Math/Science Magnet Program at Morris Hills



COMMON APPLICATION PACKET

Deadline: January 7, 2011

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Completion Instructions: The application below should be completed electronically. Use the “Tab” key to move forward between fields in the application or the “Shift” + “Tab” keys to move backward through the fields. Please complete all required information and then print the completed application. Once the application is completed, please obtain the required signatures and documents and return the entire packet to the address at the end of this packet. All applications must be return by January 7, 2011.

|I am applying for: | IB |Math Science Magnet | Both | |

SECTION 1: Personal Information

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|Last Name | |First Name | |M.I. |

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|Street Address | |Apartment # | |

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|City/Town | |State | |Zip Code | |

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|(     )      -      | | | |(     )      -      | | |

|Home Phone | | | |Cell Phone | | |

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|Parent E-mail | | | |Student E-mail | | |

|Ethnic Information (Optional): Ethnic information is required by the US Department of Health, Education and Welfare Office for Civil Rights. The |

|Morris Hills Regional High School District does not discriminate in its admission policies and practices on the basis of race, color, national |

|origin, sex, or disability. Morris Hills Values Diversity AA/EEO |

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|Please check one: | | | |Please check one: | |

| | |If other, please specify       | | Male Female | |

SECTION 2: Academic Background (To be signed by school counselor/administrator)

Below, please select your current middle school:

If other, please specify,      

Which high school would you attend if you were not applying to the magnet program?

If other, please specify,      

Are you currently enrolled in Algebra I? Yes No

Are you currently enrolled in: Spanish French Other No 2nd language

Is this program: Full Year Partial Year

Are you applying to any other specialized programs?

Yes No If yes, which program?      

Does the applicant currently have or utilize:

an IEP? Yes No If yes, classification      

504 Plan? Yes No

ESL course? Yes No

Has the applicant received Basic Skills services in the past two years?

Language Arts Yes No

Mathematics Yes No

Literacy Yes No

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|Print Name of Administrator or Counselor | |Phone Number |

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|Signature of Administrator or Counselor | |Date |

Parent/Guardian Release Statement

I have discussed this application with my child and hereby give permission for him/her to apply for admission to the International Baccalaureate (IB) Program at Morris Knolls or the Math and Science Magnet Program at Morris Hills High School.

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| | |     /     /      |

|Student Signature | |Date |

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|Parent/Guardian Signature | |Date |

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Your answers to these questions will not impact admissions decisions.

Pleas⁥慨敶礠畯⁲畧摩湡散挠畯獮汥牯漠⁲摡業楮瑳慲楴湯愠瑴捡⁨桴⁥潦汬睯湩⁧潤畣敭瑮⁳潴琠楨⁳灡汰捩瑡潩湡⁤敲畴湲ഺ潃灭敬整琠慲獮牣灩⁴牦浯䜠慲敤㜠愠摮儠慵瑲牥ㄠ漠⁦片摡⁥സ瑁整摮湡散爠捥牯⁤椨⁦潮⁴敲潣摲摥漠牴湡捳楲瑰ഩ楄捳灩楬敮删捥牯൤瑓湡慤摲穩摥吠獥⁴敒畳瑬⁳牦浯朠慲敤⁳ⴶസ桃汩⁤瑓摵⁹敔浡删捥牯獤㔯㐰倠慬椨⁦灡汰捩扡敬ഩ潃灭敬整⁤敲潣浭湥慤楴e have your guidance counselor or administration attach the following documents to this application and return:

Complete transcript from Grade 7 and Quarter 1 of Grade 8

Attendance record (if not recorded on transcript)

Discipline Record

Standardized Test Results from grades 6-8

Child Study Team Records/504 Plan (if applicable)

Completed recommendation forms

Please return completed application packet by

January 7, 2011 to:

Morris Hills Regional School District

Attn: Mrs. Nisha Zoellor

48 Knoll Drive

Rockaway, NJ 07866

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