APPLICATION FOR ADMISSION
(Please use a black ink pen and print clearly)
Grade: ________________________ Date: __________________________
Academic Year:
________________ Student SS #: ____________________
Student’s Name: ________________________________________ Nickname: _____________________
(last) (first) (middle)
Date of Birth:
_______________________City & State of
Religion:
___________________________If Catholic, what parish? _______________________________
Baptized: Yes / No Reconciliation: Yes / No 1st Communion: Yes / No Confirmed: Yes / No
Father: _____________________________________Mother:
____________________________________
Address: ___________________________________
Address: ___________________________________
E-mail: ____________________________________
E-mail: ____________________________________
Home Phone:
_______________________________ Home Phone: ________________________________
Business Phone: _____________________________
Business Phone: _____________________________
Employer: __________________________________
Employer: __________________________________
Occupation: _________________________________Occupation:
________________________________
Religion: ___________________________________
Religion: ___________________________________
Parent Information: ________Married
________Separated ________Divorced _________Deceased
Child Lives With: _____ Both
Parents _____Father_____ Mother _____Grandparents _____ Guardian
Paternal Grandparents:
___________________________________________________________________
Maternal Grandparents:
__________________________________________________________________
Please list the other
children in your family:
Name: Age: School: Grade:
____________________________ ________ _________________________________ _______
____________________________ ________ _________________________________ _______ ____________________________ ________ _________________________________ _______ ____________________________ ________ _________________________________ _______
School currently attending:
______________________________________________________________________________________
Grade average in current
school year in subjects of
English: _______________________
Math: ______________________Science: _____________________
Other schools previously
attended: (Please give name, address and
years of attendance.)
____________________________________________________________________________________________________________________________________________________________________________
Please indicate applicant’s
Hobbies:
______________________________________________________________________________________
Sports preference:
______________________________________________________________________________________
Special interests:
________________________________________________________________________
Are there any special
problems that the school should be aware of, for example, hearing, diet,
medical needs or other difficulties: ____________________________________________________________________________________________________________________________________________________________________________
If our student is accepted
for admission to Our Lady of Grace High School, we agree that we will uphold
the policies and regulations of the school as represented by the administration
and faculty; we will reinforce the student’s education through encouragement
and supervision at home. ____________________________________________ ______________________________________
Father’s signature Date
Mother’s signature Date
Non-Discriminatory Policy: Our Lady of
Grace High School is in compliance with the Civil Rights Act of 1964 and other
federal statutes of non-discrimination in its employment and admission
practices. It admits qualified students
of any race, color, sex, national or ethnic origins to all the rights,
privileges, programs and activities generally accorded or made available to
students at the school.
School hours are 8:15 – 3:50
p.m.
Base Tuition Rates For 2008-2009 School Year: $7,900
(through May 31st) $8,150 (June 1st & following)
includes textbooks.
Refund Policy: Base tuition is not refundable for any
withdrawal, whether voluntary or involuntary.
Fees are never refundable.
$250 is required at
registration. $200 of this fee will be
applied toward tuition upon acceptance of the student. If the student does not decide to attend the
school the $200 is forfeited.
Payment Options: Amount payable upon acceptance
is one half of the annual tuition, with the balance due May 31, 2007.
Please choose one method of
payment:
(1) _______ Payment in
full. $100 discount applies.
(2) _______ One half payment no later than 2 weeks from date on acceptance letter,
one half payment by
May 31.
Mail completed application
and applicable fee (no cash please) to:
Our Lady of
I understand the information
presented above and to the best of my knowledge, the information I have
provided is correct. I agree to abide by
the policies as set forth in the parent/student handbook and any other policies
as promulgated by the school administration.
Father’s Signature
__________________________________________
Date: _____________________
Mother’s Signature
_________________________________________
Date: _____________________