DeBusk Enrichment Center for Academically Talented Scholars

	Program Overview	Frequently Asked Questions
	Mission & History	Testimonials
	Our Staff	Our Crest
	Meet the Founders	Join our Staff Team
	Our Hosts at St. Rose	Population Demographics

Welcome, graduate assistants. We are thrilled that you are interested in joining us in a role of service this summer.

Please complete the following information carefully. Note that you will need your parents' help on a few areas, so you will want to complete this application while they are around to provide you with assistance.

For all phone numbers, use (xxx) xxx-xxxx format.

Last Name	A value is required.	Age	A value is required.
First Name	A value is required.	Current Grade	A value is required.
School	A value is required.	Gender	Please select an item.

Home Address	A value is required.	Your E-Mail	A value is required.Invalid format.
City	A value is required.	Parent E-mail	A value is required.Invalid format.
ZIP	A value is required.Invalid format.	Home Phone	A value is required.Use (xxx) xxx-xxxx format.
Total Years at DECATS (including this year)	A value is required.	Your Cell Phone	A value is required.Use (xxx) xxx-xxxx format.

Mother's Name	A value is required.	Father's Name	A value is required.
Mother's Occupation	A value is required.	Father's Occupation	A value is required.
Mother's Work Phone	A value is required.Use (xxx) xxx-xxxx format.	Father's Work Phone	A value is required.Use (xxx) xxx-xxxx format.
Mother's Cell Phone	A value is required.Use (xxx) xxx-xxxx format.	Father's Cell Phone	A value is required.Use (xxx) xxx-xxxx format.

Emergency Contact 1 Name	A value is required.	Emergency Contact 2 Name	A value is required.
Phone	A value is required.Use (xxx) xxx-xxxx format.	Phone	A value is required.Use (xxx) xxx-xxxx format.
Relationship to You	A value is required.	Relationship to You	A value is required.

Doctor's Name	A value is required.	Insurance Carrier	A value is required.
Doctor's Phone Number	A value is required.Use (xxx) xxx-xxxx format.	Policy / Group Numbers	A value is required.
Preferred Hospital	A value is required.	Carrier Phone Number	A value is required.Use (xxx) xxx-xxxx format.
Preferred Hospital Phone	A value is required.Use (xxx) xxx-xxxx format.

Consent for Medical Treatment and Transportation

In the event of an accident, emergency, or sudden illness to my child, I hereby authorize a representative of DECATS to seek medical attention and treatment for my child. I also give permission for a representative of DECATS to transport my child to a doctor or hospital in the event of an accident, emergency, or sudden illness. All representatives of DECATS will be released of any liability that might be incurred in the transportation and / or treatment of my child.

Please enter your full name.

Parent / Guardian Signature A value is required.

Special Needs

Please note any special needs or problems that your child may have, such as (but not limited to) learning differences, an allergy, existing illness, previous serious illness and / or injury, or hospitalizations in the last twelve (12) months, and any medication prescribed for long term, continuous use.

This information is used to provide for special accommodations and faculty awareness and does not influence admission decisions. We at DECATS at St. Rose of Lima are committed to inclusion and eager to serve gifted Scholars who have neurological, emotional, or physical differences.

Enter none if not applicable.

Acceptable Use Policy for the Use of Computers and Telecommunications

Students are responsible for appropriate behavior on St. Rose of Lima's and DECATS' computer network, just as they are in the classroom. General school standards regarding proper conduct apply to students using computers. The use of computer resources is a privilege, not a right. If the privilege is abused, it may be revoked, and additional disciplinary actions may be applied.

The user will be personally responsible for his / her actions in accessing St. Rose of Lima and DECATS computer resources. The user will be personally responsible for his / her actions when using St. Rose of Lima / DECATS equipment to access resources outside of the school network. Computer storage space is treated in the same fashion as school lockers: administrators and technical support personnel may review computer content to maintain system integrity and ensure that students are using the system responsibly. These routine searches may occur at any time for any reason. The following defines the terms for usage of computers and telecommunications at DECATS at St. Rose of Lima.

The computer hardware and software at St. Rose of Lima are the property of St. Rose of Lima Catholic School and DeBusk Enrichment Center for Academically Talented Scholars. Computer hardware, software, and network configuration are not to be modified in any manner. Changing of computer configuration includes, but is not limited to, changes made through the Control Panel of the Microsoft Windows operating system. The copying of St. Rose of Lima / DECATS computer software constitutes theft.
DECATS reserves the exclusive right to represent itself on the Internet. The DECATS name and all web contents, including, but not limited to, any descriptions, graphics, and photographs, are the sole property of DECATS and may not be used in any form without express written permission from the administration of DECATS.
Students and staff are expressly prohibited from creating, maintaining, and / or contributing to any website that purports to contain information concerning DECATS at St. Rose of Lima, any of its courses, practices, activities, or personnel.
Students may not attempt to access or alter the main network operating system or the computer storage space of another individual. Sharing passwords is forbidden.
Computers are to be used solely for bona-fide educational research and composition purposes. They are not under any circumstances to be used as a communication device. This includes, but is not limited to, accessing chat rooms, message boards, web or personal e-mail accounts, net messaging, or instant messaging systems. The playing of games is expressly forbidden. The downloading and storing of MP3s, movies, and / or videos is also not allowed.
Accessing websites which feature inappropriate material is also expressly forbidden. Inappropriate material can be defined as, but is not limited to, content containing material of a sexually explicit nature, online auctions, and web shopping. Except in the very rare cases of legitimate research, websites that advocate violence, racism, or illegal activities of any type will also be considered inappropriate. Any inappropriate material received innocently should be reported immediately to the supervising mentor.
Permission to transfer files by any means between home and St. Rose of Lima must be approved by the Communications Director. This includes, but is not limited to, transfer by means of the Internet and any media form (floppy, CD, DVD, flash drive, etc).
Students may not load, download, or install any type of software for any reason without the express consent of the Communications Director.
Only DECATS usernames and passwords are to be used while DECATS is in session. Students are not permitted at any time to use any network account issued by St. Rose of Lima to log on to any computer on campus. Students also may not use logon criterion of his / her parents who are employees at St. Rose of Lima. Students must be logged on to the network under the supervision of DECATS staff. The computer terminal must always be supervised while accessing computer resources.

The consequences of violation of these usage policies include the full range of disciplinary measures and the imposition of monetary fines to compensate St. Rose of Lima and DECATS for the time and materials necessary to repair any damage caused by the student.

By entering your name below where specified, you agree to the terms listed above in the DECATS Acceptable Use Policy for the Use of Computers and Telecommunications. You understand that the purpose of this agreement is to allow you / your Scholar to fully utilize St. Rose of Lima and DECATS computer resources in a safe manner. You recognize the need for each of these standards and understand that violation of these standards includes the consequences listed in this contract.

Graduate Assistant's Signature A value is required.

Parent / Guardian Signature A value is required.

Publications Agreement

DECATS at St. Rose of Lima is excited to produce many publications dedicated to the promotion and propagation of information about the DECATS adventure. Photographs and video are key items in the continued success of publications like DECATS Online and the DECATS DVD.

Pictures and video are taken at various points during each day. Both are instrumental as we continue to chronicle the legacy of DECATS in Houston and at St. Rose of Lima.

I acknowledge that DECATS will be taking video and photographs of the participants at DECATS 2009 at St. Rose of Lima for usage in DECATS publications, including, but not limited to, DECATS Online, the official DECATS website located at http://www.decats.org; and the DECATS DVD, a yearly product created for families and schools to celebrate and commemorate the summer session.

I understand that many pictures and videos will be taken and used at the discretion of DECATS. I also understand that any pictures and videos taken are for the exclusive use of DECATS. All DECATS publications are eligible for distribution among past, current, and future participants of DECATS, participant schools and teachers, and DeBusk Foundation Board Members, as well as select persons and groups, for the sole purpose of promotion of the program. All photographs and videos are screened before being included in any DECATS publication.

This agreement begins the date signed and does not expire. Photographs and video taken are the permanent and exclusive property of DECATS at St. Rose of Lima and will be used at the discretion of DECATS.

Graduate Assistant's Signature A value is required.

Parent / Guardian Signature A value is required.

Please verify that all information above is correct before submitting your application.