METRO NASHVILLE PUBLIC SCHOOLS
MIDDLE COLLEGE HIGH SCHOOL
at Nashville State Community College
120 White Bridge Road
Nashville, Tennessee 37209

APPLICATION FOR ADMISSION 

Please read each question carefully and answer to the best of your ability. Incomplete or ambiguous answers may delay your being considered for admission to
Middle College High School.

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Please check the selection below that indicates when you would like to begin attending MNPS Middle College High School. 2nd Semester 2009-2010 (January 2010) Fall 2010 (August 2010) MNPS Middle College High School is a collaborative agreement between the Metropolitan Nashville Public School System and Nashville State Community College. In addition to academic courses taken for high school graduation, students will select college courses that can lead to an associate's degree, technical certificates or general core courses that may lead to a bachelor's degree. The college environment encourages students to take ownership and responsibility for their education. If you believe that Middle College High School is where you want to be, then please proceed by answering the following questions. Student's Full Name: Sex: Male Female Address: Zip: Age at last birthday Date of Birth: Home Phone:  Enter a valid phone number. Example: 123-456-7890 Social Security#: Student's Cell Phone:  Enter a valid phone number. Example: 123-456-7890 Student's E-mail:  Enter a valid email address. Example: name@company.com Current School: Grade in 2009-2010: Parent/Guardian Address: Parent's Work Phone:  Enter a valid phone number. Example: 123-456-7890 Parent's Cell Phone:  Enter a valid phone number. Example: 123-456-7890 Parent's Place of Employment: Parent's E-mail:  Enter a valid email address. Example: name@company.com How did you find out about MNPS Middle College High School? (Check all that apply.) Counselor Teacher Principal Web Site Parent/Guardian Friend Other Telephone message Direct Mail Are you currently receiving any Section 504 accommodation or special education services designated through an IEP? Yes No Do you currently attend ELL classes or require ELL services? yes no If the answer to the above question is "yes", please explain which classes you take or services you receive in the following space. Middle College's special relationship with Nashville State Community College enables our students to take college-level courses in Nashville State's own classrooms which also count towards high school credit requirements ("Dual Enrollment"). Are you interested in taking college level courses? Yes No What classes would you be interested in taking at Nashville State Community College? Have you taken the PLAN Test, ACT or SAT College Entrance Exam? If so, please enter your score(s) here. (This information is not required for enrollment at Middle College High School, but assists us in planning your college classes.) Please describe your high school experience, including your involvement in any extracurricular activities such as sports, theater, clubs, etc. You may also provide a description of community involvement, such as summer league sports, church and other volunteer activities. Include employment experiences, if any. What subjects are easy for you? Which subjects are difficult? Have you received disciplinary referrals? Have you been suspended from school during your high school years? If so, please explain. (Answering "yes" to this question does not necessarily disqualify you from admission to MCHS. Please answer honestly.) Describe how do you keep yourself organized. What resources do you use to help you? What will your current principal say about your overall behavior in school? What would your principal and your teachers say about your academic habits? Think about your favorite teacher in your current school. What traits would that person say best describe you? Name one person in your life who best exemplifies your meaning of the word "trust" and explain why? How do you feel about attending school on an adult/college campus? MNPS Middle College High School and Nashville State Community College offer a rigorous academic curriculum, which will require you to demonstrate a high level of commitment, maturity, and responsibility. You are expected to demonstrate behaviors that will ensure that you have an optimal opportunity for success. Tell us how you will balance the freedoms of the college campus (such as no bells, less supervision, freedom to leave campus for lunch, and flexible scheduling) with the responsibilities of the academic program. Please describe any experiences that have occurred in the last few months that would indicate or demonstrate how you take responsibility for your actions. This space is provided for you to make any additional comments that you would like for us to consider as we examine your application. If you are accepted to MNPS Middle College High School, the teachers, administration and staff will be committed to you and your success. Are you prepared and willing to make a like commitment to completing the program at the Middle College High School? Yes ______________(initial at interview) No Parent/Guardian Signature: Date: STUDENT/PARENT SIGNATURES AND AGREEMENT Our signatures below certify to the best of our knowledge that all information provided in this application is accurate and complete. Also, if selected to attend Middle College High School, we agree to follow all the rules and regulations of Metro Nashville Public Schools, Nashville State Community College and MNPS Middle College High School at all times. Student Signature: Date: This application is not complete until we have copies of Gateway and/or EOC Tests, TCAP scores, and two letters of recommendation (from a teacher, counselor, principal, etc.) If coming from a school system outside of Metro Nashville Public Schools, or if coming from a home school environment, transcripts must also be provided.