Mater Academy Charter Middle/ High

Admission Application 2010-2011

Please complete the form below. Mandatory fields marked *

Student's Information

Last name* First name*
Middle name*
Student’s Birthdate*
MM/DD/YYYY
Current grade* MDCPS Student ID Number *

Siblings currently attending Mater Academy

1. Last NameFirst Name
ID number
2. Last NameFirst Name
ID number
3. Last NameFirst Name
ID number

Student’s Address

Number & Street * Apt. #
City*Zip code *State*

School Student Currently Attends

Parent’s / Guardian’s First & Last Name*
Relationship to student*
Parent’s / Guardian’s Home Phone #* (including area code)
Parent’s / Guardian’s Work Phone #* (including area code)
Parent’s / Guardian’s email address*

Is your child receiving Exceptional Student Education Services ?* Yes No
If the answer is yes please provide the type of exceptionality
Is your child attending a private school?* Yes No
If the answer is “YES” please fax or email the most recent report card to:
Silvia Trinceri --> fax # : 305 828 6175 or strinceri@dadeschools.net
Is your child interested in applying to our Performing Arts Academy?* Yes No
If the answer is yes, you will receive a second application by mail

Agreement of Understanding

*By signing below, I acknowledge my understanding of the following conditions for this application:

1. Only applications received from November 1, 2009, through April 1, 2010, will be considered for enrollment in the next school year 2010-2011,
2. THE DEADLINE FOR RECEIPT OF THIS APPLICATION IS APRIL 1st, 2010.
3. Priority is given to applicants with siblings who are currently enrolled at the school.
4. A random selection process will be utilized to admit eligible applicants.
5. Failure to respond by the date specified on the acceptance letter will be interpreted as a parent guardian decline of acceptance.
6. This application becomes void at the end of the current school year.
7. If accepted , you will be invited to a mandatory orientation meeting where he/she will be enrolled as a full time student at Mater Academy Charter Middle High School
8. I understand that transportation is not available and therefore I must provide his/her transportation
9. My child must demonstrate acceptable performance (as determined by school-site policy) in order to remain as a full time student at your school
Parent/Guardian Name * Date *