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Providence Diocesan Office

Catholic School Office: May Bulletin

Admissions

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Please complete the following form to submit an application.

Year of proposed entrance: Applying for Grade: Present Grade: Applicant's Name: Last First Middle Address:  Street City, State Zip Code Home Phone#  Place of Birth: ( ) - Date of Birth: Gender: / / M F Father's Name and Address: Last First Middle Street City State, Zip Same as applicant's address       Father's Occupation: ( ) - Position Firm or Institution Business Phone Number       Mother's Name and Address: Last First Middle Maiden Name:   Street City State, Zip Code Same as applicant's address           Mother's Occupation:     ( ) - Position Firm or Institution Business Phone Number       Parents are: Child lives with: Married Both Parents Separated Mother Divorced Father Other Other     Please list other children in the family: Name Age School attending       Applicant's last school: Name:   Address: Street City, State Zip Code   Has your child ever received Special Services? (Resource Help, Remedial Reading, etc.) Yes No If yes, please explain and give dates.   Has your child ever been involved in a Gifted and Talented Program? Yes No If yes, please explain and give dates. Please forward a statement from the school describing the program and admission criteria. Mother's Religion: Father's Religion:       Family's Parish:   Name:     Denomination     Street City, State Zip       Sacraments received by applicant: Baptism:   Year/Month/Day / / Church   City   State       First Communion:   Year/Month/Day / / Church City State   How did you hear about St. Philomena School?   Is either parent a St. Philomena School graduate? Yes No If so, please list year:   St. Philomena School seeks to draw students from all racial and ethnic groups. How would you describe the applicant? (OPTIONAL) American Indian or Alaskan Native Black White Asian or Pacific Islander Hispanic Multiracial   Upon submission of this application form, you accept and agree to the following conditions:   When this application is submitted, please send us the following: 1. Copies of the applicant's most recent report card and standardized test scores 2. $45.00 non-refundable application fee.   If this application leads to our child's attendance at St. Philomena School, we agree to adhere to the policies of the school and to pay all tuition expenses in accordance with the payment plan to be agreed upon with the school administration. Tuition for the 2008-09 school year is as follows: Pre-K Two Day -- $3130 Pre-K Three Day -- $4620 Pre-K Five Day -- $7700 Grades K – 7 -- $7300 Grade 8 -- $6750     St. Philomena School admits students of any race, color, national and ethnic origin and so administers its educational policies, scholarship programs, athletic and other school-administered programs.