1. Family Survey
Please submit one family survey for the entire family.
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Family Last Name *
Family Sacramental History
The purpose of this survey is to give Regina Mater a sense of your lifestyle as a Catholic family.  All surveys are confidential and will be used in order to determine if we are a good fit for your family.

Are both parents practicing Catholics?  If not, do both parents actively support Catholic formation for the children?  If divorced, is there opposition from one parent toward Catholic formation of the children? *
Does your family attend Sunday mass? *
Have your children received the relevant sacraments (Baptism, Reconciliation, Confirmation, Communion) at the typical point in your rite (Latin, Maronite, Byzantine, etc.)?  Please explain any irregular situations and how Regina Mater can help address the issues. *
Parent Personal History
The following questions help us to understand the each child's family context, especially where there are difficult situations that may affect his or her academics.  

Any family that cannot complete the Ethics and Integrity in Ministry certification may not participate in our program.  EIM is also required for any extended family visiting the school on a regular basis.
Regina Mater requires every parent to be certified with the Ethics and Integrity in Ministry program of the Diocese of Austin, which includes a criminal background check and “Called to Protect” workshop attendance.  Is there any reason why you and your spouse cannot comply with these requirements and policies set forth by the Diocese of Austin, including past allegations, convictions, or irregular situations? *
Does your family include any adopted children, foster children, or step children?  If so, how has this affected your family? *
Are there any family situations, developmental issues, or health conditions that may affect your child? *
Why do you wish to enroll your child/children in Regina Mater? *
Religious Life
Prayer: Describe your family’s prayer life.   *
As a school, we incorporate service into our curriculum. Does your family volunteer for any service organizations or serve in a particular way?  How would you like to serve as a family if given the opportunity? *
Pope John Paul II called each family a domestic church. How do you celebrate your Catholic faith as a family? *
Adult Spiritual Growth:  What things do you do as a couple to enrich your faith and marriage, or if single, your personal spiritual life?   *
Are you involved in any ecclesial movements or organizations such as Opus Dei, Schoenstatt, Regnum Christi, etc? Have you been involved in your parish?  What has that experience been like? *
Family Life Resources
Are there any parenting books or seminars that you have incorporated into your family life? *
Character Formation: Considering age appropriate development please describe each of your children’s individual character strengths and challenges. *
Tell us about each child’s temperaments and their gifts. *
Homeschooling Experience
Have you ever home schooled your children? Please describe your experiences. *
Are you confident or concerned about your abilities to be teaching your children? *
Media Policy
What are your views concerning your children’s access to mass media, i.e. computer games, social media,  videos, movies, tv, etc.?  Do you restrict certain type of media or electronic devices? *
Regina Mater occasionally uses instructional videos and narrative files in the classroom (for example, science videos and saints lives). Do you have any concerns regarding this practice? *
Additional Info
Please list any additional information you would like us to know about your child/children in considering your application. *
Submission
By submitting this form, both father and mother agree to the information provided herein.
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