Application for Admission 2014-2015

2632 W. 15th Street Los Angeles, Ca 90006 (323) 737-4730 fax (323) 737-6348

Please Print and Include $20 application/testing fee per child (non-refundable)

_____________________________________________________________________________________

Part I : Student Information_______________________________________________

Student Name: _______________________________________________________________
Last
First
Middle

_______
Age

Students address _________________________________________________Apt___________________

City____________________________ State____ Zip______Telephone____________________________
Birthdate________________________________ Place of Birth __________________________________
Citizen of U.S. Yes _____ No_____ Country_________________Grade Entering____________________
Current School Name, Address and Telephone ________________________________________________
______________________________________________________________________________________
Does your child have an IEP( Individualized Education Program) from current school? ___ If yes please
provide a copy.
Childs Baptismal Date_______________________Church______________________________________
Childs First Communion Date__________________Church_____________________________________
_____________________________________________________________________________________

Part II: Household Information/Parent Information___________________________

Home Language:

English_______Spanish_______ Both____Other________

Religion (For Both Parents) __________________________Number of people in household: ______

Parish Name ________________________ Address_____________________City/ Zip code___________
Are you a registered member of St. Thomas the Apostle Church? ______Yes

_____No

If yes please include your Sunday envelope number ____________________________________________

Father/Guardian Name: _______________________________________Birthplace___________________

Occupation: ________________________________________________Daytime Phone_______________

Mother/Guardian Name: ______________________________________ Birthplace___________________

Occupation: ________________________________________________Daytime Phone _______________

Student lives with: Both Parents_______ Father Only______ Mother Only _____Legal Guardian________
Parents Marital Status: Married _______ Single_______ Divorced_______ Separated________________

______________________________________________________________________________________

Part III: Payment Plan/Please Check One___________________________________

Fundraising Option 1____
Fundraising Option 2____

Office use only:

Testing

Full Annual Payment paid by September, 2014_____

11 Payment Plan August 2014-June 2015______

Registration

Supplies