Document 6602527

STANDARD ELEMENTARY SCHOOLS APPLICATION
2015-2016 School Year
Please read directions on opposite side. Deadline - Friday, December 12, 2014
4637
Student's First Name
Student's Last Name
Has he/she ever been a CPS student?
Grade in Fall 2015:
Yes
Is your child a multiple? (twin, triplet, etc.)
Yes
No
Gender:
No
Male
Female
Inter-American applicants only:
What is your child's primary language?
(For 3 year-old Pre-K, use P3.)
(For 4 year-old Pre-K, use P4.)
(For kindergarten, use KG.)
(For all other grades, use number.)
English
Spanish
(Choose one only. See reverse for more information.)
Birth Date (MM/DD/YYYY)
CPS Student ID (If non-CPS, LEAVE BLANK)
/
/
Please indicate whether or not your child is Hispanic/Latino and his/her race. For informational use only.
Is your child Hispanic/Latino?
Yes
Race (choose one or more)
No
White
Black/African-American
American Indian/Alaska Native
Parent/Guardian Last Name
Student's Primary Address
Asian
Native Hawaiian/Other Pacific Islander
Parent/Guardian First Name
Direction Street Name (P.O. boxes not accepted)
City
State
Zip Code
Street Type Apt#
Student's Current School
Parent/Guardian Email Address CAPITAL letters only. Write number 1, letter I, letter L, letter O and number Ø.
Primary Phone
Secondary Phone
-
-
-
FOR OFFICE
USE ONLY
-
Select up to 20 schools from the list provided. Write the school code in the spaces provided below.
IMPORTANT SIBLING INFO
SIBLING SCHOOL CODE #
Sibling CPS ID#
Sibling Last Name
Sibling CPS ID#
Sibling Last Name
If you have a child already
enrolled in a school to which
you are applying, provide that SIBLING SCHOOL CODE #
sibling's CPS ID # and last
name in the space to the
right.
SCHOOL CODE #
If you do not have a child
already enrolled in a school
to which you are applying,
you can use the sibling
SCHOOL CODE #
school code boxes to apply
to additional schools.
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
SCHOOL CODE #
I affirm that the information provided on this form is true and correct. I affirm and understand that the address
provided on this form is my child's primary address and may be used for assigning a tier in the student assignment
process. I understand that I will have to provide proof of this address at the time of enrollment, and that the validity of
my child's application is dependent on that proof. If applicable, I affirm that the applicant is a sibling of the student(s)
indicated. I approve CPS to use this address to update my child's information in the system of record (IMPACT), and
understand this application does not guarantee acceptance into any of the schools. I understand that my child may
be subject to immediate removal from the school if admission was gained based on a falsified application.
REQUIRED
Signature of Parent/Guardian
DIRECTIONS FOR COMPLETING STANDARD ELEMENTARY SCHOOLS APPLICATION
We encourage you to apply online at www.apply.cps.edu. If you prefer a paper application, complete the application on the
reverse side. If you submit an online application, do not submit a paper application. Your completed paper application MUST be
submitted to the Office of Access and Enrollment, Attn: Standard Elementary Schools Application, 125 S Clark St., 10th floor,
Chicago, IL 60603. DO NOT SEND YOUR APPLICATION TO THE SCHOOL(S) TO WHICH YOU ARE APPLYING. Processing cannot be
guaranteed for applications that are not submitted to the Office of Access and Enrollment. Applications must be postmarked by
December 12, 2014. If you have an email address, you will receive an email confirmation once your application has been
processed. If you mail your application, we strongly recommend that you: (1) have a postal official postmark your envelope in
front of you, (2) send your application via registered or certified mail so that you will have a receipt, and (3) include a selfaddressed, stamped postcard/envelope with your application. The postcard/envelope will be returned to you to indicate that
your application has been received. Contact the Office of Access and Enrollment if you do not receive your postcard/envelope
within two weeks. Use this application to apply to elementary magnet, magnet cluster, and open enrollment schools only.
1.
Use blue or black Ink only, CAPITAL LETTERS ONLY, do not photocopy, do not staple, do not allow letters or numbers to touch
the lines of the squares.
2. If you are applying to Inter-American, please identify your child’s primary language – English or Spanish – in the box
indicated. Please select only one language. At the time of registration, your child will participate in a language screening to
confirm your language selection. If your child does not demonstrate fluency in the language for which they are applying,
your child will lose his/her seat in the class.
3. If your child is currently enrolled in a Chicago public, charter, or contract school, identify his/her CPS ID number on the
application. (The CPS ID number can be found on your child’s report card or on the Parent Portal, or can be obtained by
contacting your child’s school.) If your child is not currently enrolled in a Chicago public, charter, or contract school, leave
this section blank.
4. Indicate your child’s primary address, which is defined as the residence where your child sleeps at night. If you share joint
custody and your child sleeps at night at only one residence the majority of the time, that is the child’s primary address, and
that is the address that must be entered on the application. In cases of joint custody where a child’s residence is equally
divided between two addresses, either address may be used.
5. Identify whether or not your child is Hispanic/Latino AND your child’s race. This is for informational purposes only.
6. Select up to 20 schools to which you want to apply for your child. Identify the schools by writing the code of the school in
the boxes as indicated. The code for each school can be found in the Options for Knowledge guide or on the Office of
Access and Enrollment website, www.cpsoae.org (click ‘Apply’). If a school’s code is not listed, this means that the school is
overcrowded and is not considering applications from outside of its attendance area for the 2015-2016 school year. If you
have questions regarding school codes, contact the Office of Access and Enrollment at (773) 553-2060 or [email protected].
7. Magnet schools, magnet cluster schools, and open enrollment schools give preference to sibling applicants. In order to be
eligible to apply as a sibling, the applicant must have a sibling who is currently enrolled in the school to which he/she is
applying, and the currently enrolled sibling must remain enrolled in that school for the 2015-2016 school year. Identify the
enrolled sibling by listing in the indicated boxes the code of the school where the student is enrolled, along with the enrolled
student's last name and CPS ID number. (The CPS ID number can be found on the student’s report card or on the Parent
Portal, or can be obtained by contacting the student’s school.) If your child is applying as a sibling at more than two
schools, please contact the Office of Access and Enrollment at (773) 553-2060 or [email protected]. If you do not provide
identifying sibling information, the applicant will not be given sibling preference.
8. To be eligible for 3-year-old Pre-K, students must be three years old on or before September 1, 2015. To be eligible for 4year-old Pre-K, students must be four years old on or before September 1, 2015. To be eligible for kindergarten, students
must be 5 years old on or before September 1, 2015. To be eligible for 1st grade, students must be six years old on or before
September 1, 2015, unless your child qualifies for a 1st grade age exception. For information on the 1st grade age exception,
see page 11 in the Options for Knowledge Guide, or contact the Office of Access and Enrollment at (773) 553-2060 or
[email protected]. If you do not apply for the grade that is appropriate for your child, your child’s application will be marked
ineligible for the 2015-2016 application process.
9. Submit one application per student. If more than one application is received, your child will only be considered for the
schools on the first application that is processed by the Office of Access and Enrollment.
10. If you change your address after you submit your application, you must submit a Contact Information Modification Form,
available at www.cpsoae.org (click ‘Apply’). In order for your new address to be used in the process of determining tiers
and proximity boundaries, your form must be received by the Office of Access and Enrollment by February 13, 2015.
11. If you need to change your school choices, you must submit a Standard Elementary Application Modification form,
available at www.cpsoae.org (click ‘Apply’). Forms must be received by the Office of Access and Enrollment by February
20, 2015.
Checklist: Please double check the following to ensure that your application has been completed correctly.
o
o
o
o
All address fields completed (address number, direction, street name, street type and apartment number, if applicable).
If the applicant is a CPS or charter school student, the Student ID is listed.
If the applicant is a sibling, the sibling Student ID and last name have been accurately listed.
The application is signed by the parent/guardian.
Standard Elementary Schools Application
SCHOOL CODES – page 1 of 2
A school code is provided for each elementary magnet, magnet cluster, or open enrollment school that has space to consider applicants for the
2015-2016 school year. You may select up to 20 schools. Write the correlating school code in the spaces provided on the Standard Elementary
application. If you have a child already enrolled in a school that you are applying to, provide the sibling's CPS ID # and last name. If you do not
have a child already enrolled in a school to which you are applying, you can use the sibling boxes to apply to additional schools.
School Name
ADDAMS
AGASSIZ
ALBANY PARK
ALCOTT ES
ALDRIDGE
ARIEL
ARMOUR
ASHBURN
ASHE
AUDUBON
AVALON PARK
AVONDALE-LOGANDALE
BARNARD
BARRY
BARTON
BASS
BATEMAN
BEASLEY
BEAUBIEN
BEETHOVEN
BEIDLER
BELDING
BELMONT-CRAGIN
BENNETT
BLACK
BLAINE
BOND
BOONE
BOUCHET
BRADWELL
BRENNEMANN
BRENTANO
BRIGHT
BRIGHTON PARK
BROWN, R
BROWN, W
BROWNELL
BRUNSON
BUDLONG
BURKE
BURLEY
BURNHAM
BURNSIDE
BURR
CALDWELL
CALMECA
CAMERON
CAMRAS
CARNEGIE
CARROLL
CARVER , G
CASALS
CATHER
CHALMERS
CHAPPELL
CHASE
CHAVEZ
CHOPIN
CLAREMONT
CLARK, G
School Code
2020AD
2030AG
6290AP
2040AL
2710AE
3640AI
2070AU
7100AH
6900AS
2110AB
2130AV
7560LG
2150BR
2160BY
2170BT
2180BS
2190BE
6660BM
2240BN
6540BH
2250BG
2260BX
3390BC
2280BV
7860BL
2300BK
6550BO
2320BQ
2430BF
2340BW
6600BB
2370BI
2390BI
7470BG
5040BA
2400BO
2410BN
2550MB
2440BD
2460BK
2470BL
2480BH
2520BS
2530BX
2580CA
7880CC
2610CM
8600CM
2630CE
2650CR
2690CV
4290CL
6730CJ
2740CH
2750CQ
2760CB
5640CZ
2770CI
7830CG
2230CX
School Name
CLAY
CLEVELAND
CLINTON
CLISSOLD
COLEMON
COLES
COLUMBUS
COOK
COONLEY
COOPER
CORKERY
COURTENAY
CROWN
CUFFE
CULLEN
DALEY
DARWIN
DAVIS, M
DAVIS, N
DE DIEGO
DE PRIEST
DENEEN
DETT
DEVER
DEWEY
DISNEY
DISNEY II
DIXON
DODGE
DOOLITTLE
DRAKE
DRUMMOND
DUBOIS
DUNNE
DVORAK
EARHART
EARLE
EBINGER
EDGEBROOK
EDWARDS
ERICSON
ESMOND
EVERETT
EVERGREEN
EVERS
FAIRFIELD
FARADAY
FARNSWORTH
FERNWOOD
FIELD
FINKL
FISKE
FORT DEARBORN
FOSTER PARK
FRANKLIN
FRAZIER
FULLER
FULTON
FUNSTON
GALE
School Code
2790CL
2800CE
2810CI
2820CS
6170CO
2830CC
2850CU
2860CK
2880CN
2890CP
2910CY
7910CA
2940CR
4090CF
4100CZ
6560DA
2960DR
7000DM
2970DV
7420DE
8050DP
3010DN
6740DT
3020DD
3030DY
8000DH
8045DI
3040DX
3050DG
3070DS
3100DQ
3120DJ
8010DB
6050DF
6760DV
7450EA
3130ER
3150EI
3170ED
3200EW
3240EC
3250ES
3260EV
7490EG
7990EE
4660FA
4640FR
3280FN
3330FW
3350FD
3760FK
3360FS
3400FD
3430FP
3420FM
5850FZ
3440FU
3450FT
3460FQ
3480GC
School Name
GALILEO
GALLISTEL
GARVEY
GARY
GILLESPIE
GOETHE
GOUDY
GRAHAM
GREELEY
GREEN
GREENE
GREGORY
GRESHAM
GRIMES
GRISSOM
GUNSAULUS
HAINES
HALEY
HAMILTON
HAMLINE
HAMMOND
HAMPTON
HARTE
HARVARD
HAWTHORNE
HAY
HEARST
HEDGES
HEFFERAN
HENDERSON
HENDRICKS
HENRY
HEROES
HERZL
HIBBARD
HIGGINS
HOLDEN
HOLMES
HOWE
HOYNE
HUGHES, C
HUGHES, L
INTER-AMERICAN
IRVING
JACKSON, A
JACKSON, M
JAHN
JENNER
JENSEN
JOHNSON
JOPLIN
JUNGMAN
KELLMAN
KELLOGG
KERSHAW
KILMER
KING (formerly Hinton)
KIPLING
KOZMINSKI
LANGFORD
School Code
4160GS
3490GL
5420GA
3520GY
3530GI
3560GO
3590GD
3600GH
2730GE
4410GR
3650GQ
3660GG
3670GZ
3680GK
3580GJ
3690GF
3700HA
2360HY
3730HM
3740HN
3750HD
2350LH
3780HR
3800HV
3830HW
3840HC
3890HS
3900HG
3910HF
3920HO
3930HI
3940HX
3720HB
3970HJ
4000HK
7210HG
4020HO
4030HL
4060HW
4080HY
4110HU
8060HH
4890IN
5350IR
4690JA
8090JM
4170JH
4200JN
6920JS
6940JO
2330JP
4230JU
3410KC
4240KG
4270KE
4300KI
7250HI
4350KP
4390KK
2900LD
Standard Elementary Schools Application
SCHOOL CODES – page 2 of 2
A school code is provided for each elementary magnet, magnet cluster, or open enrollment school that has space to consider applicants for the
2015-2016 school year. You may select up to 20 schools. Write the correlating school code in the spaces provided on the Standard Elementary
application. If you have a child already enrolled in a school that you are applying to, provide the sibling's CPS ID # and last name. If you do not
have a child already enrolled in a school to which you are applying, you can use the sibling boxes to apply to additional schools.
School Name
LARA
LASALLE
LASALLE II
LAVIZZO
LAWNDALE
LEE
LELAND
LEWIS
LIBBY
LINNE
LOVETT
LOWELL
LOZANO
MADERO
MADISON
MANIERRE
MANN
MARINE MILITARY AT AMES
MARQUETTE
MARSHALL, T
MASON
MAYER
MCAULIFFE
MCCLELLAN
MCCORMICK
MCCUTCHEON
MCDOWELL
MCKAY
MCNAIR
MCPHERSON
METCALFE
MIRELES
MITCHELL
MONROE
MOOS
MORRILL
MORTON
MOZART
MT VERNON
MURPHY
MURRAY
NASH
NATIONAL TEACHERS
NEIL
NETTELHORST
NEW SULLIVAN
NEWBERRY
NICHOLSON
NIGHTINGALE
NIXON
NORTHWEST
NORWOOD PARK
OGDEN HS
OROZCO
OTIS
O'TOOLE
OWEN
OWENS
PARK MANOR
PARKER
PARKSIDE
School Code
3980LA
4420LL
8040LM
6260LZ
4430LW
7170LE
7320LD
4450LS
4470LB
4490LN
4530LV
4540LJ
4380LX
6310MA
4570MD
4580MI
4610MN
2090AM
4620MQ
7520MR
4650MS
4680MX
3770MF
4710ML
4720MM
6910MH
7390MW
4760MG
7040MT
4800MU
3190ME
5880MI
4840MT
4850MR
4870MS
4880ML
6800MC
5000MZ
4980MV
5020MH
5030MG
5050NA
6480NT
5060NI
5070NH
6100NS
5080NW
2200NC
5090NG
5100NX
4600NX
5120NP
8083OD
7610OO
5220OT
5230OL
5240OW
3470OC
5290PM
5270PC
5300PS
School Name
PEIRCE
PENN
PEREZ
PERSHING
PETERSON
PICCOLO
PICKARD
PILSEN
PIRIE
PLAMONDON
POWELL
PRESCOTT
PRITZKER
PRUSSING
PULASKI
PULLMAN
RANDOLPH
RAVENSWOOD
RAY
REAVIS
REILLY
REINBERG
REVERE
ROBINSON
RUGGLES
RUIZ
RYDER
SABIN
SALAZAR
SAUCEDO
SAYRE
SCAMMON
SCHMID
SCHUBERT
SEWARD
SHERIDAN
SHERMAN
SHERWOOD
SHIELDS
SHOESMITH
SHOOP
SKINNER
SMITH
SMYTH
SOLOMON
SOUTH LOOP
SOUTH SHORE
SPENCER
SPRY
STAGG
STEM
STONE
STOWE
SUDER
SUMNER
SUTHERLAND
SWIFT
TALCOTT
TALMAN
TANNER
TAYLOR
School Code
5360PI
5370PN
2930PZ
5400PH
5410PT
5210PO
5430PD
4210PE
5440PZ
5450PQ
7010PH
5500PG
6460PI
5510PU
5520PL
5530PN
3550RA
5550RV
5560RY
5580RE
5590RY
5600RI
5610RR
6780RB
5660RJ
5390RZ
5670RX
7790SB
6720SZ
4250SC
5720SY
5730SA
5950SH
5800SU
5820SE
4920SR
5890SM
5900SI
5910SL
5920SO
5930SP
5940SW
3870ST
5970SF
5980SJ
3960SD
2015SO
6000SP
6010SY
7760ST
8678SM
6070SA
6080SX
6340SD
6110SU
6120SR
6130SF
6140TA
6680TL
6970TN
6150TY
School Name
TELPOCHCALLI
THORP, J
THORP, O
TILL
TILTON
TURNER-DREW
VANDERPOEL
WACKER
WADSWORTH
WALSH
WARD, J
WARD, L
WARREN
WASHINGTON, H
WATERS
WEBSTER
WELLS, I
WENTWORTH
WEST PARK
WESTCOTT
WHISTLER
WHITE
WHITTIER
WILDWOOD
WOODLAWN
WOODSON
YATES
YOUNG
School Code
3380TP
6180TR
6190TO
4740TI
6210TT
3110TU
6250VA
8030WK
6300WW
6320WL
6330WD
5470WA
6350WR
5380WH
6370WS
6380WT
5250WP
6390WB
5140WF
7260WC
6420WY
7440WE
6450WZ
6470WI
3860WO
7820WX
6510YT
6520YO