THE CLEVELAND SCHOOL OF ARCHITECTURE AND DESIGN
Student Application 2014-15 School Year (Page 1 of 10)
John Hay Campus 2075 Stokes Boulevard - Cleveland, Ohio 44106
“The primary goal of the Cleveland Metropolitan School District is to become a premier school district in the United States of America”
Due Date(s): Tuesday, November 5, 2013
Tuesday, January 28, 2014
Tuesday, April 8, 2014
Student Name Last: ___________________ First: __________________
Thank you for your interest in John Hay!! Our curriculum at John Hay is very rigorous and we have high expectations for our students. We have listed below some of the factors that each small school will use to determine admissions into John Hay for the 2014-15 school year.
• Interview with the principal and/or staff
• Entrance exam
• Good attendance
• O.A.T. Scores Proficient or Higher in Reading and Math
• O.G.T. Scores Proficient in all subjects
• GPA Requirements (See below for each small school)
Please indicate which particular small school at John Hay Campus is your first or second choice by writing 1or 2 in the order you are interested in applying for them:
__ School of Architecture and Design School Office Number: 229-0100
Tianna Maxey, Principal School Office Hours: 7:30 a.m. to 3:30 p.m.
GPA Requirement: 3.0
___ Cleveland Early College High School School Office Number: 229-0200
Carol Lockhart, Principal School Office Hours: 7:30 a.m. to 3:30 p.m.
GPA Requirement: 3.5
Pursuing Academic Excellence through a Rigorous, Relevant Curriculum and Meaningful Relationships
ALL of the following items must be included with your application:
□ Complete Application.. Pages 1-4, 5-6, 7-8, 9-10
□ A copy of the most current report card reflecting the GPA Requirement
□ A copy of current O.A.A. Scores or O.G.T. Scores
Date application was received by the John Hay Campus: ___________________
(School officials will insert the date the application is received)
John Hay Campus does not discriminate on the basis of race, color, religion, national or ethnic origin.
Revised 6-19-13
Student Application (Page 2 of 10)
Student Essay
Please tell us about yourself. What are your favorite subjects in school, are you involved in any extracurricular activities and why would you like to attend one of the small schools at John Hay?
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Student Name: _______________________________________
Student Application (Page 3 of 10)
Student’s name ______________________________________________________________________________________________________
(Please print) Last First Middle
Home address ______________________________________________________________________________________________
City ________________________________________________ State ____________________ Zip __________________________
For grade _______ Current Age: __________ Date of birth ____________________ Gender: M_______F _____
Month/Day/Year
__________________________________________________________________________________________________
Please complete the following Parent/Guardian information:
_____ Mother _____Guardian _____Father _____Guardian
Mother’s Name ____________________________________ Father’s Name ____________________________________
Home address _____________________________________ Home address _____________________________________
City _______________State __________Zip_____________ City ________________State __________Zip____________
Home Phone ______________________________________ Home Phone ______________________________________
Cell Phone ________________________________________ Cell Phone ________________________________________
E-mail ____________________________________________ E-mail ____________________________________________
Occupation/Position ________________________________ Occupation/Position _______________________________
Name of employer _________________________________ Name of employer _________________________________
Business address ___________________________________ Business address __________________________________
City _______________State __________Zip_____________ City _______________State __________Zip_____________
Work Phone _______________________________________ Work Phone_______________________________________
____ Single ____ Married ____Divorced ____ Deceased ____ Single ____ Married ____Divorced ____ Deceased
Relatives or friends who are students at John Hay Campus:
Name ________________________________________ Grade ________________ Relationship ___________________________
Name ________________________________________ Grade ________________ Relationship ___________________________
Student Application (Page 4 of 10)
Parent and/or Guardian Informational Questionnaire
Please complete all sections on this page and sign at the bottom. Thank you
Student’s Current School _____________________________________________________ Current Grade Level ___________
Address ____________________________________________________________________________________________________
City _________________________________________________________ State _________________________ Zip ____________
Guidance Counselor ____________________________________________________ Phone ______________________________
Principal ______________________________________________________________ Phone ______________________________
Please attach a copy of your child’s most current report card to this application. Thank you.
1. Does your child require any special personal and/or academic support at home or at school?
(Tutoring, counseling, medical, etc.?) Please specify and explain.
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. What else would you like for us to know about your child?
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Has the student ever attended or applied to John Hay Campus in the past? _____ No _____Yes
If yes, to which small school? _______________________________________________________________________
I/We have provided accurate information and agree that John Hay Campus may contact the school and persons listed herein for further information. If this application leads to the candidate’s attendance at John Hay Campus, I/we agree to the policies and regulations as set by Cleveland Metropolitan School District and John Hay Campus.
Signature of parent or guardian _____________________________________________________ Date ____________________
Student Application (Page 5 of 10)
Principal or Guidance Counselor Recommendation
Please check the small school that the student is applying for: Thank you.
_____ Architecture and Design ______ Early College
Student’s Name______________________________________________ Current Grade Level _______________
The items below ask for your sense of this student’s emotional and social growth, intellectual development and relationships within the school community. All of the information that you furnish will be kept confidential. Please check one box for each section listed below.
Academic Achievement ( Far above expectations ( Better than expected ( As expected
( Below expectations ( No basis for judgment
Self-Motivation ( Well-motivated ( Some desire to learn ( Only what is required
( Does little ( No basis for judgment
Effort ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Follows Directions ( Always ( Frequently ( Sometimes
( Rarely ( No basis for judgment
Ability to work with others ( Excellent ( Good ( Limited
( Poor ( No basis for judgment
Ability to work alone ( Does well ( Needs help occasionally ( Needs help frequently
( Needs supervision ( No basis for judgment
Content knowledge ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Organizational skills ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Study Skills ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Student Application (Page 6 of 10)
Principal or Guidance Counselor Recommendation (Continued)
Problem Solving ( Very familiar ( Familiar ( Needs help
( Limited ( No basis for judgment
Completes Assignments ( On time ( Late ( Sometimes
( Hardly ever ( No basis for judgment
General Behavior ( Outstanding ( Good ( Fair
( Poor ( No basis for judgment
Uses suggestions ( Always ( Usually ( Sometimes
( Rarely ( No basis for judgment
I recommend this student in terms of both academic ability and character:
( Enthusiastically ( Strongly
( With mild enthusiasm ( Without enthusiasm
Please explain:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Name of Principal or Guidance Counselor completing recommendation
_________________________________________________________
Length of time acquainted with student ______________________________________________________________
Name of school____________________________________________________________________________________
Address __________________________________________________________________________________________
City ___________________________________________ State __________________________ Zip _______________
May we contact you for further information? Yes No If yes, phone number ______________________
Signed ___________________________________________________________________________________________
Student Application (Page 7 of 10)
English Teacher Recommendation
Please check the small school that the student is applying for: Thank you.
______Architecture and Design ______Early College
Student’s Name_____________________________________________ Current Grade Level _______________
The items below ask for your sense of this student’s emotional and social growth, intellectual development and relationships within the school community. All of the information that you furnish will be kept confidential. Please check one box for each section listed below.
Academic Achievement ( Far above expectations ( Better than expected ( As expected
( Below expectations ( No basis for judgment
Self-Motivation ( Well-motivated ( Some desire to learn ( Only what is required
( Does little ( No basis for judgment
Effort ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Follows Directions ( Always ( Frequently ( Sometimes
( Rarely ( No basis for judgment
Ability to work with others ( Excellent ( Good ( Limited
( Poor ( No basis for judgment
Ability to work alone ( Does well ( Needs help occasionally ( Needs help frequently
( Needs supervision ( No basis for judgment
Content knowledge ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Organizational skills ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Study Skills ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Student Application (Page 8 of 10)
English Teacher Recommendation (Continued)
Problem Solving ( Very familiar ( Familiar ( Needs help
( Limited ( No basis for judgment
Completes Assignments ( On time ( Late ( Sometimes
( Hardly ever ( No basis for judgment
General Behavior ( Outstanding ( Good ( Fair
( Poor ( No basis for judgment
Uses suggestions ( Always ( Usually ( Sometimes
( Rarely ( No basis for judgment
I recommend this student in terms of both academic ability and character:
( Enthusiastically ( Strongly
( With mild enthusiasm ( Without enthusiasm
Please explain:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Name of teacher completing recommendation
_________________________________________________________
Length of time acquainted with student ______________________________________________________________
Name of school____________________________________________________________________________________
Address __________________________________________________________________________________________
City ___________________________________________ State __________________________ Zip _______________
May we contact you for further information? Yes No If yes, phone number ______________________
Signed ___________________________________________________________________________________________
Student Application (Page 9 of 10)
Mathematics Teacher Recommendation
Please check the small school that the student is applying for: Thank you.
______Architecture and Design ______Early College
Student’s Name_____________________________________________ Current Grade Level _______________
The items below ask for your sense of this student’s emotional and social growth, intellectual development and relationships within the school community. All of the information that you furnish will be kept confidential. Please check one box for each section listed below.
Academic Achievement ( Far above expectations ( Better than expected ( As expected
( Below expectations ( No basis for judgment
Self-Motivation ( Well-motivated ( Some desire to learn ( Only what is required
( Does little ( No basis for judgment
Effort ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Follows Directions ( Always ( Frequently ( Sometimes
( Rarely ( No basis for judgment
Ability to work with others ( Excellent ( Good ( Limited
( Poor ( No basis for judgment
Ability to work alone ( Does well ( Needs help occasionally ( Needs help frequently
( Needs supervision ( No basis for judgment
Content knowledge ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Organizational skills ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Study Skills ( Excellent ( Good ( Fair
( Poor ( No basis for judgment
Student Application (Page 10 of 10)
Mathematics Teacher Recommendation (Continued)
Problem Solving ( Very familiar ( Familiar ( Needs help
( Limited ( No basis for judgment
Completes Assignments ( On time ( Late ( Sometimes
( Hardly ever ( No basis for judgment
General Behavior ( Outstanding ( Good ( Fair
( Poor ( No basis for judgment
Uses suggestions ( Always ( Usually ( Sometimes
( Rarely ( No basis for judgment
I recommend this student in terms of both academic ability and character:
( Enthusiastically ( Strongly
( With mild enthusiasm ( Without enthusiasm
Please explain:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Name of teacher completing application
______________________________________________________________
Length of time acquainted with student ______________________________________________________________
Name of school____________________________________________________________________________________
Address __________________________________________________________________________________________
City ___________________________________________ State __________________________ Zip _______________
May we contact you for further information? Yes No If yes, phone number ______________________
Signed ___________________________________________________________________________________________
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