Santa Rosa de Lima Catholic School Application

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Congratulations on choosing a Catholic education for your child!

Santa Rosa de Lima Catholic School partners with parents to support students’ faith formation rooted in a Catholic identity and is committed to working with our students to achieve academic excellence centered in nurturing the mind, body, and spirit.

Email address *

Family Name *

Child(ren), date of birth, entering grade level *

Name of previous school attended (complete only if applicable)

Home address, city, state, zip code, phone number *

Religion, Parish or Church *

Parent Information: marital status *

Married

Separated

Divorced

Single

Parent Information: send correspondence to... *

Both Parents/Guardians

Father

Mother

Other:

Father's Name (Guardian) *

Father's home address, city, state, zip code *

Father's occupation *

Father's work phone *

Father's home phone/cell phone *

Mother's Name (Guardian) *

Mother's home address, city, state, zip code *

Mother's occupation *

Mother's work phone *

Mother's home phone/cell phone *

**Please provide the school office with the following documents to finish your application. *

a copy of the child's birth certificate

a copy of the child's immunization record

a copy of the child's baptism certificate (if applicable)

a copy of the child's first communion certificate (if applicable)

a nonrefundable registration fee payable to Santa Rosa de Lima Catholic School

a copy of your most recent 1040 Tax Form

Required

I (we) agree to pay the tuition for my child(ren) through Smart Tuition / Blackbaud. I (we) have read the tuition payment information and I am /we are aware of the fees that may be assessed for late payment. I am/We are also aware that my child(ren) placement in a class will be forfeited if payment is not paid in full at the time of enrollment. If complete payment is not received by that date, an additional $100.00 may be added to your enrollment fee. As well as your consent to receive text and email messages sent by an automated dialing system. Message and data rates may apply.

All parties responsible for payment must write their name and today's date.

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