Personal Information: Magruder HS PEAC Scholars Application for the 2014-2015 School Year Name: __________________________________________ Student ID: __________ Last Female First MI Male DOB: _____/____/____ Student email address: ________________________________________________________ Home address: _________________________________________________________ Number and Street Apartment # ____________________________________________________________________ City or Town State Zip Code Home phone: (_______)__________________ Cell phone: (_______)_________________ Current School: ___________________________________ Counselor’s Name: ________________________________ *Pursuing Excellence in the Academic Curricula* (If coming from a school outside of MCPS, please attach a copy of your most recent transcript and note the name of your counselor or advisor from that school.) Current Math Class (course and level): _______________________________________ For incoming 9th graders only: Would you prefer PEAC Honors Physics or PEAC Honors Matter and Energy? (Contingent upon eligibility) Please check one: PEAC Honors Physics PEAC Honors Matter and Energy Academic Honors: Briefly list any academic honors you have received since the sixth grade. ____________________________________________________________________________________________ ____________________________________________________________________________________________ ____________________________________________________________________________________________ Extracurricular Activities: Please list the extracurricular activities and community service that you are currently involved in. Activity Grade-level of participation 6 7 8 9 For School Use Only: Cumulative GPA: ___________ Teacher Recommendations: (1)___ Essay Score: _____________ Committee Decision: Yes Hrs/week (2)___ Time Commitment Wks/year (3)___ Counselor Recommendation: Y Readers: ___________________ _____________________ No Notes: Page 1 Do you plan to participate in HS? (y or n) N Teacher Recommendations Requested from: Name Course Teacher Initials/Date Received Counselor Recommendation: Name Counselor Initials/Date Received Important: If you are applying from outside of MCPS, please give the name, address and phone number of your current school below. Recommendation forms will be mailed to the teachers and counselor you name above. School: ______________________________________________________ Address: _____________________________________________________ _____________________________________________________ Phone Number: ________________________________________________ Please mail all portions of the completed student application, transcript and Student/Parent Statements to: Magruder High School 5939 Muncaster Mill Rd. Rockville, MD 20855; Fax # 301-840-4617 Attn: Betty Nataro Phone # 301 840-4600 Receipt Deadline: November 19, 2013 MCPS prohibits illegal discrimination on the basis of race, color, gender, religion, ancestry, national origin, marital status, socioeconomic status, age, disability, physical characteristics, or sexual orientation. Inquiries or complaints regarding discrimination or Title IX issues such as gender equity and sexual harassment should be directed to the Office of the Deputy Superintendent of Schools at 301-279-3126, via the Maryland Relay at 1-800-735-2258, or addressed to that office at 850 Hungerford Drive, Room 129, Rockville, MD 20850. Magruder High School—Connect, Achieve, Excel Page 2 Attachment A Col. Zadok Magruder High School PEAC Scholars Pursuing Excellence in the Academic Curricula PEAC Scholars Course Requirements and Sequence Grade English Social Studies Science Freshman/9 PEAC Honors English 9 AP NSL PEAC Honors Matter & Energy Elective Seminars Or PEAC Honors Physics* Sophomore/10 PEAC Honors English 10 AP US History Junior/11 AP Language AP World History PEAC Honors Biology Each Semester AP Science or Math Quarterly –Student’s Choice Senior/12 AP Literature PhilosophySemester 1 Quarterly + Honors Seminar in Peace Studies Semester 2 All courses are required as shown except as noted below: *Optional; if student does not qualify or does not want to take PEAC Honors Physics, they will take PEAC Honors Matter & Energy Application Procedures and Checklist Attachment B Requirements: 1. Student must be eligible to attend Magruder High School in the 2014-2015 school year; as a home school program, students cannot apply to the program if they do not live within the official Magruder boundaries. 2. Student must be currently enrolled in Algebra 1 or higher. 3. Student must currently be in 8th or 9th grade. 4. Student must request submission of recommendations from three academic teachers and their current counselor. a. Required recommendation forms can be found in the application packet. 5. Student must include a copy of his/her final 7th grade report card. (This is not required for rising 10th grade applicants) 6. All student application paperwork must be at Magruder no later than 2 pm, Tuesday, November 19, 2013 (this is the deadline for arrival at Magruder, not for a postmark). No late applications will be considered. a. This includes the application and the parent and student statements. b. It is the student’s responsibility to get the completed application to Magruder High School by the due date. It is also the student’s responsibility to request his/her recommendations in a timely manner. If not submitted at least one week prior to the application deadline, they may not be considered by your middle school counselors and/or teachers who will be sending their recommendations to Magruder under separate cover. 7. Students must sit for an on-site essay in December; dates and times will be arranged with each middle school. Arrangements will be made for individual students currently attending Parkland, Argyle or Loiederman Middle Schools, Magruder High School or a school outside of MCPS. a. Essay prompts will not be released prior to the on-site visit. b. Students with current IEP or 504 Accommodations that apply to such tasks must work through their middle school prior to the writing session to make sure they will be in place. Checklist: 1. Requirements read and understood. 2. Teacher recommendations requested and noted on application (Attachment D) Teacher # 1 ___________________ Date Requested: ___________________ Teacher # 2 ___________________ Date Requested: ___________________ Teacher # 3 ___________________ Date Requested: ___________________ 3. Counselor recommendation requested and noted on application (Attachment E) Counselor: ____________________ Date Requested: ___________________ 4. Student application completed (Pages 1 & 2) 5. Copy of final 7th grade report card made (8th graders only*) 5. Student Statement read, signed and dated. (Attachment C) 6. Parent Statement read, signed and dated. (Attachment C) 7. Application, report card*, Student Statement and Parent Statement submitted to Magruder HS Date mailed: _____________________ Date: Delivered: ____________________ (Remember: they must be delivered to Magruder by November 19, 2013) 8. Spoke with Counselor about accommodations for essay session (if applicable) ________________ -this may be done after submission of the completed application but no later than November 25, 2013 Magruder High School, 5939 Muncaster Mill Rd. Rockville, MD 20855; Fax # 301-840-4617 Attachment C Col. Zadok Magruder High School PEAC Scholars Pursuing Excellence in the Academic Curricula Important improvements have been made to the PEAC Scholars Program. Please make sure to read all the information provided, including that in the PEAC Scholars brochure which can be found on the PEAC Scholars page of the Magruder website. A. Student Statement: I have read and accept all the requirements and responsibilities related to my application to the Magruder High School PEAC Scholars Program (please see Cover Letter, Attachments A and B). - Maintain of a 3.5 weighted GPA over the four years at Magruder H.S. Successfully complete all required courses (Please see Attachment A) Successfully complete 2 senior Capstone courses (1 each semester-Please see Attachment A) Attend all required seminars (beginning in sophomore year-Please see Attachment A) Adhere to MCPS and Magruder codes of conduct. If accepted into the program, I will notify Magruder High School of my intentions in a timely manner. Student Name: _______________________________ID # ____________ Date:___________________ Signature: _______________________________________________ B. Parent Permission Statement: I hereby approve of the submission of this application to Magruder High School’s PEAC Scholars Program for the 2014-2015 school year by my child, __________________________________________. I also give my permission for school officials to report my child’s achievement and grades when required. I understand that the teacher information will be maintained in confidence by the PEAC Scholars Admissions Committee and will not be made available to the parent and/or student. I also understand and accept that, if accepted and enrolled in the PEAC Scholars Program, my student will be required to: - Maintain of a 3.5 weighted GPA over the four years at Magruder H.S. Successfully complete all required courses (Please see Cover Letter & Attachment A) Successfully complete 2 senior Capstone courses (1 each semester-Please see Attachment A) Attend all required seminars (beginning in sophomore year-Please see Attachment A) Adhere to MCPS and Magruder codes of conduct. Parent/Guardian Name: ________________________________________ Date: ___________________ Signature: ___________________________________________________ MCPS prohibits illegal discrimination on the basis of race, color, gender, religion, ancestry, national origin, marital status, socioeconomic status, age, disability, physical characteristics, or sexual orientation. Inquiries or complaints regarding discrimination or Title IX issues such as gender equity and sexual harassment should be directed to the Office of the Deputy Superintendent of Schools at 301-279-3126, via the Maryland Relay at 1-800-735-2258, or addressed to that office at 850 Hungerford Drive, Room 129, Rockville, MD 20850. Magruder High School, 5939 Muncaster Mill Rd. Rockville, MD 20855; Fax # 301-840-4617