Application to Saint Mark School for Kindergarten

Application to Saint Mark School

Saint Mark School 

"A Nationally Recognized Blue Ribbon School of Excellence"

http://www.stmarkschool.org/userfiles/Servers/Server_20265083/image/Saint%20Mark%20Little%20Lions%20Logo.pnghttp://www.stmarkschool.org/userfiles/Servers/Server_20265083/image/StMark130.png

Application for Admission 

School Year 

Student Name (Last,First, Middle Initial)

Address (STREET, CITY, STATE, ZIP)

Phone Number 

Date of Birth

*

Current Age 

Gender 

Female Male

Grade Entering 

Religion

Catholic *Non-Catholic

Place of Worship 

U.S. Citizenship

Yes **No

If No, please indicate birthplace*

Race

American Indian/Native Alaskan

Asian

African American

Native Hawaiian/Pacific Islander

Caucasin

2 or more Races 

Ethnicity

Hispanic

Non-Hispanic

Parent/Gaudian Information 

 

Father/Guardian

Mother/Guardian 

Name (Title, First, Last)

Name (Title, First, Last)

Address 

Address 

Phone Number

 Home 

 Work 

 Cell 

 

Phone Number 

 Home 

 Work 

 Cell 

 

Email

 

Email

 *

Relationship To Student 

Relationship To Student

Employer

Employer

Occupation

Occupation

Religion

Catholic 

*Non-Catholic

Religion

Catholic

*Non-Catholic 

Marital Status

*

Marital Status

*

If divorced/separated, which parent has custody?

Are visitation rights permitted to the Non-Custodial Parent? 

Student lives with 

 

*Mother 

Father 

Grandparent 

Guardian 

*Other *

Media Release

I grant permission to use my child’s image and/or name in print, electronic, or digital format for school publication, publicity, and website.

 Select one 

Yes  No

Sibling Information 

Sibling #1 Name

Date of Birth

*

Age

School 

 Sibiling #2 Name 

Date of Birth

Age 

  

School 

Schools Previously Attended

School Name 

City 

State

Grade/s

Reason for Leaving 

School Name 

City 

State

Grade/s

Reason for Leaving 

Medical Information 

Student's Pediatrician 

Name  

Phone 

Student Dentist

Name  

Phone 

Hospital Preference 

Name  

Phone 

Sacraments 

Has your child received the sacrament of Baptism

Yes

No

Has your child received the sacrament of Reconciliation? 

Yes

No

Has your child received the sacrament of Communion? 

Yes

No

If you have answered any of the questions above "Yes" please fill out the information below.

Baptism

Date 

Church 

City 

State 

Reconciliation 

Date 

Church 

City 

State 

Communion 

Date 

Church 

City 

State 

Special Services *This information is necessary for teachers to plan for your child’s success. Failure to disclose this information may halt an application and/or result in 
children being asked to transfer to receive services necessary for them to succeed. 

For students entering Pre-K or K: Has your child received services through Birth to 3?

*Yes 

*No

Have you ever been invited to attend a PPT meeting for your child?

Yes 

*No

Has your child ever had a/an: 504 Plan IEP?

Yes

No

 If "Yes", please specify 

Home Language Survey
When your child began to speak, what language did he/she speak?
What language do the parents/guardians speak to each other?
What language is spoken most often at home?
Emergency Contacts (Non-Parent or Non-Guardian)
Emergency Contact #1Emergency Contact #2
Name Name 
Daytime Phone Daytime Phone 
Relationship to Student  Relationship to Student  
Other Information 
 Bus Transportation Requested:    (Stratford residents only) Yes No
Which public school would your child attend if not St. Mark School?
Did a family currently enrolled at St. Mark School recommend our school to you?
Would you like more information on how to apply to the Bishop’s Scholarship Fund, a NEW source for tuition assistance?Yes No
 
Registration Information 

 In order to complete your application, visit https://online.factsmgt.com/signin/3D3MS and submit the following registration fees via online payment:

Pre-K Only: $150 ($50 application fee and $100 tuition deposit, both non-refundable) 

K-8: $200* ($100 application fee and $100 tuition deposit, both non-refundable)

*$150 is due at time of registration and $50 is due upon acceptance 

Please send to the school the following to complete the application: 

Copy of Birth Certificate

Copy of Baptismal Certificate 

Records Release Form (for Grades 1 - Grade 8 ONLY)

Signatures
I hereby certify that all of the above information is accurate and that my child and I agree to abide by the policies and procedures St. Mark 
School as stated in the school handbook, including the tuition policy. 
Parent/Guardian  Date 
Parent/Guardian  Date 

Thank you for choosing Catholic Education – an investment that will last a lifetime!

St. Mark School admits students without regard to race, creed or color. 



Security Measure
Registration Instructions

 In order to complete your application, visit  https://online.factsmgt.com/signin/3D3MS  to submit the following registration fees via online payment:

K-8: $200* ($100 application fee and $100 tuition deposit, both non-refundable)

*$150 is due at time of registration and $50 is due upon acceptance