Saint Elizabeth High School Application for Admission

Applying for Grade:
9th Grade 10th Grade 11th Grade 12th Grade

Student InformationStudent first name:

Student last name:

Student middle name:

Female Male
Preferred name:

Date of Birth: (YYYY/MM/DD)

Social security number:

Address: (Number & Street City Zip Code)

Home phone:

Present school:

School phone:

Number of years at present school:

What previous school(s) did you attend? How long?

Student religion:
Roman Catholic Other, if confirmed Year:
Present Parish/Church/Place of Worship:

Ethnic Identity:

Background InformationCheck the most appropiate boxes: Parents are:
Married Not married Separated Divorced Father deceased Mother deceased
Living with:
Both parents Father Mother Grandparent(s) Guardian
Parent & step-parent Part time with each parent

Student will take High School Placement Test:
At Saint Elizabeth High School Other:
To which schools are you applying?

Parent InformationIf student has parents/guardians living in two separate households, please be sure to also provide information under Household 2 section.

Household 1Home address: (Household 1)

Home phone: (Household 1)

MALE Parent /Guardian (Household 1) Note: Only complete if the male resides at the address above if not, proceed to Household 2 Parent/Guardian first and last name:

Name relationship to student:

Position and occupation:

Employer:

Work address:

Work phone:

Cell phone:

FEMALE Parent /Guardian (Household 1) Note: Only complete if the female resides at the address above if not, proceed to Household 2 Parent/Guardian first and last name:

Name relationship to student:

Position and occupation:

Employer:

Work address:

Work phone:

Cell phone:

Household 2Please do not duplicate Household 1 information in this section Home address: (Household 2)

Home phone: (Household 2)

MALE Parent /Guardian (Household 2) Note: Only complete if the male resides at the address above. Parent/Guardian first and last name:

Name relationship to student:

Position and occupation:

Employer:

Work address:

Work phone:

Cell phone:

FEMALE Parent /Guardian (Household 2) Note: Only complete if the male resides at the address above. Parent/Guardian first and last name:

Name relationship to student:

Position and occupation:

Employer:

Work address:

Work phone:

Cell phone:

Family Information

List the full names of parent(s), brother(s), and sisters(s) who are attending or have graduated from Saint Elizabeth High School:

Name:

Relationship:

Graduation year:

List the full names and ages of applicant's dependant brothers and sisters:

Name:

Age:

School:

Financial Assistance

Are you in need of financial assistance?

Yes No

If yes, then you will need to submit two forms: The Saint Elizabeth High School Tuition Assistance Application and the (PSAP) Private School Aid Service form.

Payment Method

Please select one method of payment
Mail Check or Money Order
Online payment through PayPal
Pay in person

Please note: Application will not be processed until payment is received.