Apply online at www.HISDChoice.com
ELEMENTARY SCHOOL MAGNET PROGRAMS
APPLICATION FOR 2016-2017
Pre-Kindergarten through Grade 5
Please complete all relevant sections of this application and either bring it in person or send it by mail to Office of School Choice,
4400 W 18th Street, Houston TX 77092. Applications must be received or postmarked no later than December 18, 2015 for consideration in the first round
of applications and lotteries. Please review the application process on Page 6. PLEASE PRINT CLEARLY
Section A - Student Information (must be completed for all applicants)
HISD ID#: ____________________ (May be found on student’s HISD report card or by calling student’s school.)
Name of student: ____________________________________________________________________________________________
First Name
Middle Name
Last Name
Grade applying for: __________
Ethnicity: □ Hispanic/Latino
Race: □ Asian
Date of birth: Month________ Day _______ Year________
□ Not Hispanic/Latino.
Gender: □ Male
□ Female
If not Hispanic/Latino, please indicate your child’s race on the next line.
□ American Indian and Alaska Native □ Black or African American □ Native Hawaiian or Other Pacific Islander □ White
(This information is requested in accordance with the Public Education Information System and federal regulations)
Current school: _________________________ In HISD? □ Yes
□ No
Current grade: ______
□ English □ Spanish
□ Yes □ No
Preferred language of instruction for 2016-2017 school year
If eligible, are you requesting HISD bus transportation?
Current language of instruction: ____________
(bilingual classes are not available in all programs)
Section B - Family Information (must be completed for all applicants)
With whom does the applicant live as a permanent resident? (Check one box.)
□ Both parents
□ Mother only
□ Father only
□ Mother & step parent
□ Father & step parent
□ Other
Guardian #1 - Present address of student’s parent or legal guardian (student domicile)
____________________________________________________________________________________________________________
First Name
Last Name
____________________________________________________________________________________________________________
Address
Apt.
City
State
ZIP
Phones: Home ____________________________ Cell ____________________________ Work ____________________________
Email address ______________________________________________________
Guardian #2 (Optional)
____________________________________________________________________________________________________________
First Name
Last Name
____________________________________________________________________________________________________________
Address
Apt.
City
State
ZIP
Phones: Home ____________________________ Cell ____________________________ Work ____________________________
Email address ______________________________________________________
If either parent/guardian is an HISD employee: Employee ID #_____________
HISD email address: _______________@houstonisd.org
In the event that your student is not offered a seat, would you like to be contacted by schools with space available?
In which language would you prefer us to communicate with you?
□ Yes
□ No
□ English □ Spanish
If you are a current HISD parent you may opt in to receive text messages with reminders from us. If you wish to receive texts, please write your cell phone
numbers in the spaces below. Important: before we can send you texts you must opt to receive them by texting “YES” on your cell to 68453. You may opt
out at any time by texting “STOP” to the same number.
Office Use Only – Date
Please send text alerts to: cell 1 _____________________; cell 2 _____________________
Submitted
Section C – School Selection (must be completed for all applicants)
Page 2
Rank programs listed on this page and the next in priority order, from first choice to last choice. You may apply to a maximum of 10
programs, of which no more than 5 may be Vanguard. Put “1” next to the most desired program, “2” next to the second highest ranked
choice, and so on. It is very important that you think carefully about your ranking, because if your child is accepted to a program, any
lower-ranked choices will be removed. You may adjust the order of your choices through December 18, 2015 by submitting a new paper
application listing all of your choices in Section C.
Rank
1-10
Program Name & Theme
Arabic Immersion Magnet School (Language testing in
Arabic required for first grade)
The only grade-levels
accepting applications
PK
K 1
4
First names of any brothers or sisters
also applying to same program
Askew – Vanguard (must complete section D)
K
1
2
3
4
5
Bell – Physical Development
K
1
2
3
4
5
PK PK
K
3 4
1
2
K
1
2
3
4
5
Burbank – Fine Arts
K
1
2
3
4
5
Burrus – Fine Arts
K
1
2
3
4
5
Carrillo – Vanguard (must complete section D)
K 1† 2† 3 4† 5
Codwell – Fine Arts
K* 1* 2* 3* 4* 5*
Cook – Fine Arts
K
1
2
Cornelius – Math/Science
K
1
2 3* 4* 5*
Crespo – Fine Arts
K
1
2
3
4
5
De Zavala – Vanguard (must complete section D)
K
1
2
3
4
5
Durham – IB
K
1
2
3
4
5
Elrod – Emerging Medical Scholars
K
1
2
3
4
5
Berry – Environmental Science
K
Blackshear – Montessori
Bruce – Music (must choose one focus area)
__Band/Brass __Keyboard __Guitar
__Strings __ Woodwind
Garden Oaks – Montessori (Must have recent prior
Montessori experience if applying to grades 3-5)
3 4* 5*
PK PK
K* 1* 2* 3* 4* 5*
3* 4*
Garden Villas – Music (must choose one area in grades
3-5: ___Band ___Choir ___Orchestra ___Piano)
K
Gregory-Lincoln K-8 – Fine Arts
K 1* 2* 3* 4* 5*
Harvard – STEM
Helms – Dual Language (Grades 2-5 require evidence of
K* 1* 2* 3* 4* 5*
prior academic experience in a Dual Language or Bilingual
Program)
PK
K
4
1
1
2
2
3
3
4
4
5
5
Herod – Vanguard (must complete section D)
K* 1* 2* 3* 4* 5*
Herrera – Integrated Technology
K
Kolter – Foreign Languages & Cultures
st
nd
mark 1 for 1 and 2 for 2 choice)
___French
___Spanish
___Chinese
Lantrip – Environmental Science
(must
1
2
3
4
5
1
2
3 4* 5*
K*
K
Lockhart – STEM
K*
Longfellow – Creative/Performing Arts
K* 1* 2* 3* 4* 5*
Lovett – Fine Arts
K* 1* 2* 3* 4* 5*
2* 3* 4* 5*
* Asterisk indicates only classes in English available at this school in this grade. †Only Bilingual classes available at this school in this grade
Rank
1-10
Program Name & Theme
MacGregor – Music & Science
Mandarin Chinese Language Immersion School
(Language testing in Mandarin required for first and higher)
Oak Forest – Vanguard (must complete section D)
Parker – Music (must choose one area for
Kindergarten) ___Suzuki Violin ___Suzuki Cello
___Music Enrichment
Patterson – Literature
The only grade-levels
accepting applications
K 1 2 3* 4* 5*
PK
K 1 2 3 4 5
4
K* 1* 2* 3* 4* 5*
K 1* 2* 3* 4* 5*
K
1
2
3
4
5
Poe – Fine Arts
K 1†
Pugh – Science & Technology
K
Red – STEM
K
River Oaks – Vanguard (must complete section D)
K* 1* 2* 3* 4* 5*
Roosevelt – Vanguard (must complete section D)
K
1
2
Ross – STEM
K
1
2 3* 4* 5*
Scroggins – Fine Arts
K
1
2
3
4
Sinclair – STEM
K* 1* 2
3
4 5*
The Rice School – STEM
K
3
4 5*
T.H. Rogers – Vanguard (must complete section D)
K* 1* 2* 3* 4* 5*
The Rusk School – STEM
K* 1* 2* 3* 4* 5*
Travis – Vanguard (must complete section D)
K* 1* 2* 3* 4* 5*
Twain – Literary Development
K
1
2
3
4
Valley West – STEM
K
1
2
3
4 5*
Wainwright – Math & Science
Wharton –Dual Language (Grades 1-5 require evidence of
K* 1* 2* 3* 4* 5*
prior academic experience in a Dual Language or Bilingual
Program)
Whidby – Health Science
Wilson – Montessori (Must have recent prior
Montessori experience if applying to grades 3-5)
Windsor Village – Vanguard (must complete section D)
PK
K
4
1
1
1
3† 4† 5
2
2
2
3
5
3 4* 5*
3
K* 1*
PK PK
K
3 4
K
4
4
5
5
5
4* 5*
1
2
3 4* 5*
1
2
3
4 5*
* Asterisk indicates only classes in English available at this school in this grade. †Only Bilingual classes available at this school in this grade
Siblings
Please list below the details of any brothers or sisters of the applicant who will either be attending or are applying to one of the same
Magnet programs as the applicant.
First Name
Last Name
In the case of multiple
birth children, do you
prefer them to share a
Date of Birth lottery number or each
(mm/dd/yy)
have their own?
Share
Separate
Share
Separate
Share
Separate
Share
Separate
School Currently
Attending
Current
Grade
Be sure to sign in Section F below  
Page 4
Section D - Vanguard Information (complete only if applying to a Vanguard Magnet program)
Is your student currently identified as gifted and talented (G/T) by HISD?
□ Yes
□ No
Please read carefully to avoid delays.
Be sure to submit any of the additional documentation no later than January 31, 2016.
1. If your child was in a school last
year (2014-15) but not in HISD,
please attach the following
documents to your application.
□ A copy of your child’s end of year
report card for 2014-2015, and
□ A copy of all standardized test
results (Iowa/Logramos or
Stanford/Aprenda) for 2014 – 2015
that your child took in a non-HISD
school.
2. If your child is in a school this
year (2015-16) but not in HISD and
is receiving any special services,
please check all that apply below
and submit documentation.
□ Specialized Education-Full
3. Please check the correct box in the chart below.
2015-2016 REDUCED INCOME CHART
If your annual, monthly, or weekly salary is at or below
the levels listed below for your household size, please
check the box next to the size of your household.
Individual Evaluation (FIE)
□ Section 504 – 504
Accommodation Plan
Household Size
□ Bilingual/ESL (LEP) –Not
enrolled in an HISD school (we
may contact you for a home
language survey).
□
□
□
□
□
□
□
Annual
Monthly
$ 29,471
$ 2,456
$ 567
3
$ 37,167
$ 3,098
$ 715
4
$ 44,863
$ 3,739
$ 863
5
$ 52,559
$ 4,380
$ 1,011
6
$ 60,255
$ 5,022
$ 1,159
7
$ 67,951
$ 5,663
$ 1,307
8
$ 75,647 $ 6,304
For each additional family member add:
$ 7,696
If your child was in HISD for all of last
year you do not need to attach the
above. (We already have them).
If your child is in HISD this year you
do not need to attach the above.
(We already have them).
4. If your child is applying to a
Vanguard Kindergarten program:
5. If your child is applying to 2
th
through 5 grades:
- Please complete the Parent
Recommendation form (Section H).
You do NOT submit a teacher
recommendation.
- Please attach a copy of your child’s
birth certificate.
- Please schedule testing by
completing Section E.
nd
Please separate the Teacher
Recommendation (Section J) and
have one teacher from this year or
last year complete and return it in
a sealed envelope for you to
submit with this application. Only
the first recommendation will be
considered.
Weekly
2
$
642
$ 1,455
$
If none of the above apply please check here
148
□
6. .If your child is applying to first grader:
- If the student IS in an HISD Kindergarten this year,
you will not need to request Teacher
Recommendations or testing because they will
be tested at their current HISD School and
teacher recommendations will be completed
online for all kindergarten students.
- If the student IS in a kindergarten but NOT in HISD,
please separate the Teacher Recommendation
(Section J) and have one teacher from this year
complete and return it in a sealed envelope for
you to submit with this application.
Be sure to sign the application (Section F) and submit by December 18, 2015.
Be sure to submit any of the additional documentation and recommendations no later than January 31, 2016.
You will be contacted to schedule any required testing or if any further information is required.
Page 5
Section E. ENTERING KINDERGARTEN APPLICANTS ONLY
If you chose in Section C to apply to any of the Vanguard kindergarten programs, you must complete this section and your child must
be tested. The kindergarten Vanguard programs are in the following schools.
Askew
River Oaks
Carrillo
Roosevelt
DeZavala
T. H. Rogers
I request that my child be tested in the following language:
Herod
Travis
___ English
Oak Forest
Windsor Village
___ Spanish
Listed below are scheduled testing dates and their locations for students who apply by December 18, 2015. Please indicate your first
and second choice. You will be notified of the date, location, and time of testing. There will be no additional testing dates for the
first round of screening during the 2015-2016 school year. Please plan accordingly so that you will be able to attend one of the dates
listed below. Students may only be tested once as part of the Entering Kindergarten Vanguard testing program.
Testing Dates and Locations
Please show your preference with numbers from
1 (highest) to 4 (lowest).
___ January 9, 2016
Carrillo Elementary School, 960 South Wayside, 77023
___ January 23, 2016
Carrillo Elementary School, 960 South Wayside, 77023
___ January 30, 2016
Herod Elementary School, 5627 Jason St., 77096
___ February 6, 2016
Herod Elementary School, 5627 Jason St., 77096
Remember to complete the Parent Recommendation form in Section H for children applying to Vanguard kindergarten programs.
This application will not be considered complete without a parent or guardian signature.
Section F - Signatures (must be completed for all applicants)
Parent/Guardian Signature: __________________________________________________________ Date: _________________
Knowingly submitting incorrect or misleading information will result in the invalidation of these applications.
Be sure to complete all relevant sections of this application and bring it in person or send it by mail to:
th
Office of Student Choice, 4400 W 18 Street, Houston TX 77092.
Applications must be submitted no later than December 18, 2015 for consideration in the first round of lotteries.
Page 6
Section G. Applying to Houston I.S.D. Magnet Programs
You may apply for a 2016–2017 seat in an HISD Magnet program by going online (www.HISDChoice.com) or by completing this paper application. We
strongly recommend completing the application process online as you will be able to track the status and results of all applications. An application takes
about 5 to 10 minutes to complete. Before starting, if your child is a current HISD student, it is essential, to prevent delays, to locate his or her HISD
student ID number on a report card or by calling their school.
For more information about Magnet programs and other school choice options in HISD, visit the website at http://www.houstonisd.org/SchoolChoice and
attend a School Choice Open House. The Open Houses schedule is:
Date
October 3, 2015
October 24, 2015
November 14, 2015
December 12, 2015
Location
Barbara Jordan High School
Sharpstown High School
Jack Yates High School
Northwest Mall
Time
9:00 – 12:00
9:00 – 12:00
9:00 – 12:00
10:00 – 1:00
Important Dates
Dec. 18,
2015
Dec. 19,
2015
March 24,
2016
Deadline for:
Phase 1 (first round) Magnet applications. All qualified Phase 1 applications for in-district students will be entered in lotteries or
auditions.
To make Phase 1 priority changes, either make changes online or complete a new application.
Start of:
Phase 2 application window. Qualified applications from in-district students are considered on a space-available basis, in the order
submitted.
Notification Date:
Parents will learn the outcome of all Phase 1 applications. Families will have two weeks to accept an offered seat in a Magnet program.
Students will remain on the waitlist of all programs which parents ranked higher than the highest program to which a seat is offered.
May 31,
2016
Deadline for:
Phase 2 applications. Starting June 1, Phase 3 applications — whether from in-district or out-of-district — are considered
on a space-available basis, in the order submitted, once all Phase 1 and Phase 2 applications have been processed.
Additional Information on Applications for the 2016-2017 School Year
1.
2.
3.
4.
5.
6.
7.
8.
9.
Submit only one paper application and indicate up to 10 programs in Section C. Do not submit separate applications for each choice.
This year you are required to rank your choices of programs to streamline the application process for all students.
If you wish to change the order of your rankings after you have submitted your initial application, you must submit an additional updated
application to the Office of School Choice. The deadline for changing Phase 1 rankings is December 18, 2015.
Any programs ranked below the highest program at which you are offered a seat are automatically dropped.
Applications for students who live outside the HISD boundaries may be submitted any time after October 1, 2015 but they will not be
considered until June 1. They will be considered at that point based on the order they were submitted, but only if there are no qualified indistrict students on the wait list for the program.
The children of HISD employees who live outside the HISD boundaries are treated as if they lived within the district.
If a zoned elementary student at a Magnet school or a zoned Vanguard Magnet student at any level moves out of their school’s zone they
must apply for re-admittance if they wish to return to the same program.
Students must be in attendance on day one of school. Magnet seats are not saved if there are zoned students to fill the spaces.
August 12, 2016 is the last date on which Magnet applications can be accepted by schools.
DID YOU SIGN THE APPLICATION IN SECTION F?
Section H
Page 7
2016-2017 HISD Vanguard Program Entering Kindergarten
PARENT RECOMMENDATION FORM
Submit one parent recommendation form – only if you are applying to kindergarten at a Vanguard program.
Child’s Name ___________________________________________
Evidence of Possible Giftedness: Please circle the word(s) that best indicates the degree to which the student exhibits the following
characteristics in relation to students of similar age, experience, or environment.
A. General Intellectual Ability
1. Shows a preference for complex tasks and “why” of
things
2. Has knowledge and vocabulary unusual for age or grade;
has fluent verbal ability
3. Demonstrates abstract and critical thinking ability, an
ability to think things out, to think things logically or
analytically
4. Is a keen and alert observer, often “sees more” in a
learning situation than others; may show evidence of long,
detailed memory
5. Shows an interest in problem solving and is flexible and
resourceful in problem solving
6. Has a quick grasp of concepts and underlying principles
and can see relationships between ideas, events, people and
things; may ask provocative questions
Rarely
(1)
Less than
half the time (2)
About
half the time (3)
More than
half the time (4)
Consistently
most of the time (5)
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
B. Creative Ability
1. Is curious and asks many questions
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
2. Produces work which is fresh, vital, and unique; creates
new ideas, products, and processes; does the unexpected
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
3. Exhibits playfulness and a keen sense of humor; may
make jokes, puns, etc. at times
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
About half the time
More than half the
time
Consistently most of
the time
4. Shows unusual capacity for concentration, imagination,
and originality on tasks that interest him or her
5. Bores quickly with routine tasks, memorization of facts
and details; prefers talking about ideas and problems
Rarely
Less than half t
6. Exhibits emotional sensitivity, expressing intense feelings
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
7. Enjoys variety and novelty in learning experiences
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
1. Is self-confident with peers and adults
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
2. Demonstrates a willingness for and skills in decision
making
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
3. Is willing to take risks; tends to think independently
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
4. Exhibits organizational skills with tasks, peers, time,
and/or materials
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
C. Leadership Ability
5. Carries responsibility well, works well in situations that
require initiative and independence
6. Shows empathy and tolerance toward others; generally
relates well with others
7. Can express self well; has good verbal skills and is usually
well understood
Parent’s Name (please print) _____________________________________________
Parent’s Signature ____________________________________ Date ____________
Section J.
Page 8
2014-2015 HISD Vanguard Programs
TEACHER RECOMMENDATION FORM
Student Name:
Current Grade Level:
For students currently in Kindergarten and 5th grade, this form will be completed online by the classroom teacher with collaboration from all teachers who
instruct this student. For students in all other grades, this form should be completed by the current teacher, or teacher from the previous school year
only. Submit only one teacher recommendation form with your application. This form must be returned in a sealed envelope signed by the
teacher across the seal.
Evidence of Possible Giftedness: Please circle the word(s) that best indicates the degree to which the student exhibits the following
characteristics in relation to students of similar age, experience, or environment.
A. General Intellectual Ability
1. Shows a preference for complex tasks and “why” of
things
2. Has knowledge and vocabulary unusual for age or grade;
has fluent verbal ability
3. Demonstrates abstract and critical thinking ability, an
ability to think things out, to think things logically or
analytically
4. Is a keen and alert observer, often “sees more” in a
learning situation than others; may show evidence of long,
detailed memory
5. Shows an interest in problem solving and is flexible and
resourceful in problem solving
6. Has a quick grasp of concepts and underlying principles
and can see relationships between ideas, events, people and
things; may ask provocative questions
B. Creative Ability
1. Is curious and asks many questions
Rarely (1)
Less than
time (2)
half the
About
half the time (3)
More than
time (4)
half the Consistently
the time (5)
most of
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
2. Produces work which is fresh, vital, and unique; creates
new ideas, products, and processes; does the unexpected
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
3. Exhibits playfulness and a keen sense of humor; may
make jokes, puns, etc. at times
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
3. Is willing to take risks; tends to think independently
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
4. Exhibits organizational skills with tasks, peers, time,
and/or materials
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
Rarely
Less than half the
time
About half the time
More than half the
time
Consistently most of
the time
4. Shows unusual capacity for concentration, imagination,
and originality on tasks that interest him or her
5. Bores quickly with routine tasks, memorization of facts
and details; prefers talking about ideas and problems
6. Exhibits emotional sensitivity, expressing intense feelings
7. Enjoys variety and novelty in learning experiences
C. Leadership Ability
1. Is self-confident with peers and adults
2. Demonstrates a willingness for and skills in decision
making
5. Carries responsibility well, works well in situations that
require initiative and independence
6. Shows empathy and tolerance toward others; generally
relates well with others
7. Can express self well; has good verbal skills and is usually
well understood
Student’s Name:
Current Grade Level:
Teacher’s Name (please print):
Current School:
Subject Area of Instruction:
Phone Number:
Date:
Teacher’s Signature:
Teachers: Please return completed form to parent/applicant in sealed envelope with signature across seal.