MECPS GRADE SIX 2015 -2016 APPLICATION October 10, 2014 Dear Parent/Guardian: We are pleased to provide applications for the incoming 6th Grade Class of Medgar Evers College Preparatory School Early High School program for school year 2015-2016. Students who meet the following criteria are eligible to participate in the application process:  A performance level of 3 or 4 on the New York State 4th Grade ELA and Mathematics Common Core Tests respectively.  A rating of good or excellent in all subject areas, attendance, punctuality, social/personal development, and work/study habits. If your child meets the criteria above and you would like him/her to participate in the application process, you must complete the attached application and return it with copies of the following:    June 2014 report card (4th Grade). November 2014 report card (current 5th Grade), and 4th grade New York State ELA and Mathematics Common Core Test Scores. Please submit your child’s application materials no later than Wednesday, January 7, 2015. Applications submitted without the proper documentation will not be processed. Upon complete and timely submission of all the above documentation, he/she will be eligible to:    Take a placement examination on Saturday, February 7, 2015 at MECPS. If you are a Sabbath Observer and your child is unable to take the exam on this date, please submit documentation along with your application. Receive an invitation to the Parent & Child Interview at a later date. You will be notified (by mail only) for the test and the interview. Students who are accepted in the Program will be required to attend our Mandatory Summer Program. Rubric for 6TH Grade Admissions Special Talent  Athletics  Music  Fine Arts  Dance 15 points Attendance and punctuality (90% and above) 10 points State Tests      Levels Levels Levels Levels Levels 4/4 4/3 3/3 3/2 2/2 50 points 40 points 30 points 20 points 10 points Report Card Average Average Average 90+ Average 80 – 89 Below 80 Parent/Child Interview 40 points 30 points 10 points 10 points Additional selection criteria  Conduct must be exemplary  Students will be ranked based on their total score  Eighty students with the highest total score will be considered for admission  Parent and student must be fully committed to Summer School. _____________________________________________________________ 1186 Carroll Street ▪ Brooklyn NY, 11225 ▪ (718) 703-5400 ▪ (718) 703-5600 (Fax) “Dedicated to Excellence” Please return the completed application to Ms. A. Smith (AP of Pupil Personnel) by Wednesday, January 7, 2015 Late applications will not be considered! MECPS 2015 - 2016 GRADE SIX APPLICATION (PART 1) STUDENT/PARENT INFORMATION STUDENT OSIS # __________________________________ Student’s Name: __________________________________________________________________________ (Last, First) D.O.B.: _____________________________ (MM/DD/YR) Male/Female: __________ (Choose M or F) Present Grade: _________ School Presently Attending: _______________________________________________________________ Student’s Home Language: English/Spanish/French/Creole/Other: _____________________________ (Choose Language) Parent/Guardian(s) Name: _________________________________________________________________ Relationship: __________________ Address: _________________________________ City: ________________ State: _______ Zip: ________ Home Telephone: _____________________ Work: ____________________ Cell: ___________________ {Mailing Address, if different from above:} Address: _________________________________ City: ________________ State: _______ Zip: ________ I certify that all of the information submitted with this application is correct. I hereby give permission to MECPS to enter my child in the application process for the school year 2015-2016. Student Signature: ______________________________________ Date:________________________ Parent/Guardian(s) Signature: ____________________________ Date:________________________ (PART II) TO BE COMPLETED BY GUIDANCE COUNSELOR Standardized Tests Test Date Scale Score Level Reading Math (NYS) Enter attendance for the previous year. If there are no absences or lateness’s, enter “0”. Whole Days Absent: Half Days Absent: Days Late: Extenuating circumstances for absences YES Explanation: □ Enter Current Report - Fall 2014 Report Check Check Subject Name Card if Bilingual if Accelerated English Mathematics Social Studies Science Conduct Complete the item below for Special Education and Resource Room Students Indicate Program: □ Resource Room □ MIS I □ MIS II Complete items below for Bilingual/ESL eligible Students Entitled to Bilingual/ESL (Check here) NYSESLAT □ Yes READING Test Date: (Month/Yr) Student’s Home Language: □ Haitian/Creole Years in an English Language School System by the end of this year. WRITING □ Spanish □ 0-1 Guidance Counselor Signature: ________________________________ LISTENING □ SPEAKING TOTAL SCORE Other □ 1-2 □ 2-3 □ 4 or more Date: _____________ All applications must be submitted to Ms. A. Smith, (AP, Pupil Personnel) no later than Wednesday, January 7, 2015. The criteria for admissions are based on (1) submission of completed application with all documentation, (2) a diagnostic assessment student, and (3) the Parent & Child interview. Applications must be given to and certified by your child’s Guidance Counselor/School Administrator to be complete. Please check and submit each item: ___ I have enclosed copies of my child’s 4th grade (June 2014) report card and current 5th grade (November 2014) report card. ___ I have enclosed a copy of my child’s 4th grade ELA and Mathematics New York State Common Core Test Scores. ___ I understand that my child’s eligibility to take the MECPS entrance examination will be determined after a review of the report card and the achievement test scores. ___ I have included 3 self-addressed stamped envelopes with the application. Guidance Counselor: Guidance Counselor: _________________________________________________________ (Print Name) Name of School: _________________________________________________________ School Tel: ___________________________ Date: ___________________ School Personnel Stamp Here to Certify: Parent Name: _________________________________________________________ (Print Name) Signature: _________________________________________________________ Date: _________________________________________________________ Please return the completed application, documentation on or before Wednesday, January 7, 2015 to: Ms. A. Smith, (AP of Pupil Personnel).