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Incoming 6th grade Honors Program Information

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Application for the 2019-2020 School Year

For Students Entering Sixth Grade, Harris Middle School operates an honors program for students in 6th-8th grade.

Application Deadline: February 14th, 2019

Admission Criteria for 6th grade students:

Testing for incoming 6th grade honors applicants who have met deadline requirements will take place Tuesday, February 19th from 5:30 - 7:30pm at Harris Middle School and Saturday, February 23rd at 8:00 - 10:00 am at Harris Middle School. Please choose one of these times to test. Please use the front entrance.

Notifications for acceptance will be sent out the week of March 4th, 2019. The deadline to notify the school of intent will be March 15th, 2019.

Student Name: _____________________________________________________________________
First Middle Last
Address: __________________________________________________________________________
# and Street Apt. City State Zip

Current Grade: ____ Date of Birth: __________________ Social Security Number: _____________________

Gender: __Male/ __ Female Race: ___Asian___ Black___Hispanic___American Indian ___ Indian ___White

School Currently Attending in 2018-2019: ______________________________ Teacher(s): ___________________

Proposed Grade for 2019-2020 ____________ What school would your child attend next year:_______________
Has your child ever been retained? __________________
If the answer is yes, please give the grade level and school: ___________________________________________
Father's Name: ________________________________ Mother's Name: _________________________________
Father's Work: ________________________________ Mother's Work: _________________________________
Father's Work #: ______________________________ Mother's Work #: ________________________________
Father's Cell #: _______________________________ Mother's Cell #: _________________________________
Father's Home Phone #: _________________________Mother's Home Phone #: _________________________
Father's email: _________________________________Mother's email: ________________________________
*** My child will need transportation: ____ YES ____ NO
What is your child's first language? _______________________________________________
What language does your child speak most often? ___________________________________
What language do people usually speak in your home? _______________________________

Has your child ever been identified or enrolled in a gifted education program in another school or school district? _________________________________
If yes, when? _____________________________ Where: __________________________________________
Does your child receive any Special Education Services? ___________________________________________
Resource _____________ Speech _____________ Other _____________
Please provide a copy of your child's Individualized Education Plan if he/she requires test modification or is receiving services through Special Education.
Standardized Test or TCAP Information
Attach the most recent standardized achievement test scores or TCAP scores (this can be obtained from your child's homeroom teacher or school office)
Test: _______________________________________________ Date: ____________________________

Total Reading Percentile Rank: ___________________________________
Total Mathematics Percentile Rank: _______________________________
Total Language Percentile Rank: __________________________________
Total Science Percentile Rank: ____________________________________
Total Social Studies Percentile Rank: _______________________________
We request that all of the parents or guardians of the child named above sign below to indicate agreement with this student making application to the Thomas Magnet School for the 2018-2019 school year. If custody is shared, please arrange for both parents to sign consent below:
Parent/Guardian Consent:
I give permission for my child to be evaluated.

Signature of Parent or Guardian Date

Signature of Parent or Guardian Date

Parents must submit application by Thursday, February 14th, 2019, to Harris Middle School.

Applications can be submitted in person at Harris Middle School or via mail at the address listed below:
Harris Middle School
570 Eagle Blvd.
Shelbyville, TN 37160