Registration for PreK3, PreK4, Kindergarten and Grade 1 for the 2020/2021 School Year
Thank you for choosing Immaculate Heart of Mary School for your family.  We are thrilled to have your family as a part of ours.

The age requirements for our Early Childhood Education programs are as follows:
PreK3:  Child must be 3 years of age on or before September 1, 2020
PreK4:  Child must be 4 years of age on or before September 1, 2020
Kindergarten:  Child must be 5 years of age on or before September 1, 2020
Grade 1:  Child must be 6 years of age on or before September 1, 2020

Documents which will need to be submitted with this application are:  
(1)  your child's birth certificate;  and,
(2)  current Immunization Record.

Documents which will also need to be submitted, if applicable:
(1)  Baptismal Certificate if baptized outside of Immaculate Heart of Mary Parish
(2)  Custody agreements or custody court orders
(3)  Any and all test results, including psychological testing, educational disability testing, and/or any IEP.


You will be contacted by Traci Kovach, Director of Finance and Development, with regard to submitting the rest of your registration materials.  There is a $350.00 non-refundable registration fee.
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Email *
Grade for the 2020/21 school year *
Student's Full Name *
Student is *
Date of Birth *
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Address (include City, State and Zip) *
Primary Phone Number *
Religion *
If you chose Catholic, please list your parish affiliation: *
If you chose Non Catholic, please list your religious denomination.
Student lives with (please select one) *
Mother's First and Last Name *
Father's First and Last Name *
Mother's Email Address *
Father's Email Address *
Mother or Father Address if different than the student *
Mother's Phone Number *
Father's Phone Number *
Siblings (please include name, date of birth and current school, if applicable) *
For Grade 1 applicants, is bus transportation required?
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Was your child baptized? *
If your child was baptized, please list date received and the parish where your child was baptized. *
Educational Information:  Please list the current schools and/or day cares where your child attended prior to the Covid-19 closures. *
Does your child have any allergies?  If yes, please detail below. *
Does your child have any existing medical conditions?  If yes, please detail below. *
Does your child require medication while in school?  If yes, please detail below. *
Has your child had any special testing, particularly speech therapy, psychological or special IEP assessments? *
Has your child ever been retained or skipped a grade? *
Has your child ever been suspended or expelled from any school attended? *
Name of Person (s) responsible for paying all tuition and fees.  Please include address, phone number, and email address if this person is someone other than child's parents.   *
Did a current Immaculate Heart of Mary School family refer you to our school?  If so, please identify the family's name. *
Parental Agreement for Admission:  It is our (my) wish that my child attends Immaculate Heart of Mary School.  I (We) also agree to assume the obligations to pay the specified tuition and school fees, and agree to support the philosophy, goals, objectives and regulations of Immaculate Heart of Mary School.  Please type name to indicate your agreement. *
I also understand that all registration and other fees are non-refundable.  I certify that, to the best of my knowledge, the information provided above is accurate and complete. *
A copy of your responses will be emailed to the address you provided.
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