Delta Magnet School of Academic and Performing Arts

Delta Magnet School of Academic and Performing Arts

2016-2017 STUDENT APPLICATION FORM

• Applications will be accepted at Delta Magnet School or the Morehouse Parish School Board fromMarch 1-June 24, 2016. Please complete only one application per child.
• Student records will be checked to verify grade point average(2.2 or higher), attendance (no more than 10 absences per school term), and behavior (no more than 3 major referrals per school term). Please attach a copy of the student’s most recent report card. It must include the student’s behavior and attendance information. Failure to do so may result in the application’s denial.
• If the student is selected, a parent and student interview/conference must beconducted to complete the acceptance process. Once the acceptance contract is signed, the student may not transfer to another school within the parish during the current school year. (Exceptions may apply if the student is consistently within violation of the behavior/discipline policies and contract set by MPSB and/or Delta Magnet. Any student who consistently violates the school’s and/or bus’ rules may be sent back to his/her home-based school.)

Grade for 2016-2017 School Year ______Social Security Number ______-______-_____

Student’s Name: ______Date of Birth ______

Last First Middle

Home Address: ______Home Phone ______

Street City State Zip

Mailing Address: ______

P.O. Box/Route/Street City State Zip

Sex: ____ Male ____ Female Race (Optional): ____ Black ____White ____ Asian ____Hispanic ____ Other

Current School: ______(School attended at the end of May 2016)

Mother/Guardian: ______Cell/Work Phone: ______

Father/Guardian: ______Cell/Work Phone: ______

EMERGENCY CONTACTS:

Name: ______Relationship: ______Phone: ______

Name: ______Relationship: ______Phone: ______

There is a sibling preference policy. It is the applicant’s responsibility to identify siblings. Failure to do so will result in the loss of this privilege. Please give the names of brothers and/or sisters who are currently attending or plan to attend Delta Magnet School.

______

Name Grade Name Grade

______

Name Grade Name Grade

In order for the school to offer the best services and practices in education, we’re requesting that the following questions be answered to the best of your knowledge concerning the student’s needs:

Is the student currently receiving any special services, e.g. special education, gifted/talented, 504?

_____ Yes _____ No: If “Yes,” which service is the student currently receiving? ______

Does the student have a disability or disabilities for which accommodations or modifications are required?

_____ Yes _____ No _____ Unsure: If “Yes,” what is the disability/disabilities? ______

Is the disability academic or physical? ______

What accommodation(s) or modification(s) are required?

______

Please sign verifying that the information on this application is complete and accurate.

______

Parent or Guardian’s SignatureDate

NOTE: The student’s most recent report card must be attached with this application for it to be considered for review. The report card must include the student’s behavior and attendance records. The application is subject to denial if the requested information is not provided.