Denver Public Schools

Smiley Middle School

International Preparatory Magnet

Application Form

(Please Print)

Present Grade ___

 

 

Name:_______________________________________ Student ID: ___________________ Sex: _______

                 (Last Name)                            (First Name)

Street Address:_____________________________________ Home phone:_________________________

 

City: ___________________ State:____________________ Zip Code: ____________________________

 

Date of Birth: _______________________ State/Country of birth: ________________________________

                                (Month/Day/Year)                                                                   (State/Country)

 

Ethnicity: __Amer. Indian __ African Amer. __Asian __Hispanic __White      Language Spoken:__________

 

Current School: ___________________________ Denver Neighborhood Middle School:______________

 

Do you already play an instrument?(Yes or No) _______________ Are you interested in band?(Yes or No)

                                                                                                (Instrument)

Person to contact:

                Mother’s Name: ___________________________ Mother’s Phone Number: _________________

 

                Father’s Name: ____________________________Father’s Phone Number: __________________

 

An official copy of the most recent ITBS and or CSAP test scores from your school, along with a copy of the most recent report card must be attached, and the teacher recommendation form must be received at Smiley in order for the application to be considered.

 

 

All applications and teacher recommendations must be returned to the address below

Smiley Middle School

Attn: IPM Application

2540 Holly St.

Denver, Co 80207

 

A math test and writing sample will be given on the following dates.  No appointment necessary just show up.

These tests must be taken to determine if an interview will be granted.

.

 

Office Use Only

 

ITBS Standardized Test                                CSAP Standardized Test                  Name of Standardized Test

Grade when taken: ____                                Grade when taken: ____                  Grade when taken: ______

____Reading Comprehension %                    ____Reading                                    _____Ravens

____Language Total %                                   ____Writing                                     _____COGAT

____Math Total %                                           ____Math                                         _____Other___________

____Composite %