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Fall 2024 Grade 1-8 St. Stanislaus Kostka School Registration Form
$75 Registration Fee will be added to your tuition payment account once your student is accepted.
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* Indicates required question
Email
*
Your email
Date of Application
*
MM
/
DD
/
YYYY
Student's First Name
*
Your answer
Student's Middle Name
*
Your answer
Student's Last Name
*
Your answer
Student's Date of Birth
*
MM
/
DD
/
YYYY
Student's City of Birth
*
Your answer
Student's Gender
*
Male
Female
Required
Home Address: Street Address
*
Your answer
Home Address: City
*
Your answer
Home Address: State
*
Your answer
Home Address: Zip Code
*
Your answer
Parent/Guardian's Name #1
*
Your answer
Parent/Guardian #1 Occupation
*
Your answer
Parent/Guardian #1 Cell Phone
*
Your answer
Parent/Guardian #1 Email
*
Your answer
Parent/Guardian's Name #2
*
Your answer
Parent/Guardian #2 Occupation
*
Your answer
Parent/Guardian #2 Cell Phone
*
Your answer
Parent/Guardian #2 Email
*
Your answer
Race/Ethnicity
*
Choose
African American
Asian
Hispanic
Latino
Native American
White
Child lives with:
*
Choose
Both parents
Mother
Father
Other
Religion
*
Catholic
Non-Catholic
Baptized
*
Yes
No
Parents are registered members of: (Name of Church & City/Town or N/A)
*
Your answer
We request that our child's name be submitted to our pastor for financial sponsorship.
*
Yes
No
My child is insured by: (Name of Insurance Provider or N/A)
*
Your answer
Most recent school attended: (Name of School & City/Town)
*
Your answer
Registering for Grade:
*
Choose
1
2
3
4
5
6
7
8
My child currently has:
*
An IEP (Individualized Education Plan)
A 504 Accommodation Plan
A diagnosed Learning Disability
None of the Above
Other
Required
Individual(s) responsible for payment of tuition:
*
Your answer
A copy of your responses will be emailed to the address you provided.
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