Print out this Student Application, fill it out and bring it with you when you come to register your child.
One application per child is needed.
St. Michael’s School
27 Crittenden Street Newark, N.J.
NO REFUNDS ON REGISTRATION/STUDENT FEES __________________
(Parent Initials)
*ALL NEW REGISTRATIONS FOR GRADES 6,7 & 8 ARE ON ONE MARKING PERIOD TRIAL BASIS*
STUDENT APPLICATION
FAMILY INFORMATION
PLEASE PRINT
*A PARISHIONER IS ONE WHO ATTENDS SUNDAY MASS AT ST. MICHAEL’S & USES THE WEEKLY ENVELOPES. EVERYONE ORIGINALLY IS A NON-PARISHIONER. YOUR SUNDAY ENVELOPE WILL DETERMINE YOUR STATUS.
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Family Attends ____________________________Church.
Date _________________________
Grade Entering ___________
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For Office Use Only
CHECK IF MISSING
_______ Health Record
_______ Report Card
_______ Birth Certificate
_______ Baptismal Certificate |
Name of Child _________________________________________________________________________
(Last) (First) (Middle) (Sex)
If Parent Last Name Is Different From Child, Indicate Parent Last Name Here _______________________
Birth: ________________________________________________________________________________
(City) (State) (Month) (Day) (Year) (Age)
Has Your Child Ever Been Retained? ________________ If Yes, In What Grade(s)________________
School Transferring From: ___________________________________ Reason: _____________________
Grades: Good ______ Fair ______ Poor ______ Conduct: Satisfactory ______ Unsatisfactory ______
Did your child have any psychological testing? _______________________________________________
If yes, give date, results _________________________________________________________________
Allergies/Illness Child Has ________________________________________________________________
Child Baptism _________________________________________________________________________
(Place & Date) – Copy of Certificate Must Accompany Application
Address______________________________________________________________________________
(House #) (Street) (Floor or Apt. #) (City) (State) (Zipcode) (Tel #)
Emergency Contact:_____________________________________________________________________
(Name) (Tel #)
#Of Children In Family ________ Boys ________Girls
Child Now Living With: __________________________________________________________________
Father: __________________________________________ Place of Birth _________________________
(Last Name) (First)
Citizen: Yes ________ No ________ Nationality: ____________________ Religion: ________________
Occupation, Place of Employment: ________________________________________________________
_____________________________________________________________________________________
(Address) (City) (State) (Zipcode) (Tel #)
Mother: _________________________________________ Place of Birth _________________________
(Last Name) (First)
Citizen: Yes ________ No ________ Nationality: ____________________ Religion: ________________
Occupation, Place of Employment: ________________________________________________________
_____________________________________________________________________________________
(Address) (City) (State) (Zipcode) (Tel #)
Entrance Date, St. Michael’s ______________________________________________________________
**I UNDERSTAND THAT IT IS MY RESPONSIBILITY TO READ THE INFORMATION GUIDE, PARENT HANDBOOK
AND SCHOOL CALENDAR AND TO ABIDE BY THE REQUIREMENTS OF SAME**
Parent Name _______________________________ Parent Signature ____________________________
Note: Final Approval of Application Is Determined After Principal’s Review Revised 5/02
