Educational Talent Search
2020 SUMMER PROGRAM REGISTRATION FORM (Due by May 18th)
June 8th through July 20th
Cell or Work Phone #:
Home#:
Cell or Work Phone#:
Home #:
Student’s E-mail Address:
Parent’s E-mail Address:
If the student is participating in another summer program that may conflict with ETS list name, dates and time.
If the student has an Individual Education Plan (IEP) or 504 with the district, list accommodations and attach
a copy.
__________________________________
Parent/ Gua
rdian Signature
____________________
Student Signature
Date
1. Attend scheduled classes and complete assig
nments to the best of my ability.
2. Respect all peers and staff to promote an environment conducive to positive learning. I understand to refer
unresolved personal conflicts to the attention of the ETS Director via email or phone.
3. Complete ETS Evaluation to offer my input and suggestions regarding Summer Program.
4. Return ETS property at the end of my Program.
5. Adhere to the DVC Student Code of Conduct, Student Services Procedure 3027 (see DVC Catalog). I understand
that by failing to adhere to the code of conduct and the Program rules, I may be suspended from participation in
the Summer Programs.
As the parent of a participant in the ETS Summer Program I will:
1. Make sure that my child attends all scheduled classes and complete all assigned work. I understanding the attendance
and dismissal rules: (Rule 1: Three or more absences may result in dismissal from the summer program.(Rule 2: If the
student continuously disrupts class he/she will be dropped).
2. Call and/or email ETS if my child will be absent.
3. Complete ETS Evaluation to offer my input and suggestions regarding the Summer Program.
4. Ensure that my child returns all ETS property by the end of the Summer Program.
5. Provide ETS with academic records necessary for scheduling my child into the proper classes.
6. Cell Phone Policy: Student’s cell phone must be on “silent” during classroom instruction.
Consent and Release
,has my permission to participate in supervised online and in person
activities (educational, academic, social, cultural, college, career and other college matriculation services) and field trips
with the Contra Costa Community College District, Diablo Valley College ans Educational Talent Search staff. I realize
that this will require my child to interact with and exchange information and images with staff in an online format (i.e.
Zoom, Loom, Google Classroom, Remind, TAWK, On Track, College Choices, CANVAS, UC Scout, Khan Academy
and social media). In addition, I give my permission for my child's name, photograph, work, and/or statement to be used
by Educational Talent Search and Upward Bound for promotional, publicity (web pages, social media, brochures,
newspaper, etc., or instructional purposes. :
Student Contract
As a participant in the ETS Summer Program I will:
Parent Contract
