1398 Mt. Royal Avenue, Baltimore, MD 21217 Phone: 4 10-225-3257 Fax: 410-225-3514

2011-2012:

___BH ___WIBH ___RH ___WIRH ___MBD ___WIMBD ___OA Received______

…uniting diverse communities, igniting an enduring passion for learning, developing outstanding global citizens 1398 Mt. Royal Avenue, Baltimore, MD 21217 Phone: 4 10-225-3257 Fax: 410-225-3514 Website: www.midtownacademy.org

APPLICATION Deadline for submission to be considered for the 2011-2012 admissions lottery is February 22, 2011.

As per Baltimore City Public Schools, all kindergarten applicants must be 5 years of age by September 1, 2011. *Parents whose children turn 5 between September 2nd and September 15th of the school year may request early admission to kindergarten by completing an Early Admission Request Packet(which can be picked up at the child’s zone school). Early entrance into Kindergarten is intended for children with exceptional ability who are capable of working in a classroom setting with children who are at least one year older. All openings (kindergarten – 8th grade) are filled by Baltimore City residents first, and in accordance with Midtown’s admissions process. If additional openings are available, applicants from outside of the city will be contacted.

______/___/___ Student’s Last Name First Name Middle Birth Date

Grade as of September 2011: K 1 2 3 4 5 6 7 8

For planning purposes only: _____Male _____Female

My child’s current school is: ______Years attended______

Previously my child attended: ______Years attended______

Siblings applying to The Midtown Academy: ______Grade ______Grade ______Grade ______(Please complete a separate application for each sibling.) Do you have other children currently attending The Midtown Academy? ______Is the applicant the sibling of a graduate of The Midtown Academy? ______If yes, what year did he/she graduate? ______

Legal Guardian One: ______Relationship: ______

Address: ______

______

______Work Phone Home Phone Cell Phone

______E-mail Address Fax

Legal Guardian Two: ______Relationship: ______

Address: ______

______

______Work Phone Home Phone Cell Phone

______E-mail Address Fax Does either guardian work in Bolton Hill, Reservoir Hill, or Midtown Benefits District? If so, please give company name and address: ______

School Information

______I have received a packet of information about The Midtown Academy.

______I have had a tour of The Midtown Academy.

How did you hear about The Midtown Academy?

Personal Contact: ______BCPSS: ______Television or Radio: ______Website: ______Newspaper: ______Other: ______

Parent’s Signature: ______Date: ______

Please be sure that your application has been filled out completely and that you have completed a separate application for each sibling. Mail all applications to 1398 Mt. Royal Avenue, Baltimore, Md. 21217 or email directly to Rhonda Jones at [email protected]

______

Please direct any questions or concerns to Rhonda Jones, Admissions Coordinator, by calling 410-225-3257 ext.203 or by email at [email protected]

Please Note: If your child’s application is not selected for the 2011 – 2012 school year, and you wish to apply for the following school year, you must fill out another application. Applications do not roll over from year to year.

Thank you for considering The Midtown Academy as your Baltimore City public charter school of choice.

The Midtown Academy Lottery will be held February 24, 2011, at 9:30 AM.

…uniting diverse communities, igniting an enduring passion for learning, developing outstanding global citizens