Jumoke Academy Application 2016-2017€¦ · STUDENT’APPLICATION’ JAHDHC|’JAHDSMART’...
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STUDENT APPLICATION Please fill out the below information completely – all information is required unless otherwise noted. STUDENT INFORMATION STUDENT NAME: DATE OF BIRTH: Gender: M F GRADE APPLYING FOR IN 201617: HOME ADDRESS: (STREET) (TOWN) (ZIPCODE) TO WHICH SCHOOL IS YOUR CHILD APPLYING?: StepstoPrep (Grades PreKK) PK Students must be 4yrs. Old by Dec. 31, 2016 to apply T.E.D. Jumoke Academy Elementary school (Grades 14) 250 Blue Hills Ave. Jumoke Academy Honors at the Hartford Conservatory (Grades 58) 875 Asylum Ave. * Jumoke Academy Honors Science, Math and Research Technology (SMaRT, Grades 58) 339 Blue Hills Ave. * *Please note that students applying to either of the Jumoke Academy Honors middle schools will be required to complete independent essays as part of their application (essays are on the back of this form) Is the applicant Hispanic/Latino? Yes No Is the applicant from one or more races (choose all that apply): American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White What is your child’s primary spoken language? __________________________________________ What is the primary language spoken by the child’s family? ________________________________ FAMILY INFORMATION PLEASE NAME THE STUDENT’S PARENT/LEGAL GUARIDAN (S) –I.E. THE PERSON (S) WHO HAVE PRIMARY CARE, LEGAL CUSTODY /GURDIANSHIP OF THE CHILD NAME: RELATIONSHIP TO STUDENT: HOME TELEPHONE: WORK TELEPHONE: CELL PHONE: EMAIL ADDRESS: NAME: RELATIONSHIP TO STUDENT: HOME TELEPHONE: WORK TELEPHONE: CELL PHONE: EMAIL ADDRESS: IMPORTANT: Please list the siblings of the applicant attending and not attending Jumoke Academy. (a “sibling” is defined as a blood relative living in the same household and under the legal guardianship of the same head of household): NAME: AGE: NAME: AGE: NAME: AGE: NAME: AGE: CURRENT SCHOOL INFORMATION SCHOOL NAME: TEACHER’S NAME: YEARS ATTENDED: CURRENT GRADE: SCHOOL ADDRESS: (Street) (Town) (Zip code) For StepstoPrep (Grades PreKK) Applicants only: Did your child attend PreSchool? NO YES, Days per week: If “Yes”, how did your child adjust to preSchool? Very Well Well Fair to poor I certify that the information contained in the above application is truthful and accurate, and that by signing this application, I am requesting that my child be accepted into the Jumoke Academy lottery. Parent / Legal Guardian Signature: Date: 834 Asylum Avenue, Hartford, CT 06105 | Jumoke Academy.org | Fax: (860) 2449618
Transcript of Jumoke Academy Application 2016-2017€¦ · STUDENT’APPLICATION’ JAHDHC|’JAHDSMART’...
STUDENT APPLICATION
Please fill out the below information completely – all information is required unless otherwise noted. STUDENT INFORMATION
STUDENT NAME: DATE OF BIRTH: Gender: M F GRADE APPLYING FOR IN 2016-‐17: HOME ADDRESS: (STREET) (TOWN) (ZIPCODE) TO WHICH SCHOOL IS YOUR CHILD APPLYING?:
Steps-‐to-‐Prep (Grades PreK-‐K) PK Students must be 4yrs. Old by Dec. 31, 2016 to apply
T.E.D. Jumoke Academy Elementary school (Grades 1-‐4) 250 Blue Hills Ave.
Jumoke Academy Honors at the Hartford Conservatory (Grades 5-‐8) 875 Asylum Ave. *
Jumoke Academy Honors Science, Math and Research Technology (SMaRT, Grades 5-‐8) 339 Blue Hills Ave. * *Please note that students applying to either of the Jumoke Academy Honors middle schools will be required to complete independent essays as part of their application (essays are on the back of this form)
Is the applicant Hispanic/Latino? Yes No Is the applicant from one or more races (choose all that apply):
American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
What is your child’s primary spoken language? __________________________________________ What is the primary language spoken by the child’s family? ________________________________
FAMILY INFORMATION PLEASE NAME THE STUDENT’S PARENT/LEGAL GUARIDAN (S) –I.E. THE PERSON (S) WHO HAVE PRIMARY CARE,
LEGAL CUSTODY /GURDIANSHIP OF THE CHILD
NAME:
RELATIONSHIP TO STUDENT:
HOME TELEPHONE:
WORK TELEPHONE:
CELL PHONE:
EMAIL ADDRESS:
NAME:
RELATIONSHIP TO STUDENT:
HOME TELEPHONE:
WORK TELEPHONE:
CELL PHONE:
EMAIL ADDRESS:
IMPORTANT: Please list the siblings of the applicant attending and not attending Jumoke Academy. (a “sibling” is defined as a blood relative living in the same household and under the legal guardianship of the same head of household):
NAME: AGE: NAME: AGE:
NAME: AGE: NAME: AGE:
CURRENT SCHOOL INFORMATION SCHOOL NAME: TEACHER’S NAME: YEARS ATTENDED: CURRENT GRADE: SCHOOL ADDRESS: (Street) (Town) (Zip code) For Steps-‐to-‐Prep (Grades PreK-‐K) Applicants only: Did your child attend Pre-‐School? NO YES, Days per week: If “Yes”, how did your child adjust to pre-‐School? Very Well Well Fair to poor
I certify that the information contained in the above application is truthful and accurate, and that by signing this application, I am requesting that my child be accepted into the Jumoke Academy lottery.
Parent / Legal Guardian Signature: Date:
834 Asylum Avenue, Hartford, CT 06105 | Jumoke Academy.org | Fax: (860) 244-‐9618
STUDENT APPLICATION JAH-‐HC | JAH-‐SMART
INDEPENDENT ESSAYS FOR 5-‐8TH GRADES ONLY
Note to Parents: The below prompts are independent essay questions for the students. You may discuss the questions with your child, but your child should write these essays without your assistance or the assistance of any other adult. Essays must be neatly handwritten by the student, not typed. Thank you. STUDENT NAME: CURRENT GRADE: Directions: Please respond to each of the essay questions below. All essays must be hand written.
1. Write one strong paragraph describing your favorite subject, and explain why it is your favorite subject.
2. Write two paragraphs describing which academic subject you would like to improve upon, explain why, and also explain what you have been doing on your own to improve in this subject area.
3. List three books you have read over the past two years. Which of these books was most meaningful to you? In at least two paragraphs, explain your answer in detail.
4. Jumoke Academy Honors SMaRT and Jumoke Academy Honors at Hartford Conservatory provide rigorous academic programs to prepare students for college preparatory work in high school. It also teaches its students that the word “Honor” in the school’s names does not only refer to academic grades, the word “honor” also refers to its students having strong values, good character, a positive community service record, and leadership. Please write a two to four paragraph essay describing what positive contributions you would make to the school if you are accepted into our honors middle schools. Also, discuss how you think either school would benefit you as a person and as a student.
5. Name your favorite performance artist (musician, actor/actress, dancer, recording artist, etc…)
and, in at least two paragraphs, describe what about that artist inspires you. I certify that the attached essays are a result of my own independent work and that while I may have discussed the questions with an adult, the answers are my own. Student Signature Date:
834 Asylum Avenue, Hartford, CT 06105 | Jumoke Academy.org | Fax: (860) 244-‐9618
