2014-2015 Application for Admittance to MYP IB
Jefferson County International Baccalaureate School Middle Grades Application Applicant: Last _______________________ First ________________________ Middle ___________ Address: _____________________________________________________________________________ City: _____________________________________________ State: _______ Zip Code: ____________ Home phone number: ___________________________ Parent Cell: __________________________ Parent/Guardian (primary contact regarding Application): ____________________________________ Best time to reach this person: ______________ Alt. phone number: __________________________ Parent email: ______________________________ Birth date: ______________________ (mm/dd/year) Gender (circle): Ethnicity (circle): African-American/Black Asian Male Native American Female Other White (For Statistical Purposes Only) Assigned Middle School: _________________________________________ Do you have prior experience with an International Baccalaureate Program? If so, please explain: _____________________________________________________________________________________ Extracurricular Activities and/or Volunteering Activities: ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Applying for: 6th grade _______ 7th grade _______ 8th grade ________ (check appropriate line). I understand the following regarding attendance at the Jefferson County International Baccalaureate School: • Jefferson County only provides transportation to students living in a Jefferson County School Board zoned area. I am aware that if I am not in these zoned areas that I am responsible for transporting my own student to and from school if accepted into the program. • I am also aware that if I reside outside the Jefferson County School Board zone area, tuition and a release from my school board will be required by August 1st to the Department of Student Services at the Jefferson County Board of Education. • JCIB students are required to maintain a minimum academic grade point average of 2.5 and maintain exemplary behavior. If a student does not meet either of these requirements, they may be dismissed from the program. • The IB Diploma is an alternative pathway to graduation. A student who completes the all requirements for an IB Diploma will earn an Alabama High School Diploma with an Academic Endorsement and may possibly earn an International Baccalaureate Diploma which would be awarded during the summer of their graduating year. • I understand that JCIB is in the process of applying as a candidate school for the Middle Years Programme. Once accepted as a candidate school, JCIB will pursue authorization as an MYP IB World School. Candidate status gives no guarantee that authorization will be granted. JCIB has been authorized in the Diploma Programme since 1991. _____________________________ _________________________________ ____________ Print Student’s Name Parent/Guardian Signature Date All parts of the application are due to Jefferson County Schools MYP Programme, 2100 18th Street South, Birmingham, AL 35209, by March 26, 2015. International Baccalaureate Program Application for Middle Grades Jefferson County International Baccalaureate School Middle Years Programme Birmingham, Alabama Test scores and current school recommendation TO THE SCHOOL COUNSELOR OR ADMINISTRATOR: The student named in this Application has applied for entrance into Jefferson County International Baccalaureate School. Please complete the items below and distribute the attached recommendation forms to the student’s current teachers. In addition, we require a copy of students current grades including if applicable (5th grade through first semester 7th grades) and a copy of the most recent standardized test scores (EXPLORE, ASPIRE, Global Scholar PS, etc. ). Please return all portions of this application in one envelope to Jefferson County Schools, Attention: MYP Programme, 2100 18th Street South, Birmingham, AL 35209, by March 26, 2015. Student Name ______________________________________________ Please check all that apply, and include copies of all documents: _____ 504 (Accommodation Plan) ______ GEP (Gifted Education Plan) ______ IEP (Individual Ed. Plan) Has this student received a major disciplinary infraction, including any Class III infractions? _________ Please check the box that best fits the student’s achievement in the area indicated. Below Average Barely Average Average Above Average Stellar Attendance Work Ethic Maturity to handle difficult tasks Peer interaction If you would like to add any further comments about the student, please do so in the space provided below. You may want to comment briefly on the suitability of the student’s participation in advanced studies. We would appreciate your honesty in expressing any reservations you may have, and in helping put test scores and/or the student’s academic record in context. ALL RECOMMENDATIONS ARE CONFIDENTIAL. ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ ______________________________________ _______________________________________ Print Name/Title Signature _______________ Date Thank you for your time and attention to this application. Please remember a transcript and two recommendations are required in order for this Application to be complete. All parts of the application are due to Jefferson County Schools MYP Programme, 2100 18th Street South, Birmingham, AL 35209, by March 26, 2015. Writing Prompt —-To be completed in your best handwriting, and on this page—In the space below and in your own handwriting, complete only one of the following: 1) Mt. Rushmore has the faces of four famous presidents carved in it. If you were going to select four new people to place on Mt. Rushmore, who would they be and why did you choose them. 2) Suppose you had the opportunity to travel anywhere you wanted. Write to explain where you would go and why you chose your location. 3) Select one of your earlier years in school (Kindergarten, 1st grade, 2nd grade, 3rd grade, 4th grade, or 5th grade). Describe that year and why you selected to write about it. __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ All parts of the application are due to Jefferson County Schools MYP Programme, 2100 18th Street South, Birmingham, AL 35209, by March 26, 2015. Jefferson County Schools MYP Programme 2100 18th Street South, Birmingham, AL 35209 205 379-2000 CLASSROOM TEACHER’S RECOMMENDATION FORM Student: _________________________________ Elementary/Middle School: _________________________________ Teacher: _________________________________ Course taught: _______________________________________________ TO THE TEACHER: The above student is applying to JCIB. This rigorous academic curriculum challenges students to learn how to learn, analyze, and reach considered conclusions about people, language and literature, and the scientific forces of the environment. Students must have established strong scholastic backgrounds across all core subject areas. The successful student possesses a high degree of motivation, self-discipline, and a genuine love of learning. Please return this form to the student’s counselor or to the address above by March 26, 2015. Overall Recommendation: _____ Highly Recommend _____ Recommend _____ Recommend with reservations ____ Cannot recommend _____________________________________________________ Teacher Signature ________________________ Date Check the column which best describes the student. Academic Abilities Never Seldom Sometimes Usually Always 1. Does the student demonstrate excellence on class assignments and projects? 2. Does the student complete homework and outside-of-class work in a timely and thorough manner? 3. Does the student grasp new or different concepts readily? 4. Does the student challenge, speculate, make unusual associations, or draw unique conclusions? 5. Does the student take the initiative for his/her own learning? 6. Is the student’s oral and written communication clear, mature, and correct? 7. Does this student demonstrate quick recall and mastery of factual information? Motivational Characteristics Never Seldom Sometimes Usually Always 1. Does the student show genuine excitement and enthusiasm for learning? 2. Is the student able to be self-critical and self-correcting? 3. Does the student handle outside responsibilities as well as school demands? 4. Is the student intellectually playful, curious, and imaginative? 5. Is the student self-confident and emotionally secure? Comments: ___________________________________________________________________________________________ ________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ THIS RECOMMENDATION IS CONFIDENTIAL All parts of the application are due to Jefferson County Schools MYP Programme, 2100 18th Street South, Birmingham, AL 35209, by March 26, 2015. Jefferson County Schools MYP Programme 2100 18th Street South, Birmingham, AL 35209 205 379-2000 ELECTIVE TEACHER’S RECOMMENDATION FORM Student: ___________________________________ Elementary/Middle School: ____________________________________ Teacher: ___________________________________Course taught: _______________________________________________ TO THE TEACHER: The above student is applying to the JCIB. This rigorous academic curriculum challenges students to learn how to learn, analyze, and reach considered conclusions about people, language and literature, and the scientific forces of the environment. Students must have established strong scholastic backgrounds across all core subject areas. The successful student possesses a high degree of motivation, self-discipline, and a genuine love of learning. Please return this form to the student’s counselor or to the address above by March 26, 2015. Overall Recommendation: _____ Highly Recommend _____ Recommend _____ Recommend with reservations ____ Cannot recommend _____________________________________________________ Teacher Signature ________________________ Date Check the column which best describes the student. Academic Abilities Never Seldom Sometimes Usually Always 1. Does the student demonstrate excellence on class assignments and projects? 2. Does the student complete homework and outside-of-class work in a timely and thorough manner? 3. Does the student grasp new or different concepts readily? 4. Does the student challenge, speculate, make unusual associations, or draw unique conclusions? 5. Does the student take the initiative for his/her own learning? 6. Is the student’s oral and written communication clear, mature, and correct? 7. Does this student demonstrate quick recall and mastery of factual information? Motivational Characteristics 1. 4. Does the student show genuine excitement and enthusiasm for learning? Is the student able to be self-critical and self-correcting? Does the student handle outside responsibilities as well as school demands? Is the student intellectually playful, curious, and imaginative? 5. Is the student self-confident and emotionally secure? 2. 3. Never Seldom Sometimes Usually Always Comments: ___________________________________________________________________________________________ ________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ THIS RECOMMENDATION IS CONFIDENTIAL All parts of the application are due to Jefferson County Schools MYP Programme, 2100 18th Street South, Birmingham, AL 35209, by March 26, 2015.
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