2026-2027 St Bartholomew Catholic School K-8 Application Form

Elementary School Application Form

2026-2027
Student Information
Student Name*

First NameLast Name
Student Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Student's Gender*
Student's Birth Date:*

MonthDayYear
Student's City of Birth:*

Street Address

Street Address Line 2

CityState

Zip Code
Student's State of Birth:*

Street Address

Street Address Line 2

CityState

Zip Code
Student's Race*
Student's Ethnicity*
School student currently attends*
School Name
Student's Current Grade*
Grade
Student Lives With*
Academic ConcernsSpeech and or Language ConcernGross / Fine Motor DevelopmentBehavioral ConcernsNone
Does the student have an IEP or Student Support Plan?*
Does the student have a 504 Plan?*
Has the student ever been suspended or expelled?*
Has the student ever been involved with tobacco, alcohol, or drugs?*
Have major disciplinary actions ever been necessary for the student?*
How did you hear about St Bartholomew Catholic School?*
Referral Details (Include name if applicable)
Is this student a sibling of a current St Bartholomew Catholic School Student?*
Religious Information

Please enter only the student's information below.
Religion*
Is your family an active member of St. Bartholomew Catholic Church?*
Has your child been Baptized?*
Has your child received the sacrament of First Holy Communion?*
Is your child attending a CCD Program?*
Additional Student Information
Student's hobbies or interests:
Briefly explain why you would like your child to attend St Bartholomew Catholic School:*

Parent Information

Please enter only the parent information below. Also, provide at least a minimum of 2 contacts if applicable
Mother/Guardian's Name*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Primary Phone Number:*
Format: (000) 000-0000.
Mobile Number:*
Format: (000) 000-0000.
Office Phone Number:
Format: (000) 000-0000.
Employer (If none, enter NA)*
Mother's/Guardian's E-mail*
example@example.com
Alternate Email
example@example.com
Religion*
Country of Birth*
School Alumni?
If yes, please specify year of graduation
Father's/Guardian's Name*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Father's/Guardian's Primary Phone Number:*
Format: (000) 000-0000.
Mobile Number:*
Format: (000) 000-0000.
Office Phone Number:
Format: (000) 000-0000.
Employer (If none, enter NA)*
Father's/Guardian's E-mail*
example@example.com
Alternate Email
example@example.com
Religion*
Country of Birth*
School Alumni?
If yes, please specify year of graduation

Student Medical Information
Does the student have any medical conditions*
If you answered "YES" to the question above, please list in the box below.
Medical Conditions
Does the student take any medications?*
If you answered "YES" to the question above, please list in the box below.
Medications
Does your child have any allergies? (peanuts, chocolate, etc.)*
If you answered "YES" to the question above, please list your child's allergies.
Allergies
Student Release Information
Emergency Contact #1*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
Relation*
Emergency Contact #2*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
Relation*
Emergency Contact #3*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
Relation*
In addition to those listed above (Guardian, Parents, & Emergency Contacts), please list the individuals who are also allowed to pick up your child from school.*
Allowed to pick up child.
Please list any individual who is NOT allowed to pick up your child from school.
NOT Allowed to pick up child.
Parent/ Guardian Signature*
Please submit the documents listed below if applicable

Please upload the following: Report Card showing promotion to current grade, Standardized Test Results from previous two years, Psychoeducational Evaluation Copy (if applicable), Speech/Language Evaluation Copy (if applicable), 504 Plan Copy (if applicable), Birth Certificate
Cancelof
Application Fee is Non-Refundable
Should be Empty:

Elementary School Application Form

Student Information

Religious Information

Additional Student Information

Parent Information

Student Medical Information

Student Release Information