Holy Rosary Parish Catholic School 505 California Street, Woodland CA Office: or Fax: Website:

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1 Holy Rosary Parish Catholic School 505 California Street, Woodland CA Office: or Fax: Website: The Motto of Holy Rosary Parish Catholic School is to Live, Love, and Learn with Jesus Christ as our Model. Admissions Pre-applications are now being accepted for the school year. You are requested to fill in the details and upload the documents on the Pre-Registration Form which can be found at or you can call for application information. Please turn in your pre-application form as soon as possible. All new families must complete and submit the pre-application form. All applications will be reviewed, and families will be contacted by the principal to schedule an interview. Those families with TK and Kindergarten students will be contacted by the principal to schedule an interview and assessment. Thank you for your interest in Holy Rosary Parish Catholic School! Kindergarten A child who is 5 years of age on or before September 1, 2015 may apply for Kindergarten at Holy Rosary Parish Catholic School. Transitional Kindergarten A child who is 4 years of age by September 1, 2015 may apply for Transitional Kindergarten at Holy Rosary Parish Catholic School. Children enrolled in TK are part of a two year Kindergarten program.

2 If you are registering for TK and/or for a Kindergarten position, you may do so at the information night. More details to follow regarding information night. Please bring the following items with you (if you haven t turned them in already). Birth Certificate Baptismal Certificate Application Requirements Holy Rosary Parish Catholic School accepts applications year round for both mid-year transfers and for future years. For consideration, please fill in the details and submit each applicant s birth certificate, sacrament certificate, recent report card, and standardized test scores (for transfer students). Pre-application requirements may be turned in to the school office at: 505 California Street, Woodland CA Returning Families Registration packets for returning families are available online at The FACTS tuition management system has been updated to school year. Please visit Please bring your completed registration packet to the office by March 31, If you have any questions, please call the school office at (530) **Please note: All students entering 7th grade will need to show proof of the Tdap vaccination, or they must have a personal belief exemption on file if the Tdap is not administered. A student will not be allowed to start the school year until this is done. Please call the office at if you have any questions. Thank you for your understanding and cooperation.

3 Holy Rosary Parish Catholic School 505 California Street Woodland CA Office: or Fax: Website: FOR NEW FAMILIES/STUDENTS ONLY - PLEASE PRINT ALL INFORMATION SCHOOL YEAR PRE-APPLICATION FOR GRADE! Student Last Name: First Name: MI: Address: City: State: Zip: Date of Birth: City/State/Country of Birth: Sex: Father Last Name: First Name: MI: State/Country of Birth: Home Phone: Religion: Occupation: Wk/Cell Phone: Mother Last Name: First Name: MI: State/Country of Birth: Home Phone: Religion: Occupation: Wk/Cell Phone: Parent Status: Married Divorced Student lives with: Mother Father Guardian Parent address if different from student: Family Parish of Registry: Family address: Student is currently attending: (name of school) (city/state/zip) (phone) Record of Sacraments Received: Baptism Eucharist Reconciliation Confirmation Date: Church: City, State: The following documents must accompany your application: County Birth Certificate Baptismal Certificate Current Shot Record Most Recent Report Card (grades 1-8) Office Use Only: K/1 Physical Exam Shot Record Baptismal Certificate Birth Certificate Report Card Accepted Waiting List

4 Holy Rosary Parish Catholic School 505 California Street, Woodland CA Office: or Fax: Website: REGISTRATION INFORMATION PLEASE PRINT ALL INFORMATION Student Information Gender DOB Grade in Parish Name M/F Last First MI Name M/F Last First MI Name M/F Last First MI Name M/F Last First MI Address City Zip Home Phone Parent s Address (To be used for school-home communications only) I want to be listed in the HRS Phone Roster. YES NO Mother s Information Name Work Phone Cell Phone Father s Information Name Work Phone Cell Phone Other Custodial Parent Information Name Home Phone Work Phone Cell Phone Address City Zip Ethnicity * Ethnicity Codes: The National Catholic Educational Association and the Diocese of Sacramento collect information on students ethnicity/cultural backgrounds. This information is not used in the registration process, but aggregate data is used to compare enrollment and enrollment trends across the United States and in our Diocese. A = Asian (including Philippines); B = Black/African-American; C = Caucasian; H = Hispanic; P = Native Hawaiian or Pacific Islander (not including Philippines); M = Multicultural; N = Native American or Native Alaskan

5 " 2" Holy Rosary Parish Catholic School Emergency Form (Please print) Family Name Student s Information Parish Name Date of Birth / / Grade (Last) (First) (MI) Name Date of Birth / / Grade (Last) (First) (MI) Name Date of Birth / / Grade (Last) (First) (MI) Name Date of Birth / / Grade (Last) (First) (MI) Address City Zip Phone (To be used for school-home communication only) Mother s Information Name Work Phone Religion Cell Phone Father s Information Name Work Phone Religion Cell Phone Parent s address (if different from student s) Are there any health issues (asthma, allergies, etc.) that the school should be aware of? Name of child Name of child (Please complete back page)

6 Any special home conditions (i.e., joint custody issues, etc.). This information is important for the school to know in case we do have to make any emergency calls.! Please list the names/neighbors/friends in close proximity to whom we may release your child or contact if you cannot be reached. NO STUDENT WILL BE RELEASED TO ANYONE OTHER THAN THE PARENTS, GUARDIANS, OR ADULTS LISTED ON THIS FORM. The following people have permission to pick up my child (ren) from school: 1. Name Relationship Hm Phone Cell 2. Name Relationship Hm Phone Cell 3. Name Relationship Hm Phone Cell 4. Name Relationship Hm Phone Cell 5. Name Relationship Hm Phone Cell Although the above recommendation of the parent will be respected, as far as possible, I understand that in the final disposition of an emergency case the school will prevail. Any time the above information must be changed, I will notify the school in writing. Health Insurance Information: Physician Phone No Dentist Phone No Parent Signature Parent Name (print) Date Parent Signature Parent Name (print) Date

7 " 3" Holy Rosary Parish Catholic School 505 California Street, Woodland CA Office: or Fax: Website: Mission Statement The Mission of Holy Rosary Parish Catholic School is to continue the ministry of Jesus Christ in a faith filled atmosphere: to lead our children to academic excellence: and to make evident the love of God through stewardship and community service. FINANCIAL AGREEMENT PARENT (S) FIRST and LAST NAME (please print): STUDENT (S) FIRST and LAST NAME (please print): ADDRESS: I/We, the undersigned, understand the mission of Holy Rosary Parish Catholic School, as stated above and agree to the following: (Please initial each statement to verify that you have read it and agree to follow it). Thank you. If two checks are returned by the bank, all subsequent payments shall be made in the form of money order/cashier s check or cash. Upon dismissal or withdrawal of the student for any reason, prepaid tuition will be prorated to the end of that month. I understand all fees must be brought current before student s transcripts/cumulative files may be released. A non-refundable registration fee for each student is due each year at the time of registration. Children will not be enrolled if all accounts are not current and registration fee is not paid. The Principal reserves the right at all times, within the context of the rules and regulations of the School and Diocese, to suspend or dismiss the student. Each family is expected to commit 30 parent volunteer hours. I understand that if 30 hours are not completed by April 30, 2016, I will pay my regular tuition amount for the school year, plus an additional $500 will be added to my tuition for the school year. Or I can choose to opt out of completing my parent volunteer hours and pay $500, in addition to my tuition for the school year. I/We hereby accept and agree to all terms and conditions as stated in the Parent/Student Handbook and all amendments hereto. I/We choose the following option for our yearly tuition. One annual payment due July 1, 2015 Two payments due July 1 and December 1, 2015 Eleven monthly payments."this choice must be made by automatic withdrawal through FACTS. I am new to FACTS and will register online. address: FINANCIAL AID: Please apply for financial aid assistance at You must complete the FACTS Grant and Aid form available online at and select Applicant Sign in create an account. This information is confidential and is shared only with the principal and pastors. Each pastor and principal will determine the exact amount of financial aid given to any applicant. The Grant and Aid form should be completed online by May 1, We will only consider Financial Aid applications that include completed IRS forms. " "

8 Holy Rosary Parish Catholic School TUITION REGISTRATION Tuition Parishioner Envelope # Non-Parishioner Individual party responsible for our child/children s tuition other than parents First child $4,685 First child $4,968 Second child $3,526 Second child $3,726 Name: Third child $3,067 Third child $3,067 Fourth child $2,367 Fourth child $2,367 Address: City: State: Zip: Hm phone: Cell phone: Parent Participation Hours The purpose of the Parent Participation Program is to provide an opportunity to be actively involved in our children s education. Each family is required to contribute a minimum of 30 hours. All service hours must be completed between May 1 st and April 30 th of the current school year. Non participation, or failure to complete the required service hours, will result in a $500 fee added on to your tuition fee for the school year. You may opt out of completing parent volunteer hours, but you will be required to pay an additional $500 on top of your tuition fee for the school year. For detailed parent participation hours, please see the Parent-Student Handbook. Tuition/Registration Agreement I/We (please print name), hereby apply for admission of my child(ren) to Holy Rosary Catholic School. I/We have enclosed the non-refundable application/registration fee. I/We agree to fulfill the requirements of the Parent Participation Program (minimum of 30 hours). I/We acknowledge Tuition Payment Policy I/We acknowledge all policies and practices noted in the Parent-Student Handbook. This information can be found at Parent Signature Fees Date # of students Registration Fees Registration Fee: TK through 8 th Grade $275 per student *Please note: The registration fee will increase to $325 per student if student is registered after March 31, Tech Fee: 3 rd through 8 th Grade $200 per student TOTAL AMOUNT OF REGISTRATION DUE: Office use only: Received by: Check # Amount paid: Date