SILC Application for 2023-2024

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Email *

Student ID number *

Last Name *

First Name *

Last name of your advisor *

SILC availability next year *

I will SILC during a free full block in my schedule

I will SILC during a free *half* block in my schedule (check with your SILC teacher to confirm that this is okay with them!)

Name of the teacher with whom you most prefer to work; please list Last Name, First Name *

Name of the class taught by this teacher that you would like to work in. Be specific about the course name and level, if needed. *

What sorts of activities do you anticipate doing in your SILC assignment? Please discuss this with your SILC teacher before submitting. *

If you can't be placed in this specific class, please indicate your next preference: *

Place me in another class taught by the same teacher. (Make sure you have discussed this with the teacher.)

Notify me that I can't be placed and if I want to pursue being a SILC, I know I will have to find a new situation.

What is your absence percentage this school year?

(to find this information you need to visit the adviser chair office and ask the graduating class assistant)

What date did you get your absence percentage? *

YYYY

If your absence percentage exceeds 10%, please offer an explanation:

Initial here to indicate that you know that you are required to attend the class, and that you know this leadership role does not appear on your transcript. *

A copy of your responses will be emailed to the address you provided.

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