Montessori High School at University Circle
2018-2019 Application
Part I.
General Information and Short Answer Questions
Applicant Name *
First Name
Middle Name
Last Name
Preferred Name
Gender * Female Male Self-Identify
If choosing to self identify, please elaborate.
Preferred Pronouns (he/him, she/her, etc)
Birth Date * Month
Present Age *
Grade Applying For *
Day
Year
Present Grade *
Applicant Status Day Student 5 Day Boarder 7 Day Boarder
Home Address *
Street Address
Street Address Line 2
City
State / Province
Country
Postal / Zip Code
Applicant's Personal Email *
example@example.com
Applicant's Cell Phone * Area Code
Phone Number
Applicant's Home Phone * Area Code
Phone Number
Country of Citizenship *
Country of Birth *
Dual Citizenship * Yes No
If yes, what other country do you hold citizenship?
If possible, please attach a copy of the applicant's birth certificate. A copy of the applicant's birth certificate is not required to finish the application; however, the admissions application is not considered complete until this document has been submitted.
Parents' or Guardians' Information 1: Parent or Guardian Name *
First Name
Last Name
Relationship to Applicant * Parent Guardian
Address - If different than above
Street Address
Street Address Line 2
City
Postal / Zip Code
State / Province
Country
Home Phone Number - If different than above  Area Code
Phone Number
Cell Phone Number * Â Area Code
Phone Number
E-mail *
example@example.com
Employer *
Title *
2: Parent or Guardian Name
First Name
Last Name
Relationship to Applicant Parent Guardian
Address - If different than above
Street Address
Street Address Line 2
City
Postal / Zip Code
State / Province
Country
Home Phone Number - If different than above  Area Code
Phone Number
Cell Phone Number  Area Code
Phone Number
example@example.com
Employer
Title
Student lives with: * Mother Father Both Parents Guardian(s) Other
Student's parents or guardians are: * Married Domestic Partners Single Parent Separated Divorced Widowed
Siblings Full Name
Grade
Gender
_____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________
Indicate relatives that have attended MHS. _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________
Indicate all schools attended in the last 5 years. * _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________ _____________________________________________________
Has applicant received social services such as an IEP, 504, or other similar plan? *
Yes No If yes, please define:
Attach a copy of the applicant's social service plan. PLEASE NOTE: All social service plans (IEP, 504, etc) must be included at the time of application submission. Applications will not be considered complete without official documentation. The admissions committee has the right to rescind any offers of admission due to falsification or ommission of social service documentation.
Has applicant ever received severe disciplinary censure at school or from the community? *
Yes No
Has applicant ever been asked to withdraw by school? * Yes No
Has applicant ever been expelled? * Yes No If yes for any of the above questions, please explain in detail.
Attach a copy of the applicant's unofficial transcript. An unofficial transcript is required for an admission decision. Find the MHS Transcript Release Form on the following page.
Avanti Scholarship Program The Avanti Scholarship is an MHS donor-funded scholarship designed for students who qualify for financial assistance and who have a demonstrated potential to enrich the MHS community through leadership, artistic ability, community engagement, or scholastic achievement. This program offers scholarship support for students whose financial need exceeds the maximum tuition assistance (50%). Preference will be shown to applicants who reside in the City of Cleveland. Qualities and Characteristics of an Avanti Recipient • Commitment to intellectual growth and curiosity as demonstrated through academic performance and teacher recommendations • Community engagement and citizenship demonstrated through involvement in school, neighborhood, or larger community • Desire to become an active member of the MHS community Along with completing this general admissions application, to be considered for the Avanti Scholarship, applicants must submit a financial aid application, and Avanti Scholarship Program application by November 15th. A complete MHS application includes the general information section, short answer questions, essay questions, parent statement, all recommendations, official school transcripts, student shadow experience, and application fee. Students interested in applying for the Avanti Scholarship will receive an Avanti Scholarship application upon upon completion of this general application. Students who have not completed the MHS application by November 15th will not be considered for the scholarship. Scholarship applicants will be notified if they have advanced to the semi-finalist stage on December 1st. Avanti Scholarship Program interviews for semi-finalists will be conducted between December 2nd and December 15th. Award letters will be mailed with MHS admission decision letters on January 13th.
Will you be applying for the Avanti Scholarship? Yes
Not at this time
Thank you for your interest, the scholarship committee will be contacting you regarding eligibility and application requirements.
Applicant Personal Responses Responses can be submitted in the text boxes under each question or uploaded as a file. All uploaded documents must be submitted as either .doc or .docx files or as PDF files. Short answer responses should be uploaded separately from the essay response, which will be shared with the applicant after the shadow experience.
Short Answer Questions 100-200 words each
Attach short answer response file here.
1. Tell us about the school or after-school activity that is most important to you. Explain why it is important. 2. Tell us why you are interested in joining Montessori High School at University Circle. 3. Describe any jobs held, volunteer work performed, or community service performed. If school related, please indicate. 4. What is your biggest strength? Do you use this strength to help others?
Declaration I/We do hereby attest that the information contained in this application is true and accurate to the best of my/our knowledge. I/We further acknowledge that the submission of this application permits Montessori High School at University Circle to review transcripts, test scores, evaluations, and recommendations about the applicant in the determination of admission. I/We hereby certify that I/we will notify Montessori High School at University Circle if I/we wish to withdraw this application or halt the review process.
Applicant Signature *
First Name
Last Name
Date *
Month
Day
Year
1: Parent or Guardian Signature *
First Name
Last Name
Date *
Month
Day
Year
2: Parent or Guardian Signature
First Name
Last Name
Date
Month
Day
Year
Montessori High School at University Circle provides equal opportunity for all students and applicants for admission or employment, and does not discriminate on the basis of race, color, creed, religion, national origin, sexual orientation, veteran status, age, or sex in the administration of its educational policies, admissions policies, employment policies, scholarship and loan programs, athletics, and other school-administered programs and activities. Discrimination on the basis of disability in educational programs, activities, and employment at Montessori High School at University Circle is prohibited.
A $50.00 application fee is due prior to the student shadow experience. Please pay with a credit card online, by phone, or in-person.
For further instructions regarding the application fee, please contact Stefani Rose, Associate Director of Admissions, at 216-421-3033 or by email at srose@montessorihighschool.org.