Student Payment Agreement Form
2023-2024 School Year
Student Name
*
First Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
Date
Student Grade
*
Please Select
K3
K4
K5
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
I agree to fulfill the requirements of one of the following payment plans for my child (check one):
*
Pay tuition in full by the first day of school.
Pay tuition in installments beginning July 1, 2023.
Complete an application and submit required documentation for the Milwaukee Parental Choice Program (MPCP)
Complete an application and submit required documentation for the Wisconsin Parental Choice Program (WPCP)
Complete an application and submit required documentation for the Special Needs Scholarship Program (SNSP)
If you have chosen to pay tuition through installments, please select the installment type:
Please Select
Monthly
Quarterly
Parent/Guardian Name
*
First Name
Last Name
Date
*
/
Month
/
Day
Year
Date
Parent/Guardian Acknowledgement: We are proud to provide a quality Catholic education for our students. We look forward to your child(ren) joining our school family. By signing below, you are agreeing to comply with the school’s policies and procedures outlined in the Student/Family handbook. We aim to serve as many children as possible. There may still be waiting lists for admission in certain grades and at certain times of the year. You will receive notification from our school on your official acceptance when documentation has been submitted and a seat is confirmed to be available for your child. Additionally, If your student does not get accepted into the choice program, a payment agreement will berequired to cover the cost of tuition.
*
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Internet Access at Home Survey
A new 2023-24 requirement issued by the Department of Public Instruction (DPI) is requesting that schools collect household information on the use and access of the internet in the home. Answers to the survey help identify school and district needs, target resources and funding opportunities, and are used to inform state policy and legislative initiatives.
Student Name
First Name
Last Name
Question 1: Can the student access the internet on their primary learning device at home?
Please Select
Yes
No - Not Available
No - Not Affordable
No - Other
Question 2: What is the primary type of internet service used at the residence?
Please Select
Residential Broadband (e.g. DSL, Cable, Fiber)
Cellular Network
School Provided HotSpot
Satellite
Dial-up
Other
None
Question 3: Can the student stream a video on their primary learning device without interruption?
Please Select
Yes - No Issues
Yes - Not Consistent
No
Question 4: What device does the student most often use to complete school work at home?
Please Select
Desktop/Laptop
Tablet
Chromebook
SmartPhone
None
Other
Question 5: Is the primary learning device a personal device or school-provided device and is it shared with anyone else in the household?
Please Select
Personal - Dedicated (dedicated device for the student)
Personal - Shared (sharing device with others in the household)
School Provided - Dedicated
School Provided - Shared
None
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