Enrollment Application

New Student Application Form

2019-2020

Student Information:

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Preferred Name:

Answer Required

Primary Phone*

Answer Required

Date of Birth *

Answer Required

Age*

Answer Required

Place of Birth*

Answer Required

U.S. Citizen*

Answer Required

yes

Religion *

Answer Required

Parish/Church

Answer Required

Baptized Catholic

Answer Required

yes

Present School (Name, City/State, Phone)*

Answer Required

Present Grade*

Answer Required

Parent/Guardian 1:

Title: *

Answer Required

Dr.

Mrs.

Mr.

Ms.

Relationship to Student: *

Answer Required

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Email 1*

Answer Required

Mobile Phone*

Answer Required

Home Phone

Answer Required

Work Phone

Answer Required

Occupation and Employer*

Answer Required

Parent/Guardian 2:

Title:

Answer Required

Dr.

Mrs.

Mr.

Ms.

Relationship to Student

Answer Required

First Name

Answer Required

Middle Name

Answer Required

Last Name

Answer Required

Mobile Phone

Answer Required

Home Phone

Answer Required

Work Phone

Answer Required

Address

Street Address

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Occupation and Employer

Answer Required

Please list siblings of student and ages: *

Answer Required

Please write a brief statement explaining why you wish to enroll at Annunciation Catholic School, what are your expectations and what you will contribute to the ACS community. *

Answer Required

Please provide any additional family information, educational history, special needs, comments, or questions that you would like to bring to the principal's attention or to address during the family interview process.

Answer Required

Do you have family members who are former ACS students?

Answer Required

yes

If yes, list name and years he/she attended ACS:

Answer Required

How did you hear about Annunciation Catholic School?

Answer Required

Referral's Name:

Answer Required

Did you attend the following?

Answer Required

Open House

Private Visit to ACS

I understand that the principal must conduct a family (parent and child) interview to determine acceptance to Annunciation Catho- lic School. Prior to the family interview, I must submit a copy of my child’s report card (not applicable for students applying for Prek orKindergarten.) Kindergarten applicants may be required to take a Kindergarten Readiness Evaluation prior to acceptance to Kindergarten.

I understand that if my child is accepted to attend Annunciation Catholic School that enrollment is not complete until the receipt of the non-refundable registration fee, copy of birth certificate, immunization record (MS121), proof of insurance, Emergency Contact Information Form, School Records Request Form, the Parish Verification Form (for Catholic parishioners to receive the Catholic tuition rate), the Home Language Survey, the Tuition Payment Form and Financial Contract.

I also understand that if my child is accepted, the first 90 days of his/her attendance at Annunciation Catholic School is a probationary period.

Signature: *

Answer Required

Date: *

Answer Required

Annunciation Catholic School admits students of any race, color, religion, gender or national origin.

Please fix the highlighted areas below before submitting.

Enrollment Application