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Student Information

Student Legal First Name *
Student Middle Name *
Student Last Name *
Student Suffix (Jr, III, etc...)
Student Informal Name
 
Student Address *
Street
 
City/State/Zip  
Date of Birth *  
Student Home Phone *( ) -
Gender * M   F  
School Year Enrolling * 2021-2022 
Grade Enrolling In Transfer students currently in grades 9-12 should use the Transfer Application. *
     
School Attending in 2020-2021 School Year Class of 2025 *
      

School Address
Street
 
City/State/Zip  
Public School District in Which You Reside *
Religion
Parish/Church
Ethnic Affiliation (for statistical purposes only) Asian-Pacific Islander 
Caucasian 
Latino/Hispanic 
Native American 
African American 
Multiracial (please identify) 

Student Resides with * Parents 
Mother 
Father 
Guardians 
Mother & Stepfather 
Father & Stepmother 
Other (please explain) 

Student Interests and Hobbies *
Class Registration Nights are held in February. You will be contacted to confirm your preferred date. Tuesday, February 16, 2021 
Thursday, February 18, 2021 
Student T-shirt Size

Transportation Request

Busing Options * I live in District 112 and my child will need busing. 
I do not need District 112 busing. 
I live outside of District 112 and would be interested in transportation provided by Holy Family for a fee. 

Short Answer

Additional Information Request


Is there any department, coach, or activity leader with whom you'd like to speak? Please provide a general idea in the space provided and our admissions team will make the connection.
     

Parent Responses

Name of Parent Completing
Email Address of Parent Completing *
Are you interested in learning more about our need-based tuition assistance? * Yes 
No 
To assist us in getting to know your student's needs right away, is there anything you'd like us to know? (Optional)

Mother/Guardian 1 Information

First Name
Last Name
Custodial Parent? Y   N  
Spouse's Name
Address
Street
 
City/State/Zip  
Home Phone ( ) -
Cell Phone ( ) -
Work Phone ( ) - x
Employer
Occupation
M Email

Father/Guardian 2 Information

First Name
Last Name
Custodial Parent? Y   N  
Spouse's Name
Address
Street
 
City/State/Zip  
Home Phone ( ) -
Cell Phone ( ) -
Work Phone ( ) - x
Employer
Occupation
F Email

Sibling Information

Number of siblings

Sibling Name
Grade in 2020-2021 School Year 2020-2021
Current School
Gender M   F  

Grandparent Information

Please share grandparent information so we may invite them to special events (i.e. Grandparents Day) and send our quarterly magazine, Passages.
Maternal Grandparents
MG Home Address
Street
 
City/State/Zip  
 
Maternal Grandparents Home Email
Paternal Grandparents
PG Home Address
Street
 
City/State/Zip  
Paternal Grandparents Home Email

Communication

Duplicate Mailings name of person to send duplicate mailings to
Address
Street
 
City/State/Zip  
 
How did you learn about enrollment opportunities at Holy Family? Family 
Website 
Open House 
Friend 
Neighbor 
Realtor 
School 
Parish 
Social Media 
Newspaper/Magazine 
Other (please explain) 


Consent to Release Private Data

Authorization: I authorize HOLY FAMILY CATHOLIC HIGH SCHOOL to obtain information from the school listed above.

The information to be released:
• Official School Records (e.g., name, address, attendance record, grades, test results, behavior)
• Standardized Testing Results
• Health Records
• Psychological Records
• Social Work Reports
• Current School Counselor Observations
• Chemical Abuse/Dependency Report
• Medical Reports (including related services)
• Special Education Results (including related services)

I understand that student records may be examined by parent/guardian(s) or the student if age 18 or older. I understand that this authorization takes effect the day I sign it. I understand I may change or revoke this authorization at any time. This authorization expires one year from the date of my application submission. 


Effective Date of Release * Yes, I release my child's records effective today. 
No, please request my child's records at the end of the school year. I understand this may delay final acceptance. 
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