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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 * 2020-2021 
Grade Enrolling In Transfer students currently in grades 9-12 should use the Transfer Application. *
     
School Attending in 2019-2020 School Year Class of 2024 (2019-2020) *
      

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. February 18, 2020 
February 20, 2020 
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
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 2019-2020 School Year 2019-2020
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 enrolling opportunities at Holy Family? Family 
Website 
Open House 
Friend 
Neighbor 
Realtor 
Magazine 
School 
Parish 
Facebook 
Twitter 
Newspaper Article 
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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