Hartford Board of Education
Registrar's Office
960 Main Street, 8th floor
Hartford, CT  06103
Tel:  (860) 695-8876 or (860) 695-8699
Fax:  (860) 722-6161
Hours:  8:30 am - 3:30 pm
Email:  registrarsoffice@hartfordschools.org
Website:  www.hartfordschools.org

Hartford Public Schools
Hartford Host Interdistrict Magnet Schools Application
Non-Hartford Residents Only
School Year 2008-09

Application Deadline:  February 29, 2008

Must be received or postmarked by
Friday, February 29, 2008.

Late applications will be accepted, but will be added to the waiting list.


STUDENT BASIC INFORMATION:

First Name:    Middle Name:       Last Name:    

Address:  Street #:    Street Name:   Apt.

City:      State:    Zip Code:    

Date of Birth:        Gender:     Female    Male

Race:   American Indian     Asian      Black      Hispanic      Caucasian (White)
We are required by law to report racial information about our applicant and enrollment pools.

PARENT/LEGAL GUARDIAN BASIC INFORMATION:

Salutation:     Name:  

Home Phone:    Work Phone:    Cell Phone: 

CURRENT SCHOOL INFORMATION:

Select the Student's Current School: 

B.  If the Student's Current School isn't on the dropdown list above, please enter the current school's name here:

Select the Current School's City: 

C.  If the Student's Current School City isn't on the dropdown list above, please enter the current school's city here:  

Grade applying for NEXT school year (August 2008):      (this application is valid for this grade only)

SCHOOL SELECTIONS:  Please select the schools in order of preference:

1st Choice (School Name):
2nd Choice (School Name):
3rd Choice (School Name):
4th Choice (School Name):
5th Choice (School Name):
6th Choice (School Name):
7th Choice (School Name):
8th Choice (School Name):

List any brothers or sisters sharing at least one biological parent or guardian and living at the same household with applicant, attending one of the Hartford Host Interdistrict Magnet Schools.

Name of Child     Present School Grade

Are you selecting a Hartford Host Interdistrict Magnet School as a No Child Left Behind request?   Yes    No

How did you hear about Hartford Host Interdistrict Magnet Schools?  (Check all that apply):
        TV    Newspaper    Website    School    Friends/Family    Mailer
        Other - If other, please describe:   

I am applying for placement of my child at the Hartford Host Interdistrict Magnet School(s) indicated on this form.  I understand that the information provided by me on this application will be checked for accuracy, and that false information will disqualify the student.

I understand and accept the terms of this application.                      Yes    No

Please note that Friday, February 29, 2008 at midnight was the deadline for non-Hartford applications to be accepted into the lottery.  Any application submitted now will be accepted but handled as a late application which means it will be added to the waiting list below all of the lottery applications.