Do not use this form to apply to a Vanguard school.

If you need a Vanguard application form, contact your school or the Vanguard program in which you are interested.

ELEMENTARY SCHOOL MAGNET PROGRAMS APPLICATION FOR 20122013

MAGNET SCHOOL PROGRAM APPLYING TO:_______________________________________________________________________________________________________________
School Name

How to Apply: To be considered in the first round of screening, your application must be postmarked or delivered in person no later than January 6, 2012. Applications received after the deadline will be considered on a space-available basis. Out-of-district applicants may be considered on a space-available basis after June 4, 2012. Complete one application for each Magnet program to which you are applying. If you are applying for a Vanguard Magnet program, you must complete only a Vanguard application. To obtain a copy of the Vanguard application, contact the Vanguard Magnet school you are interested in or download one from [Link]/magnet. You will be notified by mail of the status of your application on March 23, 2012. No status updates can be given before this date. For your application to be complete, you must supply copies of the following to each school where you apply: Kindergarten or first time in HISD Proof of age 5 by 9/1/2012 (copy of birth certificate preferred) Pre-K Progress Report (if applicable) Grades 15 First grading period of current report card Previous years final report card

Proof of HISD residency is required for all applicants (apartment rent receipt, utility bill receipt, or statement of residence).

1. Name of student: __________________________________________________________________________________________________________________

Last First Middle

HISD Student I.D.#: _________________________________ Grade level for 20122013: _________________________________________________________ (Age as of Sept. 1, 2012) _______ q Asian q White Sex: q Male q Female q Black/African American

2. Date of birth: Month ________ Day ________ Year ___________ 3. Ethnicity*: q Hispanic/Latino q Not Hispanic/Latino
___________________________________ City ________________ State

Race*: q American Indian/Alaskan Native q Native Hawaiian/Other Pacific Islander

Street Address ______________________________ ZIP Code

4. Present address of parent or legal guardian (domicile): ___________________________________________________________________________________

Apt. # __________________________________________________________________________ E-mail

5.

________________________________________________________ Home Phone Number

______________________________________________________________________________________________________________ Emergency Phone Number, Name and Relationship to Child

6. With whom does student live as a permanent resident? q Both parents q Mother q Father q Other Fathers name: __________________________________________________ Mothers name: __________________________________________________ 7. Guardians name:________________________________________________ ______________________________________________________________
Fathers Business Phone (Documentation of guardianship will be required at time of registration.)

_______________________________________________________________
Mothers Business Phone

______________________________________________________________
Fathers Cell Phone

_______________________________________________________________
Mothers Cell Phone

8. Is either parent/guardian an HISD employee: q Yes q No Employee I.D.#: ___________________________________________________________________ 9. If eligible, are you requesting HISD bus transportation? q Yes q No 10. School currently attending: _______________________________________________________________________________ Current grade level: ________ 11. Elementary school student zoned to attend: ____________________________________________________________________________________________ 12. Does the student have a brother or sister attending this Magnet school? q Yes q No 13. Does the student have a brother or sister applying to this Magnet school? q Yes q No If yes to either of the above questions, siblings name(s) and grade(s): ________________________________________________________________________

Parent Signature: __________________________________________________________________________ Date: ______________________________________

* The information is requested in accordance with the Public Education Information Management System (PEIMS) and federal regulations.

FOR OFFICE USE ONLY: Date Received: _______________

OVERPLEASE SEE BACK

General Information: Refer to the Office of School Choice catalog for additional information about programs. Many elementary Magnets are School-Wide Programs (SWP). If a child is zoned to a school, qualified for the Magnet offered, and decides to attend that zoned school, he/she will automatically participate in the Magnet Program. No application is needed to participate in a SWP. If you wish to participate in your zoned schools Magnet program, please talk with the Magnet Coordinator to determine if you need to submit an application. Students must submit a Magnet application to be considered for any Magnet program to which he/she is not zoned. HISD provides bus transportation for Magnet students in accordance with the Transportation of Magnet Students Guidelines.

HISD Elementary School Magnet Programs by Focus Area

Math ,Science, and/or Technology Berry ES (Environmental Science) Cornelius ES (Math and Science) Elrod ES (Math, Science, and Technology) Harvard ES (Math, Science, and Technology) Herrera ES (Integrated Technology) Lantrip ES (Environmental Science) Law ES (S.T.E.M. : Science, Technology, Engineering and Math) Lockhart ES (Math, Science, and Technology) Pugh ES (Science/Computer) Red ES (S.T.E.M. : Science, Technology, Engineering and Math) The Rice School K-8 (Spanish and Technology) Ross ES (Math and Science) The Rusk School K-8 (Science Technology) Sinclair ES (Communication/Technology) Valley West ES (S.T.E.M. : Science, Technology, Engineering and Math) Wainwright ES (Math and Science) Wesley ES (Math, Science, and Technology) West University ES (Math and Science) Whidby ES (Medical Health Science) Academy Horn ES Leadership Durham ES Montessori
(Grades 3-8 require previous Montessori experience)

Languages Mandarin Chinese Language Immersion School Literature Patterson ES Twain ES Kolter ES (Foreign Languages Languages and Culture) Kolter ES (Foreign Indicate First and Second Languages and Culture) Choice Languages: Indicate First and Second ___ French ___ Spanish Choice Languages: ___ Chinese ___ French ___ Spanish ___ Chinese

Dodson PK-7 Garden Oaks PK-6 Wilson PK-8

Dual Language Wharton K-8 Helms ES

Vanguard (Gifted and Talented) Note: Students not already in the Vanguard Program require testing. Schools will contact students to schedule testing. Askew ES Carillo ES DeZavala ES Herod ES Oak Forest ES Pleasantville ES Windsor Village ES River Oaks ES T.H. Rogers K-8 Roosevelt ES Travis ES

Fine Arts Magnet Programs Bell ES Bruce ES Crespo ES Garden Villas ES Parker ES Poe ES Garden Villas Music ONLY: Applicants choose: __Suzuki Violin __Choir __Band __Piano __Orchestra Parker Music Academy ONLY: Kinder applicants choose one: __ Suzuki Violin __ Suzuki Cello __ Music Enrichment

Burbank ES Gregory-Lincoln K-8 Roberts ES

Burrus ES Longfellow ES Scroggins ES

Codwell ES Lovett ES

Cook ES MacGregor ES

First grade choose a 1st and a 2nd choice: __ Suzuki Violin __ Suzuki Cello __ Music Enrichment __ Piano __ Rhythm Band

Second-fifth choose a 1st and a 2nd choice: __ Suzuki Violin __ Suzuki Cello __ Piano __ Band (3rd5th graders) __ Pre-Band (2nd grade only) __ Guitar

To apply to a Vanguard Magnet program, use a Vanguard application, which is due January 6, 2012.
Contact the school you are interested in for an application or download one from [Link]/magnet.

How did you hear about us? ______________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________

It is the policy of the Houston Independent School District not to discriminate on the basis of age, color, handicap or disability, ancestry, national origin, marital status, race, religion, sex, veteran status, political affiliation, sexual orientation, gender identity and/or gender expression in its educational or employment programs and activities. ES Magnet ApplicationRevised 9/11