Admissions Application

Name *
Name
Date of Birth *
Date of Birth
Home Address *
Home Address
Home Phone *
Home Phone
Parent Information
Father
Father's Name
Father's Name
Father's Home Phone
Father's Home Phone
Father's Work Phone
Father's Work Phone
Please provide the following information only if diff erent from the applicant information above
Father's Home Address
Father's Home Address
Father's Cell Phone
Father's Cell Phone
Mother
Mother's Name
Mother's Name
Mother's Home Phone
Mother's Home Phone
Mother's Work Phone
Mother's Work Phone
Please provide the following information only if diff erent from the applicant information above
Mother's Home Address
Mother's Home Address
Mother's Cell Phone
Mother's Cell Phone
Family Information
Stepparent or Guardian
Guardian's Name
Guardian's Name
Guardian's Home Phone
Guardian's Home Phone
Guardian's Work Phone
Guardian's Work Phone
Please provide the following information only if diff erent from the applicant information above
Guardian's Home Address
Guardian's Home Address
Guardian's Cell Phone
Guardian's Cell Phone
Parents (Please check all that apply)
Applicant lives with
If applicant’s parents are divorced, which parent has legal responsibility for
Name, age, grade, school attended
Scholastic Information
School Address
School Address
Please include title (Mr. Mrs. Ms. Dr. etc) fi rst name and last name
Principal/Director's Phone
Principal/Director's Phone