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#WeChooseSLPS
Stud
ent’s
Nam
e
D
ate
of B
irth
Sex
La
st
Firs
t
M
iddl
e
Addr
ess
St
reet
City
Stat
e
Zi
p
Curr
ent S
choo
l
Sc
hool
Dist
rict o
f Res
iden
ce
Hom
e Ph
one
Num
ber (
)
Em
erge
ncy
Phon
e N
umbe
r (
)
Emer
genc
y Co
ntac
t
Plea
se P
rint
to a
noth
er p
erso
n?
SPEC
IAL
EDU
CATI
ON
: Is y
our c
hild
in th
e Fi
rst S
teps
Pro
gram
? (p
resc
hool
onl
y)
Yes
No
Yes
No
Yes
No
Futu
re g
rade
in
Sep
t. 20
19
Plea
se R
ead:
-
INCO
MPL
ETE
APPL
ICAT
ION
S W
ILL
NO
T BE
PRO
CESS
ED.
Scho
ol D
esire
d
or
Firs
t cho
ice
Seco
nd c
hoic
e
(K-8
)
Lyo
n Ac
adem
y at
Blo
w
5
18(P
3-2)
g
593
(P3-
2)
g Wilk
inso
n Ea
rly C
hild
hood
at R
oe
603
(3-5
)
Hum
bold
t Aca
dem
y of
Hig
her L
earn
ing
4
96(P
4-5)
G
atew
ay E
lem
enta
ry
4
73
4
47
(P3-
5)
g Was
hing
ton
Mon
tess
ori
601
(P4-
5)
Am
es V
isual
& P
erfo
rmin
g Ar
ts
425
(P4-
5)
Sha
w V
isual
& P
erfo
rmin
g Ar
ts
5
78
K=Ki
nder
gart
en |
P3=
Pres
choo
l Age
3 |
P4=
Pres
choo
l Age
4M
agne
t Mid
dle
Scho
ols (
6-8)
Mag
net H
igh
Scho
ols (
9-12
)AE
SM@
L’O
uver
ture
325
Busc
h Sc
hool
of C
hara
cter
3
05Ga
tew
ay M
ath
& S
cien
ce P
rep
3
23
Carr
Lan
e Vi
sual
& P
erfo
rmin
g Ar
ts
3
07
# Ga
tew
ay S
TEM
111
17
3#
Met
ro A
cade
mic
& C
lass
ical
(9 a
nd 1
0 ap
plic
ants
onl
y)
156
^# C
leve
land
Nav
al Ju
nior
RO
TC @
Sou
thw
est (
9 an
d 10
app
lican
ts o
nly)
144
# Ce
ntra
l Visu
al &
Per
form
ing
Arts
(9 a
nd 1
0 ap
plic
ants
onl
y)
186
# M
cKin
ley
Clas
sical
Lea
ders
hip
Acad
emy
157
# Co
llegi
ate
Scho
ol o
f Med
icin
e an
d Bi
osci
ence
(9-1
1)
100
# Ca
rnah
an S
choo
l of t
he F
utur
e
193
# Cl
yde
C. M
iller
Aca
dem
y
117
# N
orth
wes
t Law
Aca
dem
y
194
* Ag
e el
igib
ility
bef
ore
Augu
st 1
for p
resc
hool
and
kin
derg
arte
n en
try
mus
t be
met
. See
elig
ibili
ty re
quire
men
ts a
t ww
w.s
lps.
org/
mag
net.
# Re
quire
men
ts m
ust b
e m
et to
be
elig
ible
for a
dmiss
ion.
g Bu
s tra
nspo
r-
is 42
inch
es. A
pplic
ants
for t
he 1
1th
and
12th
gra
de a
t Cle
vela
nd m
ust h
ave
prev
ious
RO
TC e
xper
ienc
e to
qua
lify
for p
lace
men
t. N
ote:
Pre
scho
ol p
rogr
ams a
re a
vaila
ble
to S
t. Lo
uis C
ity st
uden
ts. S
t. Lo
uis C
ount
y
Pare
nt 1
Nam
e
W
ork/
Cell
# (
)Pa
rent
1 E
mai
lPa
rent
2 N
ame
W
ork/
Cell
# (
)Pa
rent
2 E
mai
l
Plea
se In
dica
te A
pplic
ant’s
Rac
e:SE
LECT
ON
LY O
NE
CODE
B Bl
ack/
Afric
an A
mer
ican
*W
W
hite
/Cau
casia
nH A I
Bira
cial
- Bl
ack*
Bi
raci
al -
Non
-Bla
ck*C
ount
y Re
siden
ts o
f the
se ra
ces a
re n
ot e
ligib
le
Yes
No
Yes
No
Requ
irem
ents
mus
t be
met
to b
e el
igib
le fo
r
2019
-202
0G
ENER
AL E
DU
CATI
ON
AP
PLIC
ATIO
N20
19-2
020
Sibl
ings
are
defi
ned
as ch
ildre
n ha
ving
on
biol
ogica
l or a
dopti
ve p
aren
t in
com
mon
and
resid
e in
the
sam
e ho
useh
old.
To
rece
ive
siblin
g co
nsid
erati
on fo
r one
child
, the
oth
er ch
ild m
ust b
e en
rolle
d in
the
scho
ol o
f cho
ice a
nd b
e sc
hedu
led
to co
ntinu
e in
that
scho
ol fo
r the
com
ing
year
, and
that
scho
ol m
ust b
e lis
ted
as th
e fir
st ch
oice
on
this
appl
icatio
n fo
rm. S
iblin
g co
nsid
erati
on e
xten
ds to
one
scho
ol o
nly.
No
siblin
g ap
plica
nts w
ill b
e co
nsid
ered
for p
riorit
y pl
acem
ent a
fter t
he P
ool B
App
licati
on p
erio
d clo
ses.
ESO
L: D
oes s
tude
nt u
se a
lang
uage
oth
er th
an E
nglis
h?
Plea
se sp
ecify
:Ye
sN
o
Whi
ch la
ngua
ge(s
) doe
s the
stud
ent u
se (s
peak
) at h
ome
and
with
oth
ers?
W
hich
lang
uage
(s) d
oes t
he st
uden
t hea
r at h
ome
and
unde
rsta
nd?
Pare
nt S
igna
ture
Da
te
READ
BEF
ORE
CO
MPL
ETIN
G P
APER
APP
LICA
TIO
N: P
leas
e fil
l the
app
licati
on o
ut a
t ww
.slp
s.or
g/m
agne
t. If
you
do n
ot h
ave
com
pute
r acc
ess a
t hom
e, th
ere
are
com
pute
rs a
vaila
ble
to fi
ll ou
t and
subm
it ap
plic
ation
s at t
he O
ffice
of S
tude
nt R
ecru
itmen
t at t
he S
LPS
Boar
d of
Edu
catio
n (8
01 N
. 11t
h St
, St.
Loui
s, M
O 6
3101
). Pa
per a
pplic
ation
s will
take
add
ition
al ti
me
to p
roce
ss.