/ IndependentSchool District 191
Application forEagle Ridge Junior High School Gifted and TalentedMagnet Program
2015-2016 School Year / Mail, fax, or deliver to:
Eagle Ridge Junior High School
Gifted and Talented Magnet Program
Attn: Guidance Office
13955 Glendale Road
Savage, MN 55378
PH (952) 707-2808
FAX (952) 707-2802
DEADLINE: This application must be receivedat Eagle Ridge Junior High School by 4:00 p.m. on Friday, January30, 2015 to be eligible for the selection process for available spaces in this magnet program. Notification of placement will occur by Monday, February 9, 2015.
Magnet School Applicant
Last Name, First name / Gender
(F or M) / Date of Birth
(mm/dd/year) / Grade Level
Fall of 2015 / Current School / Student ID #

Documentation of student test scores and recommendations are attached. (See Matrix for Identification and Gifted Magnet School

Identification Criteria.)

Applicant needs to take theNaglieri Non-Verbal Ability Test (NNAT2). Offered ONLY to students with no previous testing history.

Applicant has the following sibling(s) currently attending Eagle Ridge Junior High School:

Sibling’s Name(s)______Grade Level in Fall 2014______

Parent/Guardian Information (Last Name, First Name)

Name______Address

City, State, ZIP______Email______

Home Phone______Work Phone______Cell Phone

Parent/Guardian Information (Last Name, First Name)

Name______Address______

City, State, ZIP______Email______

Home Phone______Work Phone______Cell Phone______

The Minnesota Department of Education requires that we collect racial/ethnic information in the following manner. Please CHECK ONE category that best describes your child's racial/ethnic background.

1. American Indian 2. Asian or Pacific Islander 3. Hispanic 4. Black, not of Hispanic origin 5.White, not of Hispanic origin

I have read the “Eagle Ridge Junior High School Gifted and Talented Magnet Program Enrollment Process: Terms & Conditions.”

Parent/Guardian Agreement: This application has been filled out by a parent with custodial authority or by a legal guardian. The information I have provided here is accurate to the best of my knowledge. I understand and agree to the Eagle Ridge Junior High School Gifted and Talented Magnet Program Enrollment Process: Terms & Conditions.

______

Parent/Guardian Signature Date

Si usted habla español y tiene preguntas, favor de llamar al teléfono Mary Lopez 952-707-2866

.

Eagle Ridge Junior High School
Gifted and Talented Magnet Program
Enrollment Process: Terms & Conditions

• Any junior high-aged student who lives within Independent School District 191 or Independent School District 194 has the opportunity to apply to any of the magnet schools. Families from outside these two districts are encouraged to apply, and will be considered for admission to Eagle Ridge according to the groupings within each tier of placement (See Identification Criteria).

• Morning and afternoon transportation may be provided to all District 191 and District 194 students, according to the standards set forth in Policy EEA-R, Student Transportation Services. This has not yet been determined by the Board of Education.

• Once enrolled, students may remain at the magnet school as long as their enrollment continues uninterrupted.

Enrollment in this magnet school

Placements will occur from the following groups, in this order, using the Matrix for Identification, and Tiers of Placement process, alternating by gender (magnet school application, recommendations and testing information are necessary):

a) Qualified students who live within Independent School District 191 or 194 attendance areas.

b) Qualified students who live outside the Independent School District 191 or 194 attendance area.

Completed applications must be received in Eagle Ridge Junior High School office by 4:00 p.m. on Friday, January 30, 2015.

When complete, please mail or fax this form by January 30, 2015directly to:

Eagle Ridge Junior High School Gifted and Talented Magnet Program

Attn: Guidance Office

13955 Glendale Road

Savage, MN 55378

Don Leake (Principal): 952-707-2801

Michelle Henderson (Guidance Counselor A-K): 952-707-2814

Scott Harrison (Guidance Counselor L-Z): 952-707-2978

Fax: 952-707-2802

Please take a moment to tell us how you heard about our school:

Newspaper article Web site information Teacher or other school personnel

Brochure or other mailing Neighbor/friend/other parent Other (please specify below)