Returning Student(s) - 2025-2026

Returning Student(s) - 2025-2026

Family Data Change(s)

Please enter updated information only.
Name of Mother

First NameMaiden NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mother's Mobile / Primary Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Martial Status: Select One
Email:
Please enter a valid email
Mother's Employer / Occupation:
Work Days / Hours:
Name of Father

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Mobile / Primary Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Marital Status: Select One
Email:
Please enter a valid email
Father's Employer / Occupation:
Work Days / Hours:
Name of Legal Guardian

First NameLast Name
Guardian's Mobile / Primary Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Marital Status: Select One
Email:
Please enter a valid email
Guardian's Relationship to Student: Select One
Occupation:
Work Days / Hours:
Emergency Contacts and other adults authorized to pick up your children:
St. Cletus Parish Family? Select One

YesNo
Other Parish (Please Specify):

Extended Care Program - 2025-2026
Extended Care Program Information:

Click Here
Do you plan on using the extended care program?

YesNo
Family Name: {familyLast}
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone*
Please enter a valid phone number.
Other Phone
Please enter a valid phone number.
Student Information
Choose All That May Apply:

Before Care Regular UserBefore Care Occasional UserAfter Care Regular UserAfter Care Occasional User
Please provide details:
Parent/Guardian Information

Mother: {nameOf} Work: {workPhone75} Home: {phoneNumber}

Father: {nameOf87} Work: {workPhone} Home: {homePhone}
Emergency Contacts and other adults authorized to pick up your children.*
NOTE: We may request a photo ID of the authorized person picking up your child(ren).
Parent Authorization for before/after program enrollment (please initial below)initials*

Tuition Assistance Program - 2025-2026
Families requesting tuition assistance for the 2025-2026 school year may apply for St. Cletus School assistance through FACTS Management's Tuition Grant & Aid Program.

FACTS Tuition Grant & Aid Program (St. Cletus School Tuition Assistance)

Facts Sheet
Grant & Aid Application

· FACTS charges a $30.00 application fee.

· Tuition assistance awards will be determined and assigned in June 2024.
Planning to apply for tuition assistance for 2025-2026?

YesNo

Acknowledgement, Authorization, and Consent
By signing this form, I hereby authorize the school to use the information herein provided for the processing of my child's application. I understand that the information shared herein shall be for the purpose of the admission of my child.

I authorize and provide consent to the school in releasing my child's medical and health information with the school's health services.

In the event that my child becomes ill, sustains an injury, or in any case, needs immediate medical care during under the care and supervision of the school, I hereby authorize the school to administer first aid for my child's relief.

In the event that my child needs immediate attention and it is not practical to wait for receiving instructions from the parents or appointed legal guardian or the child, I, as a parent/legal guardian, hereby authorize the school, its staff, to act as agents in delivering my child to a hospital and performing decisions necessary as recommended by an attending physician for the care of my child such as conducting X-ray, anesthetic, and other medical treatments such as surgery.

I further declare that the information I have provided in this form is true and correct to the best of my knowledge.
Signature of Parent/Guardian
Date

MonthDayYear
Date
Should be Empty: