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Please print in black ink and fill out completely. One application per student will be accepted . Contact the AMP office at (985) 474-8670 between the hours of 7:30 a.m.—3:00 p.m. for more information. Incomplete Applications will NOT be processed. NOTE: Please attach a copy of your child’s birth certificate, social security card and immunization record with the application. Students living in the Hammond School District will be given FIRST priority. Pre-Kindergarten students must be age 4 and Kindergarten students must be age 5 by September 30 of the calendar year in which the school year begins. Faxed applications can be sent to 985-542-4215. |
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___________________________________________________________________________ Student’s Last Name First name Middle Initial |
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Student’s Social Security No. ______________________________ |
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___________________________________________________________ Current School Current Grade Has this student been identified as an Exceptional Student?___________ If yes, is the student been presently receiving special education services?__________________________________________________________ If yes, please indicate the student’s exceptionality____________________ Does your child have any medical conditions? _______________________ If yes, explain: ____________________________________________________ Do you have a child presently enrolled in the same magnet program?_________________________________________________________ If yes,____________________________________________________________ Name of Sibling in AMP Program Grade INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. |
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For Office Use Only Date received_______________________ TPPS Personnel Signature___________ Screening Assessment_______________ Eligible_____________________________ |
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Hammond Accelerated Magnet Program |
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AMP |
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Sex Female___ Male___ |
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Student’s Date of Birth Mo.____Day______Yr._______ |
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_________________________________________________________ Student’s Street Address (No P.O. Box) Bldg./Apt.No. ____________________________________________________________________________ City State Zip Code ____________________________________________________________________________ Last Name of Parent/Guardian First name ____________________________________________________________________________ Home Telephone No. Business Telephone No. ____________________________________________________________________________ E-mail Address (optional) Cell Telephone No. What grade will the applicant enter in 2009-2010? Race/Ethnic Category Circle one. (Required) Pre-Kindergarten Kindergarten ___Non-Black ___Black 1st 2nd 3rd 4th 5th 6th |
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