THE MISSOURI OPTION PROGRAM ARE ONLY VALID

FOR THE MISSOURI OPTION PROGRAM. RESULTS ARE THE SOLE PROPERTY OF THE

CARUTHERSVILLE SCHOOL DISTRICT.

The scores CANNOT be used to receive a HiSET Certificate.

Students may not obtain copies of their HiSET test scores.

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Procedure and Requirements for Graduation

Students participating in the Missouri Option program will receive a Caruthersville High School Diploma.

The student will complete the program and receive their high school diploma when they have met the

following criteria:

Successful completion of a minimum of at least ½ credit in a Government class

Successful completion of the Missouri Constitution test

Successful completion of the US Constitution test

Successful completion of ½ credit in a Banking and Finance class

Successful completion of ½ credit in a Health class

Successful completion of the Algebra I End of Course Exam

Successful completion of the Biology End of Course Exam

Successful completion of the English II End of Course Exam

Successful completion of the Government End of Course Exam

Successful completion of ALL components of the HiSET

Successful completion of the class hours required in the Missouri Option Program

Successful completion of the work hours/volunteer hours required in the Missouri Option Program

4th year senior students who have met all of the criteria for graduation completed before the scheduled

graduation date may stop attending the Missouri Option class, but must bring in documentation of required

work, volunteer, and/or community service hours (an average of 30 hours per week). After successful

completion of the Missouri Option Program, the student is eligible to participate in graduation with their

kindergarten cohort.

Students beyond 4th year whose cohort group has already graduated and met all of the criteria for graduation

are eligible to receive their diploma after completion of the program. Participation in graduation is optional.

Attendance Procedures

Students are required to attend 15 hours of Missouri Option classroom instruction per week; a minimum of

three [3] hours per day.

If absent, Missouri Option students will notify the Missouri Option Instructor [573] 333-6110.

To remain in the Missouri Option Program and be eligible for testing, students are expected to maintain a

minimum attendance rate of 90%. The legal guardian, student, and Missouri Option instructor will

develop an attendance remediation plan if a student’s attendance rate is below 90%.

Missouri Option students who have attendance below 90% during the current school year will not be

allowed to participate in graduation ceremony.

Each student is allowed to be enrolled in the Missouri Option program for a maximum of two [2] years. A

student may remain in the program beyond two years with administrative approval.

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Employment / Internship Requirement

Students are required to provide proof of employment, community service, or an internship.

Students must attend a minimum of fifteen [15] hours of academic instruction per week; and be enrolled in

other school supervised instructional activities [career education, elective courses, work experience, etc.]

that lead to being classified by the district as a full-time student.

Fourth-year seniors who are in the Missouri Option Program and successfully pass the HiSET before the

end of the academic school year will remain engaged in a school-supervised course of study or

employment / internship / volunteer work equivalent to full-time student status [30 hours a week] until the

end of the academic school year.

Missouri Option Program Employment/Internship Work Hour Forms are due to the instructor on a weekly

basis. Paycheck stubs are due to the instructor upon receipt.

STUDENTS MUST HAVE ALL OF THEIR WORK HOURS UP TO DATE BEFORE BEING

ALLOWED TO GRADUATE.

Program Location /Contact Information

The Missouri Option program is located:

Caruthersville School District

1708 Ward Avenue


www.cps18.org

Missouri Option instructor may be contacted at [573] 333-6110, Extension #2350.

Athletics

Students enrolled in Missouri Option, and who qualify according to MSHSAA guidelines, may be eligible to

participate in CHS athletic programs.

Discipline Procedures

Missouri Option students will abide by all district policies and the Caruthersville High School Student

Handbook.

http://www.cps18.org/

Page 4

HiSET [High School Equivalency Test] Information http://hiset.ets.org/states_educators/ Click on Test at a Glance [pdf]

A candidate must pass all five of the HiSET individual subtests listed below, which

each require a minimum score of [8 out of 20]. In addition Part II of the Language

Arts Writing requires an essay score of at least two [2] out of six [6] points. ETS

[Educational Testing Services] has set a combined scaled score of 45 to pass the

HiSET exam. An overall total scaled score of 45 points, or higher, is required to pass

1. Language Arts Writing:

The Language Arts Writing test provides information about a candidate’s skill in

recognizing and producing effective standard American written English. Part 1 of the

test measures a candidate’s ability to edit and revise written text. Part 2 of the test

measures a candidate’s ability to generate and organize ideas in writing.

a. Part I has 50 multiple-choice questions (75 minutes). Content categories of Part 1 include:

Organization of ideas (20%); language facility (25%); and writing conventions (55%).

Part 1 requires candidates to make revision choices concerning organization, diction and

clarity, sentence structure, usage, and mechanics. The test questions are embedded in

complete texts in the form of letters, essays, newspaper articles, personal accounts, and

reports.

b. Part II is an essay (45 minutes). There is one Essay Question. This is graded on a six [6]

point scoring guide. A score of two [2], or higher, is required. Content categories of Part

2 include: Development of ideas; organization of ideas; language facility; and writing

conventions. Part 2 of the test measures proficiency in the generation and organization of

ideas through a direct assessment of writing. Candidates are evaluated on development,

organization, language facility, and writing conventions.

2. Language Arts Reading

The Language Arts Reading test provides evidence of a candidate’s ability to understand,

comprehend, interpret, and analyze a variety of reading material.

a. This test has 40 multiple-choice questions (65 minutes). The test includes the following

Content Categories: literary texts (60%); and Informational Texts (40%). Process

Categories include: Comprehension, Inference and Interpretation, Analysis, and

Synthesis/Generalization].

http://hiset.ets.org/states_educators/

Page 5

3. Mathematics

The Mathematics test assesses mathematical knowledge and competencies. The test

measures a candidate’s ability to solve quantitative problems using fundamental concepts

and reasoning skills. The questions present practical problems that require numerical

operations, measurement, estimation, data interpretation, and logical thinking. Problems

are based on realistic situations and may test abstract concepts such as algebraic patterns,

precision in measurement, and probability. The use of calculators is an option.

a. This test has 50 multiple-choice questions (90 minutes). The content categories include:

numbers and operations on numbers (25%); measurement/Geometry (25%); data

analysis/probability/statistics (25%); and algebraic concepts (25%). The process categories

include the following: understand mathematical concepts and procedures; analyze and interpret

information; and synthesize data and solve problems.

4. Social Studies

The Social Studies test provides evidence of a candidate’s ability to analyze and

evaluate various kinds of social studies information. The test uses materials from a

variety of content areas, including history, political science, psychology, sociology,

anthropology, geography, and economics.

a. This test has 50 multiple-choice questions (70 minutes). Content categories include history

(45%); civics/government (30%); economics (15%); and geography (10%). Process categories

include the following: interpret and apply; analyze; and evaluate and generalize.

5. Science

The Science test provides evidence of a candidate’s ability to use science content knowledge,

apply principles of scientific inquiry, and interpret and evaluate scientific information.

a. This test has 50 multiple-choice questions (80 minutes). This test includes the following

content categories: life sciences (50%); physical science (25%); and Earth Science (25%).

Process categories include: interpret and apply; analyze; and evaluate and generalize.

Page 6

Missouri Option Program Frequently Asked Questions

(Partial excerpt from: http://dese.mo.gov/divcareered/Missouri_option_faq.htm)

The Missouri Option Program is available in participating public school districts and eligible agencies during

the regular school year. To offer this program, local schools must meet requirements established by the HiSET

Testing Service and the Missouri Department of Elementary and Secondary Education. Participation is

voluntary for schools and students.

What is the Missouri Option Program?

The Missouri Option Program is designed to target students who have the capabilities to complete Missouri

High School Graduation Requirements, but for a variety of reasons lack the credits needed to graduate with

their class and are at risk of leaving school without a high school diploma.

The program specifically targets those students who are 17 years of age or older and are at least one year

behind their cohort group or for other significant reasons identified in the local Missouri Option Program plan.

Note: For the Missouri Option Program, cohort is defined as

when a student started kindergarten, not high school.

When did the Missouri Option Program begin in Missouri?

In 2002 the Missouri Department of Elementary and Secondary Education initiated the Missouri Option

Program. The program is approved by the American Council on Education (owners of the HiSET Tests) and

the Missouri State Board of Education.

How does the Missouri Option Program benefit a school?

School Districts approved by DESE to participate in the Missouri Option Program can continue to receive

average daily attendance funds for the participating students. Additionally, students remain in school and are

not required to dropout when it is time to take the HiSET Tests. Once the school district issues a High School

diploma, participants are then counted as graduates.

Note: A credential that includes the word "diploma" will be awarded. The school district should issue a

"regular" High School Diploma (the same as awarded to all students by local boards of education) or

"other" High School Diploma (the same as issued to students in an alternative program)

The Caruthersville School District Missouri Option diploma is a regular high school diploma; it is not

“other” or “alternative”. The diploma awarded to graduates of the Caruthersville School District

Missouri Option Program is exactly the same as a diploma awarded at Caruthersville High School.

Page 7

How does the Missouri Option Program benefit a student?

Students in the Missouri Option Program will be provided guidance and counseling services consistent with

the high school program. Ongoing academic/career advisement will be provided by the Missouri Option

Program instructor(s), with supplemental guidance and counseling provided, as needed. Students will have

access to all educational programs and services available in the school district, have the opportunity to stay in

school, receive valuable academic and life-skills instruction, earn a high school diploma, and have the option

of taking part in commencement ceremonies.

What is required of Missouri Option Program students?

A minimum of 15 hours of academic instruction per week will be provided. Students must also be enrolled in

other school supervised instructional activities (career education courses, elective classes, work experience,

etc.) that lead to student's classification by the district as a full-time student. The school district/eligible agency

should provide a level and quality of education that ensures the integrity of the Missouri Option Program and

locally issued Caruthersville High School diploma.

School districts may have additional requirements when issuing a regular high school diploma that is

consistent with what is required of all students. Students must take the Missouri End of Course [EOC] tests

appropriate for their age/grade level. They must take a course in government and the functions of government

and pass the required tests related to the U.S. and Missouri Constitutions. In addition, they must participate in

appropriate substantive counseling and life-skills training that will assist them with job-readiness, financial

management and independent living skills.

If a student takes the HiSET, what documentation will the district receive from the state verifying the

students results?

The HiSET Tests are designed to measure the major academic skills and knowledge associated with a high

school program of study. Students enrolled in the Missouri Option Program take (and pass) the HiSET Tests to

demonstrate and document the attainment of high school-level skills. The HiSET score report is one of the

academic components required for the awarding of a high school diploma by the local district, and as such, is

placed in the student's permanent record. Since the purpose of the Missouri Option Program is to qualify

the student for a high school diploma, the scores are only valid in that context.

What happens if a student fails to complete the Missouri Option Program?

Should a student fail to complete other program requirements even if they have achieved a passing score on

their HiSET, they will receive neither a high school diploma nor a certificate of High School Equivalence

(HiSET). Their status will revert to that of a high school dropout. The student would have to take the HiSET

Test as a dropout to be eligible to earn a HiSET certificate.

Page 8

What are some common misconceptions about the Missouri Option Program?

The Missouri Option Program is NOT an "early out" program or "easy out" alternative. Schools that attempt to

use it for these purposes will be disqualified. It is specifically intended to meet the needs of students who are

credit-deficient (for whatever reasons), but who otherwise could be expected to meet regular graduation

requirements. This program is NOT just intended to prepare students for the HiSET Test; it must provide

substantive academic content aligned with the school's regular curriculum and expectations. Students must

attend school regularly and have access to the kind of counseling and support services that are available to all

students.

What are the requirements for the faculty in the Missouri Option Program?

Teachers working in this program must have a valid Missouri teaching certificate in any secondary-level area

or in Adult Education and Literacy (AEL). AEL certification is not required if the educator already has a valid

teaching certificate.

Note: Student/teacher ratios will not exceed 20/1

For additional information – http://dese.mo.gov/divcareered/Missouri_option_faq.htm

Page 9

Caruthersville School District #18 MISSOURI OPTION PROGRAM APPLICATION

This Application MUST be filled out completely.

PLEASE PRINT CLEARLY

Part I: To be filled out by the applicant along with the parent(s)/guardian(s)

Student Name:_______________________________________________ Date of Birth:_______________

Home Address: ______________________________ City: _____________________State/Zip:____________

Phone Number: _________________________ SS#________-______-_________

Do you currently have an IEP, 504 plan? YES or NO (Circle one)

If you have an IEP, who is your case manager? __________________________________________________

Please provide the name(s) and phone contact(s) of your parent(s)/guardian(s) (unless you are live on your

own) Parent/Guardian Name: ________________________________________________________________

Home Phone #: _________________________ Cell or Work phone: __________________________

Name of Emergency Contact: ______________________________________________________________

Home Phone #: _______________________ Cell or Work Phone:___________________________

Does the student have any medical conditions that we need to be aware of? YES or NO

If yes, please list (be sure to turn in the proper medical forms to the CHS nurse as well):

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

What is the student’s plan for transportation to and from the program?

________________________________________________________________________________________

________________________________________________________________________________________

Page 10

Part II: To be filled out completely by the student / applicant

Please answer each question completely and LEGIBLY!

Why do you feel you are a good candidate for the Missouri Option Program?

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

What difficulties have you experienced in school in the past that has stopped you from succeeding?

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

Why do want to enroll in the Missouri Option Program as opposed to getting your HiSET? Do you plan

to go to college?

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

What do you feel are your strengths and weaknesses?

__________________________________________________________________________________

__________________________________________________________________________________ _____

Page 11

Part III: To be completed by the Missouri Option Program Coordinator[s] prior to student placement

Name of student: ______________________________________________________________________

Grade:________________ Date of Birth:_____________________ Age:__________________

Current Total Credits: ______Cohort Kindergarten:__________ Is the student a 4th year senior? _____

If not, what cohort graduation year? _________________Has the student ever been retained? _________

If so, how many years and when? _________________________________________________________

Student’s plan for achieving the work requirement: _____________________________________

Please answer yes or no to the following:

_____1) The Missouri Option application and contract is completed and signed by both student and parent

guardian (parent / guardian must approve and sign unless student is 18 years of age)

_____2) ½ credit in Health completed

_____3) ½ credit of Banking and Finance completed

_____4) Minimum of at least ½ credit of U.S. Government completed

_____5) US constitution test passed _________ Missouri Constitution Test passed

_____6) U.S. Government End of Course Exam taken

_____7) Algebra I End of Course Exam taken

_____8) Biology End of Course Taken

_____9) English II End of Course Taken

CHS Counselor Signature: ______________________________________________Date:_____________

CHS Principal Signature: _______________________________________________Date: ____________

Missouri Option Coordinator Signature ___________________________________ Date:____________

Missouri Option Instructor Signature: _____________________________________Date:_____________

If accepted into the program, copies of Missouri Option Forms will be available with CHS

Counselor and the Missouri Option Instructor[s]:

Student Transcript – Attached

Student’s Health Form on file with the CHS Nurse.

CARUTHERSVILLE HIGH SCHOOL

Dr. Roger Alsup, Principal

[email protected]

1708 Ward Avenue


Phone: (573) 333-6100 / Fax: (573) 333-6117

MISSOURI OPTION STUDENT AGREEMENT

I, _______________________________, agree to the following educational plan for the duration of my career at

Caruthersville High School.

_____ I understand that the Missouri Option is a voluntary program. I must attend a minimum of fifteen [15] hours

of academic instruction per week; and be enrolled in other school supervised instructional activities [career

education, elective courses, work experience, etc.] that lead to being classified by the district as a full time

student. I understand that I must take and pass all components of the HiSET test to earn a high school

diploma.

_____ I must meet the graduation requirements for students in Missouri Public Schools by completion of the

following: Health .5 [1/2 unit]; Banking and Finance .5 [1/2 unit]; and Government .5 [minimum 1/2 unit]. In

addition, I must pass both the Missouri and United States Constitution tests.

_____ I understand the HiSET test is an academic test; the results which are owned by the Caruthersville School

District. The HiSET Score Report will be placed in my permanent record.

_____ I am aware that all state, federal, and Caruthersville School District policies, including the rules outlined in the

Caruthersville High School Handbook applies to students enrolled in the Missouri Option Program.

_____ I will attend school as agreed and arrive on time. I must have 90% attendance to participate in the graduation ceremony.

_____ I will participate fully in all aspects of the educational plan, including counseling as appropriate.

_____ I will participate in appropriate state assessments, including all required End of Course [EOC] Assessments.

As a student of Caruthersville High School, I agree to the above conditions and further understand that failure to meet

these conditions could result in the termination of this contract and my opportunity to complete my high school

education through the Missouri Option Program.

Student ______________________________________________ Date: __________ Date of Birth: _______

Parent/Guardian ______________________________________ Date: __________

CHS School Administrator ______________________________ Date: __________

CHS Guidance Counselor _______________________________ Date: __________

Missouri Option Director/Instructor ______________________ Date: __________

mailto:[email protected]

YEAR _______ ____ MO OPTION ____ SCHOOL FLEX ____ JAG

ENROLLMENT INFORMATON

Student: ________________________________________________________ Maiden: ______________________________________

Last First Middle Initial

Address: ______________________________________________________________ SSN# __________ - __________ - __________

City: _______________________________________________________________________ State: _______ Zip: _________________

Home Phone: (_____) _____ - ____________ Cell: (_____) _____ - ___________ Emergency: (_____) _____ - __________

Birth Date: _____/_____/19_____ Age: ______ Male/Female___________

Parent/Guardian: _____________________________________________ Occupation: __________________________________

Last First Middle Initial Address: ____________________________________________________________ Home Phone: (_____) _____ - ____________

City: _______________________________________________________________________ State: _______ Zip: _________________

Alt. Phone: (_____) _____ - ____________ Cell: (_____) _____ - ___________ Emergency: (_____) _____ - _____________

Does one parent have primary custody? _____YES _____NO If YES, which? ________________________

*Emergency Contact: Closest relative [besides your parents] who will be able to reach you.

Name: _____________________________________________________________ Relationship: _____________________________ Last First Middle Initial

Address: ______________________________________________________________ Home Phone: (_____) _____ - __________

City: _______________________________________________________________________ State: _______ Zip: _________________

Alt. Phone: (_____) _____ - ____________ Cell: (_____) _____ - ___________ Emergency: (_____) _____ - _____________

By signing this document, I affirm that the information provided above is accurate for student enrollment into the Caruthersville School District .

Parent/Guardian: ____________________________________________________________________ Date: _____/_____/20___

Student Signature: ___________________________________________ Interview Date: ______/ ______/ 20___ Interviewer Signature[s]: ___________________________________ __________________________________________

Counselor: ____________________________________________________________________________Date: _____/_____/20___ Principal: _____________________________________________________________________________ Date: _____/_____/20___

CHS ICAP: Individual Career & Academic Plan

COMMUNICATION ARTS {4 UNITS}

□ ENGLISH I SEM 1 DATE: _______

□ ENGLISH II SEM 2 DATE: _______



□ ENGLISH III SEM 1 DATE: _______

□ ENGLISH III SEM 2 DATE: _______

□ ENGLISH IV SEM 1 DATE: _______

□ ENGLISH IV SEM 2 DATE: _______

MATHEMATICS {3 UNITS}

□ ALGEBRA I SEM 1 DATE: _______

□ ALGEBRA I SEM 2 DATE: _______

□ GEOMETRY SEM 1 DATE: _______

□ GEOMETRY SEM 2 DATE: _______

□ _________________________________ SEM 1 DATE: _______

□ _________________________________ SEM 2 DATE: _______

SCIENCE {3 UNITS}

□ PHYSICAL SCIENCE SEM 1 DATE: _______

□ PHYSICAL SCIENCE SEM 2 DATE: _______

□ BIOLOGY SEM 1 DATE: _______

□ BIOLOGY SEM 2 DATE: _______

□ _________________________________ SEM 1 DATE: _______

□ _________________________________ SEM 2 DATE: _______

SOCIAL SCIENCE {3 UNITS: GOV’T MUST BE AT LEAST .5 UNIT}

□ AMERICAN HISTORY SEM 1 DATE: _______

□ AMERICAN HISTORY SEM 2 DATE: _______

□ WORLD HISTORY SEM 1 DATE: _______

□ WORLD HISTORY SEM 2 DATE: _______

□ GOVERNMENT SEM 1 DATE: _______

□ GOVERNMENT SEM 2 DATE: _______

□ _________________________________ SEM _ DATE:_______

PHYSICAL EDUCATION {1 UNIT}

□ _________________________________ SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

HEALTH {.5 UNIT}

□ HEALTH DATE: _______ FINE ARTS

{1 UNIT}

□ __________________________________SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

PRACTICAL ARTS {2 UNITS}

□ __________________________________SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

□ __________________________________SEM 1 DATE:_______

□ __________________________________SEM 2 DATE:_______

ELECTIVES {6.5 UNITS}

□ PERSONAL FINANCE [REQUIRED .5] DATE: _______

□ _________________________________ SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

□ __________________________________SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

□ __________________________________SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

□ __________________________________SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

□ __________________________________SEM 1 DATE: _______

□ __________________________________SEM 2 DATE: _______

□ __________________________________SEM 1 DATE: _______

□ _________________________________SEM 2 DATE:_______

REQUIRED END OF COURSE EXAMS

□ ALGEBRA I DATE: _______

□ BIOLOGY DATE: _______

□ ENGLISH II DATE: _______

□ GOVERNMENT DATE: _______

CONSTITUTION EXAMS

□ MISSOURI CONSTITUTION DATE: _______

□ U. S. CONSTITUTION DATE: _______

COLLEGE & CAREER READINESS OBJECTIVES

□ CAREER PORTFOLIO DATE:_______ o MISSOURI CONNECTIONS DATE: _______ o JOB SHADOW DATE:_______

□ ________________________ _________________ DATE:_______

Student:

__________________________________________

___________

CARUTHERSVILLE HIGH SCHOOL EMPLOYMENT / INTERNSHIP AGREEMENT

_____ SCHOOL FLEX ______ MO OPTION _____ JAG

Student: _________________________________________ Employer: _____________________________________

Home Address: ___________________________________ Business Address: ______________________________

City: ____________________________________________ City: _________________________________________

Home Phone: _____________________________________ Phone: _______________________________________

Cell Phone: _______________________________________ Contact Person: ________________________________

Start Date: _______________________________________ Ending Date: ___________________________________

Career Objective: ___________________________________________________________________________________

Purpose of Employment / Internship Agreement: The purpose of this agreement is to clearly define the responsibility of the student, employer, parent/guardian, and Caruthersville School District. To maintain full-time status, the student must complete an average of 15 hours per week.

Responsibilities of the Student: 1. Conform to all rules and policies of Caruthersville High School and the work site. The student is expected to

demonstrate honesty, punctuality, cooperation, courtesy and a willingness to learn. 2. Maintain regular attendance at CHS and on the job. Attendance on the job “may” include days when school is

not in session, such as Christmas and Spring Break[s]; or after school work hours. 3. Report absences in advance to the employer and CHS personnel. Keep records and provide documentation to

CHS personnel as required. Participate in activities as listed in CHS Program.

Responsibilities of the Parent / Guardian: 1. Encourage the student to do well in the supervised employment/internship; and sign agreement if student is

under 18 years of age. 2. Be responsible for providing transportation for the student both to school and to the employer. 3. Be responsible, along with the student, for the safety and conduct of the student.

Responsibilities of the Employer/Work Site: 1. Train the student for the initial job duties, and offer additional training as the student’s competencies advance.

The training period shall be an average of at least 15 hours per week. Assist in evaluating student performance. 2. Conform to Federal, State and local laws and regulations regarding employment, child labor laws, and

compensation of student learners. Student learners are not eligible for unemployment benefits, but must be covered by workman’s compensation.

3. Reserve the right to discharge the student for just cause from the training site. CHS personnel requests notification prior to the action of student termination.

Responsibilities of Caruthersville School District Personnel: 1. Secure, organize, and present related study materials in keeping with the student’s I-CAP [Individual Career &

Academic Plan]. Coordination of academic instruction and work experience to prepare the student for his/her career objective. Evaluate student performance as it relates to academics and employment / internship.

2. Consult with the employer concerning student’s work performance; make periodic visits to the training site. 3. Counsel the student about individual work experiences and be available to assist with training problems or

program changes.

______________________ ______________________ _________________ ________________ _____ Student Signature Parent/Guardian Signature Employer Signature CHS Representative Date

CARUTHERSVILLE SCHOOL DISTRICT #18 INTERNSHIP/WORK FORM __________________________ School Official Signature / Date

Work Form Revised 3/15

MO OPTION ____ SCHOOL FLEX _____

NAME ___________________________________ Month/Year ____________________ Name of Business/Employer ___________________________________

Date ________Time In ______ Time Out ______ = ________

Date ________ Time In ______ Time Out ______ = ________





























I verify the Missouri Option Student listed above has worked _____ hours as indicated.

Signature/Position: __________________________________________________________

Work Form Revised 3/15

ALS (A+nyWhere Learning System)/CREDIT COMPLETION FORM

LAST NAME: ________________________________ FIRST NAME: ___________________________ GRADUATION YEAR: ______

Course Semester Counselor/Principal Course Enrollment Facilitator Transcript

Parent Contact [date and initial]

Letter Meeting Call

ALS (A+nyWhere Learning System)/CREDIT COMPLETION

TOTAL HOURS: _________ MASTERED: ________ % FINAL EXAM: ________% DATE COMPLETED: ____________

Completion of the above listed course and semester will be entered for .5 credit on student transcript.

_________________________________ _________________________________ ____________ Student Signature Teacher/Facilitator Signature Date

_________________________________ _________________________________ CHS Guidance Counselor Signature CHS Principal Signature

________ CREDIT RECOVERY ________ MO OPTION ________ SCHOOL FLEX

Documents

Caruthersville High School Missouri Option Program · The Missouri Option Program is designed to target students who have the capabilities to complete Missouri High School Graduation