KINDERGARTEN APPLICANTS MUST BE 5 BY SEPTEMBER 1^ST. NO EXCEPTIONS WILL BE MADE.

Dear Parent, Please complete all of the information asked and return this form to the school office. Information regarding testing dates and applicable fees can be found on the accompanying paperwork.

LAST NAME                                                                                                             GRADE (Sept. 2010)              

Registered in Sacred Heart Parish  ___Yes  ___No   Date registered                             Parish Envelope ___________

Student’s Last Name                                        First Name                                                       Middle Name

Home Phone Number                                      Sex (M/F)                                                         Birthplace/Date

Home Street Address                                       City                                                                  Zip Code

Child lives with :  ____ Both Natural Parents   ____ Mother   ____ Father    _____ Other: ______________________

Schools Previously Attended       Grade(s)                   Street               City/State/Zip Code                  Phone Number           

________________________           _______                   _____________________________________    ____________
________________________           _______                   _____________________________________    ____________  ________________________           _______                   _____________________________________    ____________                 

Baptism Date                           Church & Street Address                                  City                              State/Zip

____________                           ___________________________________           __________________     ____________  

(Please note that if you are a legal guardian, cross out Father or Mother and write in “Legal Guardian”.)

Father’s Last Name                  First Name                   Religion                                   Occupation/Work Phone #

_____________________           ________________        __________________                 ___________/_____________

Home Address: __________________________________________________                    Home Phone # ____________

Marital Status __Single __Married __Divorced __Remarried          Email Address: _________________

Cell Phone Number: _____________________

Mother’s Last Name                 First Name                   Religion                                   Occupation/Work Phone #

_____________________           ________________        __________________                 ___________/_____________

Home Address: __________________________________________________                    Home Phone # ____________

Marital Status __Single __Married __Divorced __Remarried          Email Address: _________________

Cell Phone Number: _____________________

Child Applicant’s Name                                                                                                                                              

                                                Last                                             First                                         Nickname

Entering Grade                                      Birthdate                                                          Present Age                          

Religious Education Attendance:         Yes                                    No                          

If Yes, Where?                                                                                                                                                            

Has your child attended Catholic school previously?                            If so, how long attended?                             

Previous School(s) Attended:  (If school attended was Catholic, please asterisk)

Name of School:                                                                                                  From                             To                  

Name of School:                                                                                                  From                             To                  

Name of School:                                                                                                  From                             To                  

Mother/Guardian                                                                                                                          _______________

                                                 Last                                       First                           Maiden                                Religion                       

E-Mail: ________________

If name different from applicant’s, what name is used?                                                                                                      

Father/Guardian                                                                                                                           _______________

                                                 Last                                       First                           Maiden                                Religion                        

E-Mail: ________________

If name different from applicant’s, what name is used?                                                                                                      

Who has legal custody of the applicant?                                                                                                                         

Please check where applicable:

Catholic                                      Non-Catholic                              Do you attend Mass regularly?                         

Are you a “registered parishioner” of Sacred Heart Church?  (i.e. receiving envelopes/contributing regularly):

No  ___Yes  ___   Envelope Number                                  Year Registered                                  

Please indicate the parish in which you reside (not necessarily the parish where you are registered):

Name of Parish                                                                    City

Have you been active in Sacred Heart Parish?  ___No  ___Yes (i.e., festival, religious education, youth ministry, etc.)    

If yes, in what capacity?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        

Do you belong to any parish groups or organizations? ___No ___ Yes

If yes, please list.

                                                                                                                                                            OVER->

How did you find out about Sacred Heart School?  (Be specific, please)    ________________________________

Do you have other children applying for admission for the 2010-2011 school year? ___ Yes   ___No

If so, please list below.

Name                                                  Applying for Grade:

_________________________          ______________

_________________________          ______________

_________________________          ______________

Do you have other children currently enrolled in Sacred Heart School?  ___Yes   ___No

If so, please list below.

Name                                                  Grade in 2010-11

_________________________          ______________

_________________________          ______________

_________________________          ______________

If you have more than one child applying, would you be willing to send only one child if we do not have room for the others?

Are there any special circumstances of which we should be aware?  (i.e. family situations, personal etc.) 

___ Yes   ___ No    If yes, please describe:

Why do you want your child to attend Sacred Heart School?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           

Please add any information, which might be pertinent in helping us evaluate this application.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                

Any other family background information which you would like to add?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   

Please list any relatives that attend or have attended Sacred Heart School:

First and Last Name               Past or Present Student         Years attended            Relationship to Applicant

__________________            _____________________      _____________          _____________________

__________________            _____________________      _____________          _____________________

__________________            _____________________      _____________          _____________________

__________________            _____________________      _____________          _____________________