Application

OLOL Application

A non-refundable application fee must accompany this application. Checks should be made payable to Our Lady of Lourdes School. Application must be filled out completely. A copy of the student’s Birth Certificate must accompany this application. If Catholic, a copy of your child’s Baptismal certificate should also accompany this completed application.

Step 1 of 7

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Student Information
Student Name*
First Middle Last
Grade entering for the 2018-19 School Year*
Home Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Date of Birth*
Birth place: (City, State, Country)*
Student lives with*
- Both Parents
- Mother
- Father
- Guardian
Guardian Name and Relation to Student

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Mother / Guardian Information
Name*
First Last
Cell Phone*
Does the mother / guardian live at the same address as the student?*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Occupation*
Employer*

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Father / Guardian Information
Name*
First Last
Cell Phone*
Does the father / guardian live at the same address as the student?*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Occupation*
Employer*

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Family Information
Other children in the family*
Please provide the name, age, grade, and school they are currently attending for each child. If you do not have any other children please type NA.
Please list other relativies who have or are attending OLOL.
Please provide the name and years attending for each relative.

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Religion
What religion does the student practice?*
What religion does the father/ guaridan practice?
What religion does the mother / guaridan practice?
If Catholic, please list the parish that you are a member of
Is the student Baptized?*
Date of Baptism
Church Name, Town, State*
Has the student received their First Communion?*
Date of First Communion
Church Name, Town, State*

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Academic Background
Has the student attended other schools prior to applying at OLOL?*
Please list the School Name, Grades Completed, Years of Attendance, and Reason for leaving for each school the student has attended.*
Has your student ever been expelled or refused admission or readmission from any school?*
If yes, state the name of the school and reason for the action:*
Has your child ever received or been evaluated for Special Education services in a private or public setting?*
If yes, please identify who did the evaluation and provide a brief description of the services required below.*
Has your child ever undergone psycho-educational testing?*
If yes, please provide a brief description of the testing done.*
Name and Address of Tester:*

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Parent Signature
I hereby give Our Lady of Lourdes School the right to contact any previously attended school in regards to the recent enrollment of my child. I hereby authorize said school to supply any and all information requested. I release all persons, companies’ and corporations’ supplying ad receiving such information to Our Lady of Lourdes School, and anyone acting on its/their behalf from and against any ad all liability which might result from furnishing or receiving such information. I hereby certify that the information submitted in the application process, including this application is true. I understand that if it is determined that any information I have provided is false, the admission of my child may be revoked or if my child is already in attendance, he or she may be subject to immediate expulsion. Our Lady of Lourdes School is a Catholic school that accepts students from different religious, racial and ethnic backgrounds.
Name*
By submitting this form I agree to the terms stated above.
First Last

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OLOL Application

Step 1 of 7

Student Information

Mother / Guardian Information

Father / Guardian Information

Family Information

Religion

Academic Background

Parent Signature