Holy Child Academy (PA): Apply

Graderequired

Academic Yearrequired

Nursery 2 applicant must be two (2) years of age on or before August 31.

Nursery 3 applicant must be three (3) years of age on or before August 31, as well as fully independent in the bathroom.

Pre-Kindergarten applicants must be four (4) years of age on or before August 31.

Kindergarten applicant must be five (5) years of age on or before August 31.

1st Grade applicant must be six (6) years of age on or before August 31.

Please select programrequired

Applicant's First Namerequired

Applicant's Familiar Name

Middle

Last Namerequired

Applicant's Birth Daterequired

Gender*

Male Female

Applicant's Place of Birthrequired

Religion of Applicantrequired

Parish or Church Affiliationrequired

Date of Baptism (if applicable)

Place of Baptism (if applicable)

School District in which applicant residesrequired

Public elementary school applicant would be assignedrequired

Applicant's Current Schoolrequired

Current Grade or Levelrequired

Address of Current School (if applicable)required

City

State

Zip

Name of principal/head/directorrequired

School phonerequired

List schools attended, most recent first, giving location, and length of time at each.required

Has the applicant ever been recommended for evaluation or evaluated for academic, speech, language, sensory integration, physical, behavioral, emotional, or attention difficulties by a school official, psychologist, physician or other professional?*

Yes No

If yes, please state condition.required

Has the applicant ever been diagnosed with a medical condition or allergy?*

Yes No

If yes, please state condition.required

Does the applicant take any prescription medication?*

Yes No

If yes, please list medication(s).required

Application to Holy Child Academy

Family Information

Father/Guardian

Education

Mother/Guardian

Education

Family Information

Agreement