Application Window Opens November 3, 2014 Application Due Date February 27, 2015 KEY DATES Acceptance notifications complete Late Registration WEEK OF April 6, 2015 Call school for seat availability 504-‐ 227-‐3810 2015-‐16 Application New Orleans Military and Maritime Academy 425 O’Bannon Street New Orleans, LA 70114 * NOMMA accepts applications statewide, Applications can be mailed, delivered to the school office between 9:00 AM and 2:00 PM or faxed to 504-875-4326. Deadline for timely applications is February 27, 2015. * PLEASE NOTE: Application to NOMMA REQUIRES that parents and applicants attend a NOMMA Open House. The dates for Open Houses are: October 27, November 17, December 15, January 26 and February 23. Open House begins at 5:30 PM. All participants must arrive before 6:00 PM to receive an attendance receipt. Applications for children of active duty military are accepted year round. STUDENT Information (Please PRINT All Information) Last Name First Name Student Home Address: Active Duty Military !Yes Sex: !M !F Date of Birth (MM/DD/YY): Middle Name Grade applying for Date of Open House attended !No Open House receipt# Please check one or more of the following that best describes your child. !Hispanic/Latino !American Indian/Alaskan Native !Asian !Black/African American !Native Hawaiian/Pacific Islander !Caucasian PARENT/GUARDIAN Information (Please PRINT All Information) Mother’s / Legal Guardian’s name Father’s / Legal Guardian’s name Stepparent (if any) Stepparent (if any) Home address Home address City State Zip code City Mailing address (if different from above) City Home phone Work phone Email address Cell phone Zip code Mailing address (if different from above) State State Zip code City Home phone Work phone Email address State Zip code Cell phone With whom does the student live? !Mother Guardianship papers attached: !Yes !No !Father !Both !Other !NA USE If you are not the student's birth parent, please provide a Certified True Copy of the Transfer of Custody/Legal Guardianship. Documentation indicating the purpose of the transfer of custody may also be requested. Legal Guardians must be: (1) appointed by the court, (2) awarded custody by a court judgment or (3) granted temporary custody by a state agency. A NOTARIZED STATEMENT NOT IN COMPLIANCE WITH THE LAWS GOVERNING CUSTODY BY MANDATE IS NOT CONSIDERED PROOF OF GUARDIANSHIP. Student's Name ___________________________________________ SCHOOL Information (List most recent first) School Name City, State Reason for Leaving (promotion, move, expulsion, etc.) Years Attended Name of Siblings School Phone Date of Birth Name of School Currently Attending Grade List any other matters concerning your child’s admission Have you ever been enrolled in a New Orleans Public School? !YES !NO COMPLETE APPLICATIONS MUST INCLUDE COPIES OF THE FOLLOWING: ! Last year’s final report card (for grade placement) ! Student’s birth certificate ! Student’s immunization record ! Current Individualized Education Plan (IEP) or IFSP, if applicable ! Current Individualized Accommodation Plan (IAP/504 Plan), if applicable ! Other states' standardized tests ! Proof of Louisiana residency (All proof of residency must be in the parent's/guardian's name(s) and at the same address as the student) ! AFDC card (Aid to Families with Dependent Children) ! Homestead exemption form / Property tax bill ! Military Orders to Louisiana ! Cable or Internet service bill ! Current lease ! LA State ID or LA Driver’s License ! Official letter from a Family Services caseworker ! Entergy bill (utility) and (gas and electricity) ! Sewerage/water board bill ! Voter Registration Card ! Payroll check stub with home address Certification: I certify that I am legally responsible for the child for whom this application is being made and have the legal right to apply, on behalf of the child, for admissions and to register the child if placement is offered. I have responded to all sections of this application and certify that all the information contained herein is true to the best of my knowledge. I understand that falsification of any part of this application will render the entire application and attached documents null and void and any placement offered will thereby be revoked. Parent/Guardian Signature: Date: New Orleans Military and Maritime Academy does not discriminate in the rendering of services to/or employment of individuals because of race, color, religion, sex, age, national origin, disability, veteran status, or any other non-‐merit factor.