2022 - 2023 St. Mary School Swormville Enrollment Application

Application for admission to: St. Mary School Swormville 6919 Transit Road East Amherst, NY 14051

Financial

You will qualify for the in-parish tuition rate if your Catholic home parish has no school and you are an active member at that parish or if you are an active member of St. Mary’s Parish. An active parishioner is a person or family who is registered in their church, who regularly attends Mass, who contributes to the mission of the Parish in time, talent, and financially through the Commitment to Parish Life (CPL) Program. Families new to the parish will be charged the out-of-parish rate for the first three (3) months of enrollment. Upon review and confirmation of parish support, the in-parish rates for the remaining seven (7) months. Church records will be checked to verify active membership. If you are not active, you will be billed the non-parishioner rate

Agreements

I/We agree,by signing this application in writing or typing my/our names on the parent/guardian signature line: A. to read the 2022-23 St. Mary School Parent/Student Handbook, found on St. Mary's website B. to the terms and conditions set forth in the St. Mary School Parent/Student Handbook upon my child's acceptance for admission C. after April 1, 2023, and before June 3, 2023 to set up a FACTS Tuition Management System account to register our tuition payment schedule for the 2023-24 school year.

Application Submission

I confirm, by signing this application in writing or typing my/our names on the parent/guardian signature line, that I/we are the lawful guardians of the candidate and all information contained within this application is true and accurate. To complete this application, it must be signed and dated by the parent(s)/guardian(s) of the candidate and submitted with a non-refundable $150.00 registration fee* (checks made payable to St. Mary School), birth certificate copy, and proof of immunizations per NYS guidelines.

2023 - 2024 St. Mary School Swormville Enrollment Application

71 Questions

1) Date of Application

2) CANDIDATE FULL NAME

3) FOR ADMISSION TO*

Please choose the appropriate grade level from the drop down list.

4) GENDER*

5) DATE OF BIRTH*

6) Was your child born in the U.S.A.?*

If not born in the U.S.A., provide Country and Date of Entry.

7) PRIMARY HOUSEHOLD ADDRESS* Street Address

8) PRIMARY HOUSEHOLD ADDRESS* Address Line 2

9) PRIMARY HOUSEHOLD ADDRESS* City

10) PRIMARY HOUSEHOLD ADDRESS* State

11) PRIMARY HOUSEHOLD ADDRESS* ZIP Code

12) PRIMARY HOUSEHOLD PHONE*

13) PRIMARY HOUSEHOLD EMAIL*

14) PUBLIC SCHOOL DISTRICT OF RESIDENCE*

15) DATE AND CHURCH OF SACRAMENTS*

List the date and the church where any/all of these sacraments were received: Baptism, First Reconciliation, First Eucharist. If no sacraments have been received, write "None"

16) CURRENT PARISH*

If not Catholic, write "N/A"

17) DENOMINATION*

If no religious affiliation, write "None"

18) Prefix:

Household Information Mother's/stepmother's/guardian's Name*

19) MOTHER'S/STEPMOTHER'S/GUARDIAN'S FIRST NAME*

20) MOTHER'S/STEPMOTHER'S/GUARDIAN'S LAST NAME*

21) Relationship to Candidate:

22) Street Address (optional)

PROVIDE MOTHER'S ADDRESS IF DIFFERENT FROM CANDIDATE'S

23) Address Line 2 (optional)

24) City (optional)

25) State (optional)

26) ZIP Code (optional)

27) MOTHER'S PRIMARY EMAIL ADDRESS*

28) MOTHER'S CELL PHONE NUMBER*

29) Mother's Occupation / Employer (optional)

30) Mother's Work Phone Number (optional)

31) Prefix

Father's/stepfather's/guardian's Name*

32) FATHER'S/STEPFATHER'S/GUARDIAN'S FIRST NAME*

33) FATHER'S/STEPFATHER'S/GUARDIAN'S LAST NAME*

34) Relationship to Candidate

35) Street Address: (optional)

Provide Father's Address If Different From Candidate's

36) Address Line 2: (optional)

37) City: (optional)

38) State: (optional)

39) ZIP Code: (optional)

40) FATHER'S CELL PHONE NUMBER*

41) FATHER'S PRIMARY EMAIL ADDRESS*

42) Father's Occupation / Employer (optional)

43) Father's Work Phone Number (optional)

44) WITH WHOM DOES THE CANDIDATE LIVE?*

If the candidate does not live full time in one household with both father and mother, describe candidates living arrangements.

45) WILL SIBLINGS APPLY TO ST. MARY SCHOOL ALSO?*

Yes

46) SIBLING(S) NAMES AND AGE(S) (optional)

47) EDUCATIONAL HISTORY

CURRENT GRADE LEVEL*

48) CURRENT SCHOOL*

If entering Kindergarten or Montessori with Preschool experience, please list. If no prior education outside the home, list "None"

49) CURRENT SCHOOL ADDRESS AND PHONE NUMBER (optional)

50) PREVIOUS SCHOOLS (optional)

List previous elementary or middle schools attended prior to the current school, with dates attended.

51) CATHOLIC EDUCATION PLANS

Is it your intention to continue Catholic education throughout the elementary and middle school years?

52) OTHER CANDIDATE BACKGROUND INFORMATION

ETHNICITY* Information for Diocesan Census

53) MEDICAL/PHYSICAL (optional)

Please detail any allergies or other medical/physical conditions or restrictions that could affect our child's participation in school activities, or of which we should otherwise be aware.

54) SERVICES* Has your child ever qualified for special education services, had an IEP/IESP/504, or had psychological or psychiatric counseling of which we should be aware?

Please note: the Principal must review any IEP's/requests for accommodations prior to acceptance. It is in each unique child's interest to be sure that St. Mary School is able to meet his/her needs.

55) PRIMARY EMERGENCY CONTACT* First Name

56) PRIMARY EMERGENCY CONTACT* Last Name

57) Relationship to Candidate*:

58) Phone*

59) SECONDARY EMERGENCY CONTACT First Name (optional)

60) SECONDARY EMERGENCY CONTACT Last Name (optional)

61) Relationship to Candidate: * (optional)

62) Phone (optional)

63) TUITION RATE*

Please read the Financial Information Below

64) PAYMENTS

Please read the Financial Information Below

65) PROMOTIONAL CONSENT - NAME USE*

Do you give permission for your child's name to be used in St. Mary School promotional material and news updates?

66) PROMOTIONAL CONSENT - PHOTO USE*

Do you give permission for your child's picture to be used in St. Mary School promotional material and news updates?

67) SCHOOL DIRECTORY CONSENT*

Do you give permission for your family’s contact information with child's name and grade to be used in the school directory to be shared with other families?

Yes

68) Parent/Guardian Signature*

69) Date*

70) Parent/Guardian Signature:

71) Date

The applicant's parents/guardians will receive an acceptance letter when the application process is complete. *If St. Mary School is unable to hold a position due to unavailability or unforeseen circumstances, the registration fee will be refunded.