application

APPLICATION

MARY GRIMES EDUCATION CENTER

"We're Building A Better World One Student at a Time"

1745 Hutton Rd. * Carrollton, Texas * 75006* (972) 968-5600

Please complete this application and return it to your counselor at your C.F.B.I.S.D. High School. Your application must include the following items: (your home campus will have these items.)

current transcript
immunization record
home language survey
EXIT TAAS/10th or 11th TAKS PROFILE
At Risk Profile
Code of Conduct signature page
Graduation Plan

If you are not enrolled in a C.F.B.I.S.D. school, you must be 18-21 years of age to apply directly to Grimes. Your application must include:

current transcript
immunization record
home language survey
EXIT TAAS/10th or 11th TAKS PROFILE
proof of residency within C.F.B.I.S.D.
copy of birth certificate
Social Security card

APPLICATION CANNOT BE CONSIDERED UNTIL ALL ITEMS ARE ON FILE WITH M.G.E.C.



^{Student Name}	^{male female Grade Date}
^{________________________________________}
^{School ID Number}
	( )
^{Date of Birth Age}	^{Home Phone Number}

^{Street Address}	^{City State Zip Code}
	( )
^{Mother's Name}	^{Work Phone Number}
	( )
^{Father's Name}	^{Work Phone Number}
	( )
^{E-mail Address}	^{Beeper/Cell Phone}

^{Last School Attended - R.L.T.} ^N.S. ^{R.V. _____ C.V.} ^{Other (name
of school)}

^{If other, give address}

^{City
State
Zip Code}

Have you ever been in special education classes? yes no

Have you ever been in English as a Second Language classes? yes no

Have you ever been in Gifted/Talented classes? yes no

Have you taken the 10th grade TAKS? yes no

Please check the reason(s) you are applying to M.G.E.C.:

Failed 2 or more core subjects	Retained one or more school years	Unable to pass TAAS/TAKS
On Parole, Probation, or deferred Prosecution	Previously reported as a drop out	Parenting
Coming from another alternative school	Previously Expelled	Pregnant
Previously assigned to Discipline A.E.P.		Homeless
In care, custody, or referred to Dept. of Protection and Regulatory Services (C.P.S.)
Placement in Residential Treatment Facility or foster care

Your application will be reviewed by a counselor at M.G.E.C. You will be notified by M.G.E.C. staff id you have been accepted.

^{Student Signature
Parent Signature}

Please complete the back of this application

TO BE COMPLETED BY THE PARENT

1. Your son's/daughter's decision to attend school is an important one. Please discuss how you will provide support for his/her decision.

TO BE COMPLETED BY THE STUDENT

2. Please tell us about your previous experiences that have led you to make an application to Mary Grimes.

3. We want you to be successful at Mary Grimes. What changes and committments are you willing to make to achieve success?