East columbus magnet academy gifted and talented magnet




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EAST COLUMBUS MAGNET ACADEMY

GIFTED AND TALENTED MAGNET

Name: _________________________________________________________________________

Street Address: _________________________ City, State: ____________ Zip: _________

School currently attending: __________________________ Current Grade: ________

Homeroom teacher: _______________________________ Date of Birth: ______________

Father/Guardian’s Name: _______________________________ Home phone: ______________

E – mail address: _____________________________________ Cell phone: ________________

Mother/Guardian’s Name: ______________________________ Home phone: ______________

E – mail address: _____________________________________ Cell phone: ________________

Name of Employer: ____________________________________ Work phone: ______________
List your extracurricular activities (church, scouts, volunteer work, etc.): ___________________
______________________________________________________________________________________________________________________________________________________________
List Honors and Awards (academic, music, athletics, etc.): _______________________________

______________________________________________________________________________________________________________________________________________________________



Two 5th grade teachers’ signatures of recommendation:
_______________________________________________ ________________________________

Signature Subject area


_______________________________________________ ________________________________

Signature Subject area




THIS COMPLETED APPLICATION MUST BE ACCOMPANIED BY:

1. A copy of your current grade report card

2. A copy of your 4th grade report card
Please return application to:

East Columbus Magnet Academy

6100 Georgetown Drive

Columbus, GA 31907

Attn: Magnet Coordinator



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