Read MCM-Application-RegistrationForm_C1.pdf text version

HOWARD D. McMILLAN MIDDLE SCHOOL / CAMBRIDGE ROBOTICS

ENGINEERING and TECHNOLOGY EDUCATION (CREATE) ACADEMY

MAGNET APPLICATION

THE CAMBRIDGE ROBOTICS ENGINEERING AND TECHNOLOGY EDUCATION (CREATE) ACADEMY AT HOWARD D. MCMILLAN MIDDLE SCHOOL is a magnet program of the Miami-Dade County Public School System. This program is based on the academy model, utilizing the International Cambridge Curriculum with advanced academics in Science, Mathematics and English applied to Robotic Engineering concepts. This magnet academy has real world applications in medicine, law enforcement, military services, aerospace and automotive industries.

DIRECTIONS: 1. Applications MUST be received by July 20, 2011. 2. Use black or blue ink to fully complete the application. 3. Read and sign the Agreement of Understanding. ELIGIBILITY REQUIREMENTS: · Must maintain a cumulative 2.00 GPA or higher in core subjects · Must have a minimum 2.00 or higher in conduct · Students who have ten (10) or more absences/tardies may be excluded

Please use the student's legal name as indicated on birth certificate. Do not use nicknames, assumed names, etc.

Student Last Name Student Birthdate (MM/DD/YYYY) Student Address - Number and Street ZIP State

First Name Gender (circle one) Social Security #

Male | Female

Middle Name Current Grade M-DCPS Student ID Number Apt. # City

School Student Currently Attends

Public School? Yes

Yes Yes

No No No

1. Is parent presently serving in the active military or full-time Reserves? (Documentation Required - Send to School) 2. Is the student applying as a twin or triplet to the same magnet? If you answer YES to question 2, provide the following required information: Last Name First Name

Twin M-DCPS ID Number (REQUIRED)

Parent/Guardian Last Name Relationship to Student E-Mail Address

First Name (Area Code) Home Phone (Area Code) Work Phone

AGREEMENT OF UNDERSTANDING - I, hereby, give permission for my child to be screened for admission to the selected magnet program(s) designated in

this application. If accepted, he/she will be enrolled as a full-time student at the school of acceptance. Transportation availability is limited and may not be available to all students. My child must demonstrate acceptable performance (as determined by school-site policy) in order to remain in the magnet program. This application becomes void at the end of the application period.

Parent/Guardian Signature Parent/Guardian Name (PLEASE PRINT)

Date

APPLICATION FORM DEADLINE: July 20, 2011

SUBMIT ORIGINAL COMPLETED APPLICATION FORM TO: HOWARD D. McMILLAN MIDDLE SCHOOL 13100 SW 59 STREET MIAMI, FL 33183 PHONE: (305) 385-6877

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