Application For 2019/20 Admission

INSTRUCTIONS

1. Please complete this application in its entirety in order to receive full consideration for admission.

2. Please provide copies of the two most recent report cards and standardized test scores (if applicable) for the applicant.

3. Please provide a copy of the applicant's birth certificate.

4. Applicants must submit the recommendation forms to be filled out by the applicant's current teacher and/or an administrator.

5. Applicants must submit a non-refundable application fee of $100. (Applications received after March 1st are $125 and applications received after May 1st is $150.)

SPECIAL NOTES

1. Our school's policy requires that children must be 4 years of age upon entering transitional kindergarten, 5 years of age upon entering kindergarten, 6 years of age upon entering first grade. St. Monica Catholic Elementary School will assess applicants to determine whether our curriculum fits their educational needs.

2. Applicants who have provided a completed application with all supporting documentation and payment of the application fee will be contacted for the next steps in the admissions process.

3. Upon acceptance and prior to enrollment, parents must provide their child's immunization records as required by California State Law.

4. California State Law also requires all entering first graders and students new to California to provide a completed Report of Health Examination For School Entry form upon enrollment.

Please complete the form below. Required fields marked *

Today's Date*

Answer Required

Family Name*

Answer Required

Applicant Information

Applicant's Last Name *

Answer Required

Applicant's First Name*

Answer Required

Applicant's Middle Name

Answer Required

Street Address*

Answer Required

City*

Answer Required

State*

Answer Required

Zip/Postal*

Answer Required

Date of Birth*

Answer Required

Place of Birth*

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Male or Female*

Answer Required

Male

Female

Family Information

Applicant lives with:*

Answer Required

Both Parents

Mother

Father

Other:

Parents are:*

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Living Together

Separted

Divorced

Mother Deceased

Father Deceased

Primary language spoken at home:*

Answer Required

English

Spanish

Other:

Are any relatives alumni of SMCES?

Answer Required

Mother

Father

Other:

Father Name (Last, First, Middle)

Answer Required

Religion:

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Occupation:

Answer Required

Home Address (if different from above):

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Home Phone:

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Work Phone

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Cell Phone

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Email:

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Mother's Name(Maiden, First, Middle)

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Religion

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Occupation

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Home Address (if different from above)

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Home Phone

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Work Phone

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Cell Phone

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Guardian or Stepparent (if applicable)

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Name (Last, First, Middle)

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Religion

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Occupation:

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Home Address (if different from above)

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Home Phone

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Work Phone

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Cell Phone

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Siblings

Please list applicant's siblings who are currently or were previously enrolled at St. Monica Catholic Elementary School.

Names, Ages, Grades:

Answer Required

Please list all other siblings of the Applicant:

Names, Ages, Grades, Schools:

Answer Required

School Information

Please list previous schools this applicant has attended:

School Name:

Answer Required

City and State:

Answer Required

Current Grade:

Answer Required

Reason for Leaving:

Answer Required

School #2 Name, City and State, Dates Attended, Reason for Leaving:

Answer Required

School #3 Name, City and State, Dates Attended, Reason for Leaving:

Answer Required

Has your child ever been retained or repeated a grade?

Answer Required

Yes

Has your child ever received disciplinary action, such as suspension or expulsion?

Answer Required

Yes

Does your child take ANY prescribed daily medication?

e.g. insulin for diabetes, inhalers for asthma, stimulant or non-stimulant drugs for ADHD?

Answer Required

Yes

If you answered "yes" to any of the above questions, please explain below:

Answer Required

SACRAMENTAL & CHURCH INFORMATION

Baptism Date, Church, City/State:

Answer Required

First Communion Date, Church, City/State:

Answer Required

In what parish are you currently registered?

Answer Required

In what activities do you participate in your parish?

Answer Required

Please explain why you are choosing St. Monica Catholic Elementary School as your child's school.

Answer Required

What are your expectations for your child as a student at St. Monica Catholic Elementary School?

Answer Required

How can the staff of St. Monica Catholic Elementary School best serve your child?

Answer Required

Is there anything else you would like us to know about your child or family?

Answer Required

AGREEMENT

In accordance with the Family Educational Rights and Privacy Act of 1974 and California State Law, I hereby authorize the release of all school records, including grades, health records, and any other developmental information regarding my child. I agree to support St. Monica Catholic Elementary School's academic/discipline policies, administration, faculty, and parent organizations. I also agree to meet the financial responsibilities (tuition/fees) for this child. The school/parent relationship is a collaborative one, providing false, misleading, or incomplete information in this application can result in termination of any subsequent enrollment agreements.

Please sign and date below*

Answer Required

Please upload all required supplementary documentation.

Birth, Baptismal certificates, most recent report cards, Standardized test scores, etc.

Answer Required

Choose a file or drag it here.

Please fix the highlighted areas below before submitting.