| Application for: |
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| Student's Name: |
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| Gender: |
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| Address: |
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| Date of Birth: |
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| Religion: |
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| Home Phone: |
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| Father's Name: |
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| Father's Religion: |
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Father's Address
(if not the same as the student's): |
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Father's Home Phone
(if not the same as the student's): |
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| Father's Work Phone: |
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| Father's Cell Phone: |
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| Father's Occupation: |
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| Father's Business Name/Employer: |
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| Father's Business/Employer's Address: |
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| Mother's Name: |
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| Mother's Religion: |
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| Mother's Address (if not the same as the student's): |
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| Mother's Home Phone (if not the same as the student's): |
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| Mother's Work Phone: |
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| Mother's Cell Phone: |
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| Mother's Occupation: |
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| Mother's Business/Employer's Name: |
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| Mother's Business/Employer's Address: |
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| Language(s) Spoken at Home: |
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| Registered Member of St. Anns Church: |
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| If NO, please name parish: |
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| Child lives with: |
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| Correspondence and bills should be sent to: |
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| School Student Last Attended: |
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| Please read: |
I understand that I must send a copy of my student's academic records to St. Ann's Academy in order to be considered for admission. |
| Address: |
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| Current Grade: |
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| Has your child received diagnostic/psychological testing?: |
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| If YES, please read: |
I understand that I must provide a complete copy of diagnostic/psychological testing to St. Ann's Academy. |
| Baptism date and place: |
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| Penance date and place: |
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| Holy Eucharist date and place: |
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| Confirmation date and place: |
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| Names, Ages, and Current Schools of Siblings: |
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| Is either parent or another family member an alumnus of St. Anns Academy? |
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| If YES, please list name, class, and relationship to the student: |
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| Please read: |
I understand that there is a $50.00 non-refundable processing fee for this application. I understand that the processing fee should be mailed to the address listed above. |
Both parents/guardians must sign and date.
Parent/Guardian Signature #1
In the event that my child is accepted, my typed name on this electronic form indicates my agreement to abide by all St. Ann's Academy guidelines and policies including the following:
1. Parents are expected to volunteer their services and expertise within the school.
2. Parents agree to adhere to the school's policies as given in the school handbook.
3. As part of a contract with the school, parents assume the responsibility of paying all tuition and fees according to the school's tuition policy, and the signed agree to pay all costs of collection, including attorney's fees, should they fail to pay all of such tuition and fees. |
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Both parents/guardians must sign and date.
Parent/Guardian Signature #2
In the event that my child is accepted, my typed name on this electronic form indicates my agreement to abide by all St. Ann's Academy guidelines and policies including the following:
1. Parents are expected to volunteer their services and expertise within the school.
2. Parents agree to adhere to the school's policies as given in the school handbook.
3. As part of a contract with the school, parents assume the responsibility of paying all tuition and fees according to the school's tuition policy, and the signed agree to pay all costs of collection, including attorney's fees, should they fail to pay all of such tuition and fees. |
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