Forms

Attendance Appeals Form

Student’s Name:_______________________________________________ Date:___________ Grade:_________

Petition to Appeal In accordance with the Becton Regional High School attendance policy, this petition is being submitted to the Principal within ten days after receipt of notice of loss of credit.

NOTE: Appeals should be based on “…unforeseen factors which may create hardships relating to the Attendance Policy”.

1. The date of receipt of loss of credit was __________________________

2. The following subject(s) is/are involved in this appeal:

______________________________________________ ________________________________________________ ________________________________________________

______________________________________________ ________________________________________________ ________________________________________________

3. My explanation for the days absent this semester/year, which now total more than 8(semester) or 17 (year) is: _________________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________

4. My specific reason for this appeal is: ______________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________

Parent Signature ____________________________________________________ Student Signature ____________________________________________________

RECORD OF ATTENDANCE APPEAL PROCEDURE (for office use only)

Date of Appeal Hearing:_______________________

Alumni Transcript Release Form

ALUMNI TRANSCRIPT RELEASE FORM
PDF Version

Please fill out completely and return to the Guidance Department by fax or mail.

Date of Request: __________________________________________________________

Name: __________________________________________________________________________________
(Please indicate both maiden name and married name (if applicable)

Address: _________________________________________________________________________________

Phone #:________________________________________________________________

Year of Graduation or Withdrawn Date: ______________________________________

Name and address to which transcript will be sent:
_______________________________________________________________________

_______________________________________________________________________

Signature of former student: ________________________________________________

OFFICE USE ONLY

Date transcript sent: ______________________________________________________

Transcript sent by: ________________________________________________________

BCC Prep Application

BCC Prep Program & Application

BCC Prep Application PDF Version

Objective: The College Prep Program is a unique educational opportunity designed to provide high school seniors with a true college experience by earning academic credits during the afternoon hours at Bergen Community College. BCC Prep students will attend their Becton Regional High School classes in the morning and return to school in time for extracurricular activities. Student may earn up to 18 highly transferable college credits through BCC Prep by the time they graduate high school. Students are responsible to pay the per credit rate of $199 (estimate).

Application: Complete and return Bergen’s Prep Program Application along with our Option 2 Application to the Guidance Department. You cannot move ahead with the process until you have completed the application for BCC and receive a BCC student ID #.

Testing: Students will take the ACCUPLACER test to determine a student’s level in English, mathematics and elementary algebra. The Accuplacer examination is a computer delivered exam. Students are required to take the ACCUPLACER test on their own prior to registering for courses. We encourage students to test between April and May 2020. No appointments necessary- click the link to view Bergen’s testing calendar https://bergen.edu/testing/
*Please reach out to Mr. Caprio for further information on this.

The Accuplacer examination is administered in Room S-127 in the Pitkin Education Center at the Paramus campus on a walk-in basis. Make sure to have a pen, a government issued photo ID, Social Security number and BCC Student ID # with you prior to testing. No test will be administered without proper identification.

Transportation: It is the responsibility of each student, not BRHS, to arrange for their own independent transportation to and from Bergen Community College. If a sufficient amount of students are participating in the BCC Prep Program, transportation might be provided by Becton.

For more information:
https://bergen.edu/academics/college-high-school-partnership-programs/bcc-prep-program-for-high-school-seniors/

Option II Application

Please complete the first page of this application along with the pages for the program you are applying for. You must submit the cover sheet along with your application(s).

Application due to school counselor by Friday, February 21, 2020

Student Name: _________________________________________________________________

School Counselor: ______________________________________________________________

Date of Application: ____________________________________________________________

Email: _______________________________________________________________________

Please sign for all Option II Programs: Signatures below indicate agreement to endorse the specifics outlined in this proposal and serve as an agreement to participate in the Option II program above.

Student: ____________________________________________________________

Parent: ____________________________________________________________

What is my APPROXIMATE COST per semester?
Credits   In County Rate   Credits   In County Rate
1 $199.00 7 $1,303.00
2 $383.00 8 $1,487.00
3 $567.00 9 $1,671.00
4 $751.00
5 $935.00
6 $1,119.00

College Visit Form

COLLEGE VISIT FORM

PDF Version

Please immediately complete and return this form to the Main Office after a college visit and upon return to school.

NOTE: A student’s parent/guardian must call the school’s Main Office to report the absence prior to being absent.

Becton Regional High School feels it is imperative that students visit prospective colleges in order to help them determine the college of their choice. With this thought in mind, we grant seniors and juniors three (3) excused days per year for college visitations if documented with proper signatures.

Student Name:_________________________________________________________________

College/University Name:________________________________________________________

Date(s) of Visit:___________________________________________________________________

SIGNATURES

College/University Representative Signature:___________________________________________ Date:____________________________________________________

College/University Representative Printed Name:_______________________________________________________________________

Parent Signature:________________________________________________Date:___________

Counselor Signature:_____________________________________________Date:___________

Assistant Principal Signature:______________________________________Date:___________

Course Adjustment Form

PDF Version

Complete this form in its entirety and turn in on time for any course adjustment request. Students must provide valid reasons for requesting the program change. Submit this form to the teacher no later than March 27, 2020. No changes will be allowed unless this form is complete and all signatures are recorded. Course changes will only be considered if space is available in the requested course.

Internship Program Application

PDF Version

APPLICANT INFORMATION:

Name: ______________________________________________________________________

Home Address: ______________________________________________________________________

Home Phone: ______________________________________________________________________

Cell Phone: ______________________________________________________________________

Email: ______________________________________________________________________

DOB: ______________________________________________________________________

Guidance Counselor: ______________________________________________________________________

EMERGENCY CONTACT INFORMATION:

Parent/Guardian: ______________________________________________________________________

Name & Relationship: ______________________________________________________________________

Home Address: ______________________________________________________________________

Home Phone: ______________________________________________________________________

Business Phone: ______________________________________________________________________

Cell Phone: ______________________________________________________________________

Email: ______________________________________________________________________

I hereby give permission for my son/daughter to participate in Becton Regional High School’s Career Exploration Internship Program.

Parent/Guardian Signature: _________________________________________ Student Signature: _________________________________________

Career Exploration Internship Program

CAREER CHOICE 1	CAREER CHOICE 2

Current GPA:
Related Courses:
Awards:
Extracurricular Activities:
Volunteer Activities:
Employment Experiences:
Hobbies/Interests:
Foreign Languages:
Computer Skills:
Other Skills:
Strengths:
Challenges:
Strongest Subjects:

Do you have a personal computer?  YES  NO

Do you have Internet access?  YES  NO

Do you have transportation?  YES  NO

If no, how will you get to internship?

Do you have school or employment obligations that may interfere with the internship?  YES  NO

If yes, please explain.

Do you have health issues that may affect internship attendance?  YES  NO

If yes, please explain.

ESSAY QUESTION

Please type a one-page essay and attach to this application. Use proper report formatting learned in English or computer class.

Why are you interested in your particular career field?
Why do you think this career is a good fit for you?
Why do you want to participate in the Career Exploration Internship Program and how do you think the experience will benefit you?

Request to See Your Counselor

Requirements for Promotion and Graduation

Scheduling

Senior Brag Sheet

PDF Version

Class of 20____

Name _____________________________________________________________________________________________________________________
(Last) (First) (Middle Initial) (Preferred Name)

Future Plans

Check any of the following which apply / Record name of schools being considered

___________ 4-year College _______________________________________________________________________

____________ 2-year College _______________________________________________________________________

____________ Vocational School _______________________________________________________________________

____________ Armed Services _______________________________________________________________________

____________ Other _______________________________________________________________________

Career Goal Get ready to brag! Please complete this form as accurately and complete as possible, and don’t forget to highlight your accomplishments—in other words—brag!

List and describe all activities and leadership roles and any honors and awards received beginning with 9th grade (clubs, organizations, sports):

•

List community service or volunteering projects and what you learned from your experience:

•

List and describe all work/internships experience (past & present). If possible, include employer, position, and dates worked:

•

List any skills, talents and strengths you possess:

•

List two adjectives your peers would use to describe you:

•

What, if any, has been your biggest weakness/obstacle, and how have you overcome it? What benefit would the university gain by admitting you as a student?

Where possible, give examples/ information specific to the university/universities you are applying to (it helps to think about your strongest personal assets).

•

Is there anything else we should be made aware of in writing your recommendation letter? (personal hardships or anything else you’re particularly proud of, etc.)

Teacher Recommendation Request Form

STUDENTS: Before giving this form to the teacher of your choice, it is expected that you have approached that teacher and have requested permission to use him/her as a reference. Once the teacher has agreed to write a recommendation for you, it is important that you complete the sections below in a careful and complete manner to assist the teacher in writing a recommendation. Please present this form to the teacher at least two (2) weeks prior to the time that you need the recommendation.

Teacher Recommendation Form

PDF Version

Student Name:______________________________________________________________________

Teacher: ___________________________________________________ Today’s Date: ___________________________

For what class(es) did you have this teacher? _____________________________

Intended Major:___________________________________ Career Interest________________________

1. Describe an academic experience in my class that has been a highlight for you (a paper, a project, a book, etc.). What were some of your favorite topics in class?

______________________________________________________________________________________________________________________________________________________________________________________

2. Describe what you learned about yourself personally and/or as a student in my class: ______________________________________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________________________________

3. Tell about a favorite memory or proudest moment from this class: ______________________________________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________________________________

4. Explain what aspect(s) of this class was/were most challenging:

______________________________________________________________________________________________________________________________________________________________________________________

5. Describe a specific moment or experience in class that forced you to stretch your work habits and/or abilities: ______________________________________________________________________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________________________________________________________________

6. How did you grow personally and academically as a result of taking this class? _________________________________________________________________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________________________________________________________________

7. List six words that you, your family, or your friends would use to describe you.

1. ___________________________ 2. _____________________________

3. ___________________________ 4. _____________________________

5. ___________________________ 6. _____________________________

TEACHERS:

This form was designed to assist you in writing a student letter of recommendation. The primary objective and basis for your letter should revolve around the direct contact that you have had with the student. The main purpose of the teacher recommendation letter is to give a snapshot of the student’s participation in your class,
his/her interest in learning, level of achievement relative to other students, and their overall academic ability compared to other students over the years.

Please include as many examples as possible, of anecdotal statements and your thoughts on the student’s personality traits, motivation, creativity, self-discipline, leadership, self-confidence, independence, personal initiative, emotional maturity, respect of peers, personal responsibility, class participation, organizational skills,
and seriousness of purpose, academic achievement, school involvement, and potential for academic growth. Also, include significant challenges, which the student may have faced and overcome within your class.

Transcript Request Information for Dual Enrollment

Transcript Request Information for Dual Enrollment Students

In order for your college to see the credits you took through Bergen Community College, you must request a transcript from Bergen Community. As grades from High Schools may be reported to the College by the end of the school year, the best time to request transcripts is after grades are posted on the student’s College academics records. We recommend students wait till mid-July to request transcripts from Bergen Community College. Below is where you can request a transcript.

If you have completed your Dual Enrollment courses and your grade(s) have been posted please order your transcripts at www.getmytranscript.com

If you encounter any issues requesting your transcript please contact the Registration Department (One Stop) in room A129 or email transcripts@bergen.edu

For information please contact Catherine Malone at 201-612-5568.

VHS Learning Registration Forms

VHS REGISTRATION FORMS

PDF Version

Accessing VHS Courses for Enrollment

www.govhs.org / Click Catalog on the VHS home page to access all VHS Learning courses available.

Please pre-select courses for enrollment and return forms to Guidance Office.

Student Name_______________________________ Grade Level for the 2020-2021 School Year ________

Student Email: ___________________________________________
^{Please print e-mail address clearly}

Course Selection: 1^st Semester (exact course title must be listed below)

#1______________________________________

#2______________________________________

#3______________________________________

Course Selection: 2^nd Semester (exact course title must be listed below)

1______________________________________

#2_____________________________________

#3_____________________________________

I understand that participation in the second semester of VHS is dependent upon full participation in my first semester as a VHS student.

Student Signature: ___________________________________________________

I give my child permission to participate in the Virtual High School.

Parent Signature: ____________________________________________________

I recommend this student for participation in the Virtual High School.

Guidance Counselor Signature: ________________________________________

PLEASE RETURN TO GUIDANCE

Henry P. Becton Regional High School

VHS Student Contract

(to be signed by student and parent)

I, ____________________________________ (name of student), agree to participate in my VHS online course and:

I will attend and fully participate in my VHS online course.
I am aware of the following guideline for expected hours of work by level:
- A standard level class requires students to be actively engaged in their coursework for approximately 6 - 8 hours per week.
- An honors level class requires students to be actively engaged in their coursework for approximately 8 - 10 hours per week.
- An AP level class requires students to be actively engaged in their coursework for approximately 10 - 12 hours per week.
I will inform my VHS Site Coordinator in a timely manner if I am experiencing difficulties in my online course due to:
- technical difficulties with the network or computer;
- navigation difficulties in the course platform; or
- difficulties in understanding my assignments or posting my assignments.
I will inform my VHS teacher of any scheduled absences due to school or personal schedules.
I will inform my VHS teacher and Site Coordinator of any absence due to illness or unforeseen circumstances and will make up missed work in a timely manner.
Be aware that if I drop a semester 1 course, I will not be eligible to take a semester 2 course.
Be aware that after the add/drop deadline, students who withdraw will receive a grade of 'W/F' for Withdraw Fail or 'W/P' for Withdraw Pass, which will be reported to their school’s administrative office and appear on my permanent transcripts.
I will use courteous language while communicating with my VHS peers and teacher.
I will use the school network in conformance with the Acceptable Use Policy.

Signed: _________________________________________________________________ Date _________________
(student)

Signed: _________________________________________________________________ Date__________________
(parent)

Teacher Recommendation

Student Name: Date:

CHOICES 1st SEM. (FALL) Level 2nd SEM. (SPRING) Level

1st

(circle)

H AP S

(circle)

H AP S

2nd

H AP S

3rd

H AP S

H-Honors AP-Advanced Placement S-Standard

VHS students are expected to attend and participate in their online course as fully as they would attend and participate in a traditional classroom course. All assigned work should be completed in a timely fashion, and students must actively participate in course discussions.

At an absolute minimum, students are required to log-in and perform work in their online course five times per week, bearing in mind that a week is expected to contain at least 5-7 hours of coursework.

Time management and self-motivation are essential skills for success in a Virtual High School class. Please consider this when endorsing a student’s request to participate in Virtual High School. Participation in an online course will require students to be involved in independent and collaborative projects and research. Students must plan their work, be responsive to deadlines, and be conscientious in completing assigned tasks.

____________ I endorse this student’s candidacy for Virtual High School NetCourses.

____________ I endorse, with reservations, this student’s candidacy for Virtual High School NetCourses. Please indicate reasons on back of this sheet. *

____________ I do not endorse this student’s candidacy for Virtual High School NetCourses. Please indicate reasons on back of this sheet. *

Faculty/Staff Signature: ___________________________________ Date: _____________

*RECOMMENDATION MUST BE FROM AN ACADEMIC DEPARTMENT TEACHER*
* All teacher remarks are confidential

PLEASE RETURN TO GUIDANCE

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Attendance Appeals Form

Alumni Transcript Release Form

ALUMNI TRANSCRIPT RELEASE FORM
PDF Version

BCC Prep Application

BCC Prep Program & Application

College Visit Form

COLLEGE VISIT FORM

SIGNATURES

Course Adjustment Form

Course Adjustment Form

Internship Program Application

Internship Program Application

APPLICANT INFORMATION:

EMERGENCY CONTACT INFORMATION:

ESSAY QUESTION

Request to See Your Counselor

Requirements for Promotion and Graduation

Scheduling

Scheduling: Making Course Requests for the Upcoming School Year

Senior Brag Sheet

Senior Brag Sheet

Future Plans

Career Goal Get ready to brag! Please complete this form as accurately and complete as possible, and don’t forget to highlight your accomplishments—in other words—brag!

Teacher Recommendation Request Form

Teacher Recommendation Form

TEACHERS:

Transcript Request Information for Dual Enrollment

Transcript Request Information for Dual Enrollment Students

VHS Learning Registration Forms

VHS REGISTRATION FORMS

Teacher Recommendation

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