Holy Angels Academy Application for Admission

HOLY ANGELS ACADEMY

Thank you for your interest in Holy Angels Academy! This is our application for enrollment. Please complete this form in entirety and click "Submit" at the end of the form. Our office will then be in touch with next steps.

One application can be submitted for your entire family. On page 3 (this being page 1), you'll be asked how many children you are interested in enrolling. Depending on your answer, you will complete the "Student Information" section of this application for each child. If you are enrolling more than 8 children, please contact our office first as this form can only accomodate up to 8 children.

If at any point you wish to pause your application, please click "Save & Continue Later" at the end of each page. You'll receive an email with a link to resume your application at a later time.

Holy Angels Academy

visits@holyangelslouisville.com | (502) 254-9440

12201 Old Henry Road, Louisville, KY 40223

Application for Admission

Please complete this application in entirety and someone in our office will reach out with more details. Please note: a $28 application fee will be charged before this application can be submitted. This must be paid with credit or debit card.
Please tell us who is submitting this application so we can contact you if any questions arise.
Your Name*

First NameLast Name
Your Email Address*
example@example.com
Your Phone Number*
Please enter a valid phone number.
How did you hear about Holy Angels Academy?*

Parent Contact Information:

Please open each of the dropdown sections to fill in contact information for each individual.

Father's Contact Information
Father's Name

First NameLast Name
Occupation
Employer
Work Phone
Home Phone
Cell Phone
Fax
Email Address
Religion
Address

Street Address

Street Address Line 2

CityState

Zip Code

Mother's Contact Information:
Mother's Name

First NameLast Name
Occupation
Employer
Work Phone
Home Phone
Cell Phone
Fax
Email Address
Religion
Address

Street Address

Street Address Line 2

CityState

Zip Code

Step Parent/Other's Contact Information
Step Parent/Other's Name

First NameLast Name
Occupation
Employer
Work Phone
Home Phone
Cell Phone
Fax
Email Address
Religion
Address

Street Address

Street Address Line 2

CityState

Zip Code

Emergency Contacts:
Please specify at least 2 additional emergency contacts (must not be living with the student(s)):*

Medical Information

Authorization: I hereby grant permission to the representatives of Holy Angels Academy to decide, in case of emergency, what steps would be taken in the care of my child according to the prudent judgment of the Academy’s staff and, if necessary, an attending physician. I further accept responsibility for any and all medical expenses incurred in the treatment and care of my child while under the care of Holy Angels Academy.
Parent Signature*

Clear
Parent's Name*

First NameLast Name
Do you authorize the staff at Holy Angels Academy to administer Tylenol and/or Ibuprofen to your child(ren)? Please check all that apply.*

I authorize the use of IbuprofenI authorize the use of TylenolI DO NOT authorize the use of Ibuprofen or Tylenol

Medical Insurance Information
Does the student(s) have medical insurance?*

YesNo
Name of Company:
Company Address

Street Address

Street Address Line 2

CityState

Zip Code
Name of Subscriber:

Financial Responsibility
Person(s) financially responsible for the student:*
Does your family request financial assistance?*

YesNo
Please read financial assistance philosophy and particulars on the annual tuition handout. Consult the office if an application is needed.

Posting of Photo(s) & Inclusion of Name (Optional)

Do you permit your child(ren)’s photograph/name and/or our immediate family’s photography/name to appear in school and community publications, videos, and on the school website? Please sign below if you authorize this.
Parent's Signature

Clear
Parent's Name

First NameLast Name

Parent Questionnaire
How did you discover Holy Angels Academy?*
What attracted you to Holy Angels Academy?*
Why do you want your child(ren) to attend Holy Angels Academy?*
What do you see as your child(ren)’s main assets, qualities, strengths, and talents (academically, socially, physically, morally)? *
What approaches do you think are advantageous for teachers to be able to draw out the best attitude and achievement from your child(ren)?*
What talents, hobbies, or interests does the father of the student(s) have, including musical, dramatic, athletic, technological, gardening, lawn care, etc.?*
Are there any areas of professional expertise?
What talents, hobbies, or interests does the mother of the student(s) have, including musical, dramatic, athletic, technological, gardening, lawn care, etc.?*
Are there any areas of professional expertise?

Current Enrollment Status
Is your family currently attending Holy Angels Academy?*

Yes, we currently attend Holy Angels AcademyNo, we do not currently attend Holy Angels Academy

Application Fee

To submit your application, please complete the information below to pay your $28 fee. If you have any questions or concerns, please reach out to the office: (502) 254-9440.

Enter $28.00 (amount to be paid):

USDApplication fee: $28 per family not actively enrolled at Holy Angels Academy.

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Email Address for Receipt:
Billing Address

Street Address

Street Address Line 2

CityState

Zip Code

Completion of Form

All information on this application is considered by the school to be strictly confidential. Deliberate falsification of any information may result in the removal of the student from Holy Angels Academy. By signing below, you certify this to be true.
Parent Signature*

Clear
Parent's Name*

First NameLast Name
Note: If after clicking "Submit" you do not see our "Thank You" page, please click "Save & Continue Later". You'll receive an email with the link to your submission. Please forward this to info@holyangelslouisville.com and we can troubleshoot your submission.
Should be Empty:

	Received	Church/Parish	City & State	Date
Baptism
Penance
Eucharist
Confirmation

	School Name	School Address	Grade(s)	Dates
School #1
School #2
School #3

	Received	Church/Parish	City & State	Date
Baptism
Penance
Eucharist
Confirmation

	School Name	School Address	Grade(s)	Dates
School #1
School #2
School #3

	Received	Church/Parish	City & State	Date
Baptism
Penance
Eucharist
Confirmation

Application for Admission

Please tell us who is submitting this application so we can contact you if any questions arise.

Tell Us About Your Family

Parent Contact Information:

Medical Insurance Information

Financial Responsibility

Parent Questionnaire

Student #1's Information

Student Background Questionnaire

Student Interests

Student #2's Information

Student Background Questionnaire

Student Interests

Student #3's Information

Student Background Questionnaire

Student Interests

Student #4's Information

Student Background Questionnaire

Student Interests

Student #5's Information

Student Background Questionnaire

Student Interests

Student #6's Information

Student Background Questionnaire

Student Interests

Student #7's Information

Student Background Questionnaire

Student Interests

Student #8's Information

Student Background Questionnaire

Student Interests

Current Enrollment Status

Application Fee