Student Application

        Please complete all items and print for your records. 

        Incomplete applications will not be processed. Please send the $25 per student application fee. 

Student's Name

Age   Date of Birth   Entering Grade 7 8 9 10 11 12

Street Address

City:   State: Zip:

Religious affiliation (applicant):

Parish:

Pastor:

Pastor's Address:

City:   State: Zip:  

 Phone Number:

PARENT / GUARDIAN INFORMATION:

Name  

Street Address:

City:   State: Zip:  

Occupation

Work Phone Home Phone

Name  

Street Address:

City:   State: Zip:  

Occupation

Work Phone Home Phone  

Religious Affiliation: Father/Guardian  

Religious Affiliation: Mother/Guardian

List Applicant’s Siblings:

SCHOOL INFORMATION:

School Currently Attending

Current Average   (Select one)  A B C D F

Address of Current School

Phone Number of Current School 

REFERENCES:  Please list two people not related to you who will recommend you to Holy Cross Academy:

1. Name  

Address:

City:   State: Zip:

Phone:

2. Name  

Address:

City:   State: Zip:  

Phone:

STUDENT'S INTERESTS:

Musical instrument? Hobbies ?

Clubs, organizations, activities outside school, sports, charitable work, etc.?

Books recently read? 

How often do you attend Mass or Church services?

SPECIAL NEEDS:

Does the applicant have any physical handicaps?

Emotional or nervous disorders?

Allergies?

Does the applicant require any medication during the school day?

Any special educational needs?

How often are Religious subjects discussed in the Home? Never Seldom Sometimes Often ALways

Would the parents/guardians be willing to attend classes pertaining to the Catholic Faith if offered?      YES NO

Be prepared at the interview to explain how Religion and Academics are important to your family.

            I understand the philosophy and mission of Holy Cross Academy, and I agree to work closely with Holy Cross Academy to ensure the best possible education for my child.

By entering our names below, we agree to the statement above and also agree to submit a signed form at the interview.

Father's / Guardian’s Name    Date

Mother's / Guardian’s Name Date