Screening Form RM_StatsLast NameFirst NameSubmission ID# - ApplicationGenderGrade - TERMS A13Select an option89101112Sibling also applying? - Application, note sibling name in commentsSelect an optionYesNoUNW CUM GPA - TERMS A13Do the transcripts reflect C, D or F grades?Select an optionYesNoGrade Notes:Can student take majority of CA classes?Select an optionYesNoCA classes already earned credit for: ENC1101 ENC1102 LIT2000 SLS1501 MAC1105 MAC1114 MAC1140 POS2041 ECO2013 AMH2010 AHM2020 IDH2121 Attendance Acknowledgement StatementSelect an optionYesNoAttendance - Terms A07 & A15Select an optionFineConcernsAttendance NotesDiscipline - TERMS A24; SY 22 and 23Select an optionFineConcernsDiscipline NotesTERMS Address in Broward County - TERMS A03Select an optionYesNoCampus - ApplicationSelect an optionCentralNorthIs the applicant eligible for bus transportation Yes - in boundary for selected campus No - lives outside of boundary but will provide own transportation No - lives North of Sunrise but selected Central Campus No - lives South of Sunrise but selected North Campus Has BC ID# - ApplicationSelect an optionYesNoHas BC Email - ApplicationSelect an optionYesNoTesting StatusSelect an optionPendingSent to TestSent to RetestReceivedTestSelect an optionACCUPLACERPERTSATACTReadingWritingMathHLMIs applicant a Priority Student?Select an optionYesNoPrioritySelect an optionMilitaryCA employeeSiblingApplication StatusSelect an optionPendingProceed to TestingHoldReferred to Admissions CommitteeNot EligibleIn Qualified Applicant PoolWait ListOffered AdmissionAccepted AdmissionDeclined AdmissionWithdrew ApplicationNot Eligible ReasonSelect an optionNot 10th gradeNot Broward ResidentGPA <3.0GPA 3.0 - 3.24Low Math ScoreLow Reading ScoreLow Writing ScoreLow Multi ScoresNo Test ScoresNo Transcripts ReceivedDisciplineAttendanceIncomplete ApplicationDuplicate ApplicationScreened bySelect an optionLynde VoetCarol MooreAdmission Comments - include mm/dd and your initialsEmail - Applicants initials@example.com * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
