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School Forms » Application for the Seal of Biliteracy

Application for the Seal of Biliteracy

 

Ukiah Unified School District Seal of Biliteracy Application
For Seniors to Receive the Seal of Biliteracy Upon Graduation, Spring 2018

 

Due Date: March 15, 2018

 

STUDENT INFORMATION:
 
Name ____________________________________________________________________________________
 
Street Address ____________________________________________________________________________
 
City, State, ZIP ____________________________________________________________________________
 
Primary Phone ____________________________Secondary Phone_________________________________
 
E-Mail Address _____________________________________________________________________________
 
School ____________________________________________________________________________________
 
Student Permanent ID Number ________________________________________________________________
 
Birthdate __________________________________________________________________________________
 
For What Target World Language (s) are you applying? ______________________________________________ 

 

First Target World Language (other than English)

 

World Language ____________________ Dialect ________________________

 

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I have met the following criteria and I wish to receive the Seal of Biliteracy on my high school diploma:
  • ______ Successful completion of all high school graduation requirements in English with a 2.0 or above overall.
  • ______ Proficient or Advanced on the 11th Grade California Standards Test in English Language Arts
  • ______ Received at 3 or above on the Advanced Placement Language Test in a language other than English.

Date AP Language test taken: ____________________________
 
Student Signature ____________________________________________________Date __________________

 

 

Counselor’s Signature ________________________________________________ Date __________________

 

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OFFICE USE ONLY
 

 

Student Name____________________________ Permanent ID number _________________________

 

The candidate has:
  • ______ Successfully completed all high school graduation requirements in English with a 2.0 or above overall.
  • ______ Been Proficient or Advanced on the 11th Grade California Standards Test in English Language Arts
  • ______ Received at 3 or above on the Advanced Placement Language Test in a language other than English.
Date AP Language test taken: _______________
 

 

_______ Approved for the Seal of Biliteracy Award

 

_______ Not approved due to the following: __________________________________________

 

_____________________________________________________________________________

 

 

UUSD Seal Program Coordinator: __________________________ Date __________________

 

 

Registrar : ______________________________________________ Date __________________