Holy Family Catholic School Admission Application

Holy Family Catholic School Admission Application

Kindergarten - 8th Grade
Student Information
Please Select Year Applying for:
Students Name

First NameLast Name
Students Date of Birth

MonthDayYear
Date
Place of Birth
Gender
Student is entering which grade?
Students Ethnic Background
Students Racial Background (Click all that Apply)
Students Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary Address (If applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Previous School
Reason for leaving last school
Student Custodial Information
Does other Parent have legal access? ***If applicable please attach a true copy of the Shared Parental Responsibility of the Final Judgement.
Student Emergency Contact List
Primary Contact 1

First NameLast Name
Phone Number 1
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Contact 2

First NameLast Name
Phone Number 2
Please enter a valid phone number.Format: (000) 000-0000.
If Primary / Seconadry can't be reached Contact 3

First NameLast Name
Phone Number 3
Please enter a valid phone number.Format: (000) 000-0000.
Student Religion
Student Baptism Date / Church / Address
Student Reconciliation Date / Church / Address
Student First Eucharist Date / Church / Address
Student Confirmation Date / Church / Address
Has your child been tested for exceptional education?
Has your child been tested for special learning needs? If yes, please submit a copy of the evaluation and date of the of that evaluation.
Has your child been diagnosed with special learning needs?
Has your child received services from a resource teacher, Title I teacher, or learning specialist?
Has your child received accomidations in the learning process? If yes, then please provide a copy of the SSP or IEP.
Does your child have an SSP, IEP or 504 Plan in place? If yes please provide a copy to the plan.
Please list the days your child was absent days absent and days tardy* last school year.
Please list any Co-Curricular Activities in which your child has participated in
EX: Sports, Dance/Cheer, Theater, Altar Server, Music...
Please list any allergies / and medications for your child
Essay: All students applying for admission in grades 6th, 7th or 8th grades are required to Handwrite an essay on the topic of:

"The importance of an education....."
1. Parent / Guardian Information

Information for First Parent / Guardian
1. Parent / Guardian Name

First NameLast Name
1. Parent / Guardian Primary Phone #
Please enter a valid phone number.Format: (000) 000-0000.
1. Parent / Guardian Secondary #
Please enter a valid phone number.Format: (000) 000-0000.
1. Parent / Guardian Primary Email
example@example.com
1. Parent / Guardian Secondary Email
example@example.com
1. Relationship to the Student
1. Marital Status
1. Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
1. Level of Education
1. Graduate from Holy Family Catholic School ?
1. Parent / Guardian Occupation
1. Employer
1. Religion

Other
1. Member of Holy Family Church
Parish Affiliation:
I /we are not members of Holy Family Church. I/we members of Name of Church* .
2. Parent / Guardian Information

Information for Second Parent / Guardian
2. Parent / Guardian Name

First NameLast Name
2. Parent / Guardian Primary Phone #
Please enter a valid phone number.Format: (000) 000-0000.
2. Parent / Guardian Secondary #
Please enter a valid phone number.Format: (000) 000-0000.
2. Parent / Guardian Primary Email
example@example.com
2. Parent / Guardian Secondary Email
example@example.com
2. Relationship to the student
2. Marital Status
2. Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2. Level of Education
2. Graduate from Holy Family Catholic School ?
2. Parent / Guardian Occupation
2. Employer
2. Religion

Other
2. Member of Holy Family Church
Parish Affiliation:
I /we are not members of Holy Family Church. I/we are members of Name of Church* .
Family Financial Obligations
Is your child currently enrolled with a Step Up for Students Scholarship?
Which Up for Students Scholarship are you applying / reapplying for?
Application and Registration Fees (non-refundable): $50 Application Fee per student to be included with this application form. Once accepted, the balance of Student Registration Fee is due (non-refundable) will be billed through Facts and is due before the start of School.

The school tuition and registration fees may be greater than the amount of the Step Up For Students Scholarship Award. Remainder of the balance will be the responsibility of the legal parent or legal guardian. All finances are through FACTS Tuition Management Software. Payment plans will be available.

This application is not a guarantee that you will be accepted by Holy Family Catholic School for the coming school year. It represents your request that HFCS accepts your child for enrollment during the coming year. HFCS reserves the right to decline enrollment.

I certify that all the information contained in this application is correct. I acknowledge that the falsification of information or any misrepresentation of the facts can be sufficient reason for denying application and/or dismissal from school.
Please Acknowledge the above Terms:
Parent / Guardian Signatures:

In divorce or separation situations, each parent must act within the authority granted by the custody agreement. One parent may not sign a school application on behalf of the other. Applications must be signed by the parent or legal guardian with legal or educational decision-making authority.
Legal Parent / Legal Guardian
Legal Parent / Legal Guardian 2

HFCS Application Fee

USDEnrollment Application Fee

Credit Card

Should be Empty:

Holy Family Catholic School Admission Application

Student Information

Student Emergency Contact List

1. Parent / Guardian Information

2. Parent / Guardian Information

Family Financial Obligations

Parent / Guardian Signatures:

HFCS Application Fee *

Credit Card

HFCS Application Fee