Application 2021-2022

Application 2021-2022
Student Information
Student's Name:

First NameMiddle NameLast Name
Gender

MaleFemale
Age
Religion
Telephone
Format: (000) 000-0000.
Applying to Grade
Current School
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Place

CityState
Birth Date
PLEASE CHECK ALL THAT APPLY: THIS INFORMATION IS CONFIDENTIAL.
Ethnic Background

HispanicWhiteAfrican AmericanPacific IslanderFilipinoAmerican IndianAlaskan NativeOther non-whiteAsian(Please specify)Other
Home Status(Dependent & Living with)

Both parentsFatherMotherLegal GuardianFoster ParentShared CustodyOther
Language Spoken at Home

EnglishSpanishOther
Student's Spoken Language(s)

EnglishSpanishOther
Parental Information - Father

MarriedSingleSeparatedRemarriedDivorcedDeceased
Parental Information - Mother

MarriedSingleSeparatedRemarriedDivorcedDeceased
Student’s Citizenship:

U.S. CitizenOther
Student Visa

YesNo
Family Information
Parent 1 Information
Parent 1 Name

First NameLast Name
Email
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number

Area CodePhone Number
Birth Place
Occupation
Name of Business
Type of work
US Citizen

YesNo
Religion
Car Driver's License
This information is strictly Confidential
Social Security Number
This information is strictly Confidential
Parent 2 Information
Parent 2 Name

First NameMiddle NameLast Name
Email
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number

Area CodePhone Number
Birth Place
Occupation
Name of Business
Type of Work
US Citizen

YesNo
Religion
Car Driver's License
This information is strictly Confidential
Social Security Number
This information is strictly Confidential
Sibling's Information
Sibling Name 1

First NameLast Name
Date of Birth
Sibling Name 2

First NameLast Name
Date of Birth
Sibling Name 3

First NameLast Name
Date of Birth
IF CHILD NOT LIVING WITH PARENT(S)
Legal Guardian

First NameLast Name
Relationship to child
Home Address of Legal Guardian

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Work Address of Legal Guardian

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation
Business Phone Number

Area CodePhone Number
WHO WILL BE RESPONSIBLE FOR PAYMENT OF TUITION?
Name

First NameMiddle NameLast Name
Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Cell Phone Number

Area CodePhone Number
Name of Parish, Church, or temple currently attending
City
Registered?

YesNo
SCHOOLS: List school(s) previously attended, include preschool and kindergarten as well as elementary
School Name 1
School Address
Street,City,Zip,Phone
Phone Number
Format: (000) 000-0000.
School Name 2
School Address
Street,City,Zip,Phone
Phone Number
Format: (000) 000-0000.
School Name 3
School Address
Street,City,Zip,Phone
Phone Number
Format: (000) 000-0000.
Has child received special testing?

YesNo
If Yes, explain
Child's special health concerns
Reason for interest in Holy Cross School
Neighbourhood public school
Other Family Members Who are attending Holy Cross School:
Name 1
Grade
Name 2
Grade
Name 3
Grade
Name 4
Grade
Other Family Members Who have Attended Holy Cross School:
Name 1
Year of Graduation
Name 2
Year of Graduation
Name 3
Year of Graduation
Name 4
Year of Graduation
How Did You Learn About Holy Cross School? (check all that apply)

Newspaper AdvertisementPosted FlyerWeb siteFacebook pageParish BulletinWord of mouthDriving through areaAlumni referralCurrent family referralOther
Submitter's Email*
example@example.com
Date
APPLICATION FEE of $75 must be paid before the application is processed. Submit below when your payment is complete.
Please enter your payment confirmation number*
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Application 2021-2022

Student Information

Family Information

Sibling's Information

IF CHILD NOT LIVING WITH PARENT(S)

WHO WILL BE RESPONSIBLE FOR PAYMENT OF TUITION?