Wayzata High School Academic Study Block Application

Wayzata High School Academic Study Block Application

Once this application is submitted, it will be reviewed by student support teams to determine qualification prior to enrollment in an Academic Study Block. If approved, the Academic Study Block will be added to the student's schedule by a student support team member. Applications must be submitted before the start of the term for consideration.
School Year

2024-20252025-2026
Student Name*

First NameLast Name
Student Email*
example@example.com
Student Phone Number*
Please enter a valid phone number.
Grade:*

Grade 11Grade 12
Student Support Team*

A-FJFL-LAQLAR-RARB-Z
What term(s) are you requesting an academic study block?*

Term 1Term 2Term 3Term 4
Which block(s) are you requesting an academic study block?*

Block 1Block 2Block 4
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email*
example@example.com; Please avoid using a Comcast.net email address.
Parent/Guardian Phone Number*
Please enter a valid phone number.
Reason for requesting an academic study block:*
Academic Study Block (ASB) Policy

This policy may be subject to review and revision by the school administration. Students should consult with their Student Support Teams for guidance on ASB eligibility and application procedures.
Eligibility:
- Good Academic Standing: Students must be on track for graduation with no failing grades ("N" grades) and no outstanding attendance or behavioral concerns.
- Application Limit: Students may apply for a maximum of four ASB blocks throughout their high school career.
- Annual Limit: A maximum of two ASB blocks may be used within a single academic year.
- ASB blocks will be offered during the following instructional periods: Block 1, Block 2, or Block 4.
Student Responsibilities:
- Students are responsible for self-reporting their attendance in ASB blocks each day.
I UNDERSTAND AND AGREE TO THE ACADEMIC STUDY BLOCK REQUIREMENTS.
Signature

Clear
Should be Empty:

Wayzata High School Academic Study Block Application

Academic Study Block (ASB) Policy