Jackson Madison County School District

Early College High and Academic Academy Application

Verification

Which school are you applying to?

JCM-Early College High

Student Information

Legal First Name Isaac Gender [en:Male][es:Masculino]

Legal Middle Name Edward Date of Birth 01/03/2007
Legal Last Name Adriano

Residential Address

Address 42 Bryant St State Tennessee

City Jackson Zip Code 38301

Where is the student zoned to attend school for the 2021-2022 school year?
Liberty Technology Magnet High School

Academic Information

Applying Grade 9

Jackson Central Merry Early College

Applying School
High

Which school does your student currently attend?

North Parkway Middle School

Has you student been involved in the GEMS program?

[en:No][es:No]

Previous School

Has your child previously attended or is currently attending a Jackson-Madison county school?
[en:Yes][es:Sí]

Select school North Parkway Middle School

Last enroll date 07/29/2020

Is this student currently enrolled in:

Special Education No
English as a Second Language No
Section 504 Plan No
Gifted and Talented No
Speech No

Ethnicity

Is the student of Hispanic/Latino heritage?

[en:Yes][es:Sí]

Race

Student's Race [en:White (Caucasian)][es:Blanco (Caucásico)]

[ ] American Indian
 [ ] Asian
[ ] African American
[ ] Pacific Islander

Parent/Legal Guardian Information

Who does the student live with?

[en:Both Parents][es:Ambos Padres]

Are there special custodial court instructions for this student?

[en:No][es:No]

Mother
Primary Phone 731-267-3889
First Name Fidelia Phone Type Cell
Last Name Adriano
Email [email protected]
Does this parent reside at a different address other than the [ ] Check if this parent does not have an email
student's primary address? address
[en:No][es:No]
Employer House Wife
Work Phone
Extension

Education level completed

Less than High School Diploma

Father
Primary Phone 731-267-3417
First Name Isaac Phone Type Cell
Last Name Adriano
Email [email protected]
Does this parent reside at a different address other than the [ ] Check if this parent does not have an email
student's primary address? address
[en:No][es:No]
Employer Construction Worker
Work Phone
Extension

Education level completed

Less than High School Diploma

Legal Guardian - Only if different from Mother or Father

Primary Phone
First Name Phone Type
Last Name
Email
Relationship to Student [ ] Check if this parent does not have an email
address
Does this guardian reside at a different address other than the
student's primary address? Employer
Work Phone
Extension

Education level completed

Application Questions
(To be completed by Parent/Guardian) Evaluate your child on the following characteristics by checking the appropriate box.
 Accepts academic challenge Often
Accepts personal responsibility Often
Accepts responsibility for learning Often
Communicates ideas effectively Often
Completes tasks Often
Has interests beyond the classroom Occasionally
Makes decisions independent of
Rarely
peers
Shows respect for authority Often
Works independently Occasionally
Works well with peers Often

Social/Emotional Characteristics
(To be completed by Parent/Guardian) Evaluate your child on the following characteristics by checking the appropriate box.

Enthusiasm Excellent
Integrity/Honesty Excellent
Judgement/Common Sense Excellent
Kindness Excellent
Leadership Excellent
Maturity Excellent
Motivation Excellent
Patience with Others Excellent
Social Skills Excellent

Essay Questions

Š You may submit your essays by uploading a saved copy or using the text fields below.

Essay 1

This essay is to be written by the parent/guardian using the space provided on this form. Respond to both questions:

Š Why do you want your child to attend JCM Early College High School?
Š How will you support your child as a student at JCM Early College High School?

[X] I wish to upload my essay

Type Response Here:

Upload your document

Parent Essay.docx
here

Essay 2

This essay is to be written by the student using the space provided on this form. Respond to all three questions:

Š What are your academic strengths and talents?

Š Why did you choose to apply to JCM Early College High School?
Š Why should JCM Early College High School accept you?

[X] I wish to upload my essay

Type Response Here:

Upload your document

Early College High.docx
here

Teacher Evaluations
The application process for Jackson Central Merry Early College High requires 3 teacher evaluation forms.

Š It is the applicants responsibility to email the teacher or other school employee requesting the recommendation form be submitted. You can
find email addresses of all district employees on the JMCSS website.
 Š Three recommendations are required: (1) Mathematics (2) English (3) Other

STUDENT EXPECTATIONS
If you are accepted to JCM Early College High School, you agree to accept and follow the expectations below:

Š I will make education a high priority in my life, including positive participation in class and school activities.
Š I will work to achieve and exceed my potential.
Š I will be punctual and maintain good attendance in all high school and college classes.
Š I will take responsibility for my own learning, behavior, and success.
Š I will devote time each night to homework, studying, and reading.
Š I will behave in a manner that shows respect for the high school, college, school facilities, and equipment.
Š I will maturely handle the freedoms of scheduling in a college setting, and understanding that taking college courses is a privilege, not a
right.
Š I will adhere to the technology agreements of JCM Early College High School, Jackson State Community College, and TCAT.
Š I understand that I will be required to complete several classroom projects to help me apply classroom concepts to real world situations.
Š I understand that it is my responsibility to be familiar with the Student Handbook and adhere to the policies therein.

PARENT/GUARDIAN EXPECTATIONS
If your child is accepted to JCM Early College High School, you agree to accept and follow the expectations below:

Š I will ensure that my student has good attendance and arrives to school on time.
Š I will ensure that my student has transportation to and from school and other functions as needed.
Š I will expect my student to complete homework and assignments to the best of his/her ability.
Š I will stay informed about JCM Early College High School activities by checking the school website, and reading information sent home with
my student or via email.
Š I will attend any parent meetings or conferences arranged by the JCM Early College High School staff.
Š I understand that my student is responsible for following all rules and regulations for JCM Early College High School, Jackson State
Community College, and TCAT.
Š I understand that my student may have homework each night.
Š I understand that my student will be required to complete several classroom projects to help him or her apply the concepts to real world
situations.
Š I understand that it is my responsibility to be familiar with the Student Handbook and adhere to the policies therein.

Parent/Legal Guardian Signature

The electronic signature below and its related fields are treated by the school district like a handwritten signature on a paper form.

I Agree [en:Yes][es:Sí] Date 02/26/2021

Parent's/Guardian's
Fidelia Adriano
Signature