Application for Admission School Year

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1 Application for Admission School Year Mail or deliver applications to: Admissions Office Cristo Rey Columbus High School 400 East Town Street Columbus, Ohio Phone: (614) x Fax: (614)

2 Cristo Rey Columbus High School Admission for School Year Deadlines for Applications Early Admission Deadline.. Wednesday, November 18, 2015 * Applications will be accepted after November 18 until we have filled all available seats. To have the best chance at being accepted we encourage completing the application as early as possible. Part 1- Application In order for your application to be processed, your file must include the following items. Part 2- Entrance Exam Application for Admission (this packet) Student must be eligible to work in the United States Submit Request for Records form (yellow packet) to student s current school requesting: Completed Recommendation Form from English teacher Completed Recommendation Form from Math teacher Completed Recommendation Form from School Leader Copy of Report Cards, discipline records, and attendance records from current and previous grade Copy of Standardized Test scores from current and previous grade IEP/ISP records, if applicable Financial Aid Forms FACTS Grant and Aid Application (must include $30 processing fee) Applicants will also take the Cristo Rey Columbus High School Entrance Exam on one of the dates below. Please call x12009 to reserve a space. Entrance Exam.. Saturday, October 24, 2015; 9 am -11:30 am Entrance Exam.. Saturday, November 21, 2015; 9 am -11:30 am * More dates may be added if needed. Part 3- Interview Applicants who complete their applications may move into the second phase of the admissions process. Applicants who meet the criteria to be a Cristo Rey Columbus student may be invited to interview with the Director of Admissions or other school representative. Student and Parent/Guardian interview with the Director of Admissions or other school representative For Accepted Students only Part 4- Registration Students will receive notification of admission to Cristo Rey Columbus High School via mail. Students who are accepted and plan to attend Cristo Rey Columbus must register to secure their placement in the class. Register at Cristo Rey Columbus and submit $50 Registration Fee

3 APPLICATION INSTRUCTIONS Please type or print clearly. Use blue or black ink. Fill in all blanks provided. OFFICE USE ONLY Date Received Staff Receiving SECTION A: STUDENT S PERSONAL DATA Full Name (as on Birth Certificate): Current School: Last First Middle Initial Grade: Birth Date: / / Religion (optional): Month Day Year If Catholic, which parish? Is this student a first generation college student? Yes No (Please circle one.) Please mark racial and/or ethnic identity (optional) Black or African American Caribbean Islander Hispanic or Latino Multiracial Asian White Other Home Address: Address Apt. City State Zip Home Phone: - - Birth Place: Gender : Male Female Language spoken at home: Other Languages Spoken: Student s Cell Phone (optional): - - Student Lives With: (Check all that apply.) Mother only Father only Both Parents Grandmother Grandfather Aunt or Uncle Foster Care Provider Other Relationship: Parent/Guardian s Current Marital Status: (Check all that apply.) Single Parent Parents Married Parents Together Divorced Separated Mother Remarried Father Remarried Mother Deceased Father Deceased Under DYFS Custody

4 SECTION B: STUDENT QUESTIONNAIRE This must be completed in student s own handwriting, without parental assistance. If needed, use additional paper or the back of this page. Student Name: Date: Explain why Cristo Rey Columbus is a good fit for you, and why you are a good fit for Cristo Rey: Do you know any current Cristo Rey students? If so, who? How did you hear about Cristo Rey Columbus? (check all that apply) Cristo Rey Representatives visited my school Cristo Rey Representatives visited my church Friend, neighbor, or relative Teacher, counselor, or clergy Community event (festival, fair, etc.) Received something in the mail Received a phone call Newspaper Article Word of mouth (family, friend, etc.) What high school would you attend next year if you do not attend Cristo Rey Columbus? What is your district home high school?

5 SECTION C: FAMILY INFORMATION (to be completed by parent or guardian) Personal Data of Parent or Guardian 1 Full Name: Last First Middle Initial Gender: Male Female English Speaker: Yes No If no, list preferred spoken language: Relationship to Student: Legal Guardian? Yes No Home Address: Address Apt. City State Zip Home Phone: - - Work Phone: - - Employer: Parent Cell Phone: - - Please check the best way to contact you. Occupation: Work Phone Home Phone Cell Phone Text Message If is a preference, please write your address: Personal Data of Parent or Guardian 2 Full Name: Last First Middle Initial Gender: Male Female English Speaker: Yes No If no, list preferred spoken language: Relationship to Student: Legal Guardian? Yes No Home Address: Apt./Street City State Zip Home Phone: - - Work Phone: - - Employer: Parent Cell Phone: - - Please check the best way to contact you. Occupation: Work Phone Home Phone Cell Phone Text Message If is a preference, please write your address:

6 SECTION D: PARENT QUESTIONNAIRE (to be completed by parent or guardian) List all schools the student has attended in the last THREE years: (1) (2) (3) (4) Current School City, State Year(s) Attended School City, State Years(s) Attended School City, State Years(s) Attended School City, State Year(s) Attended Learning and Medical Profile Has the student been diagnosed with a learning disability? Yes No Has the student been diagnosed with ADD or ADHD? Yes No Has the student now or ever been enrolled in special education classes? Yes No Has the student now or ever been enrolled in gifted classes? Yes No Has the student been enrolled in English as a Second Language (ESL) classes? Yes No Does the student currently have, or ever had, an Individual Education Plan (IEP)? Yes No If Yes, a copy of the IEP must be included with the application. If you answered YES to any of the questions above, please explain below. Why do you want your son or daughter to attend Cristo Rey Columbus? Why do you believe he or she would do well here? Household Income How many adults live in your house? Relationship(s) to child: How many children live in your house? Relationship(s) to child: Please check the most appropriate range of your total household income. Less than $20,000 $20,001-40,000 $40,001-60,000 $60,001-80,000 Higher than $80,000 * All applicant families are required to complete the FACTS Financial Application before receiving an official admissions decision from Cristo Rey Columbus.

7 IMPORTANT NOTE TO STUDENTS, PARENTS AND GUARDIANS: Please review carefully and sign below. I understand that Cristo Rey Columbus High School is an academically challenging, Catholic school with a code of mandatory attendance, dress, and conduct. The hallmark of the school is its Professional Work-Study Program in which the students work one full day each week and a fifth day approximately every four weeks of the school year, excluding holidays and days when school is closed. I understand the student s earnings will be used to fund a portion of the cost of their high school education. I further understand that full participation of parents and guardians is necessary in order to fulfill requirements of the school. Admission to Cristo Rey Columbus High School is subject to our receipt of an official transcript demonstrating successful completion of the applicant s current grade and satisfactory completion of our mandatory summer business training program. Admission and enrollment decisions are made at the sole discretion of Cristo Rey Columbus administration. I certify that the information furnished in this application is complete and accurate. Furthermore, I understand that if I knowingly provide false information, my child s admissions may be jeopardized. My signature indicates my permission for the release of my child s school records to Cristo Rey Columbus High School. Student Signature Date Parent/Guardian Signature Date NOTA IMPORTANTE PARA ESTUDIANTES, LOS PADRES O REPRESENTANTES: Por favor revise cuidadosamente y firme a continuación. Comprendo que la Escuela Secundaria Cristo Rey Columbus es una escuela católica con un riguroso programa académico que posee un código de asistencia obligatoria, vestimenta y conducta. La marca que diferencia esta escuela es su Programa Profesional de Trabajo-Estudio en el cual los estudiantes trabajan un día entero cada semana y un quinto día cada cuatro semanas del año escolar aproximadamente, con excepción de los días feriados y los días en que no haya clase. Comprendo que lo que gane el estudiante cubrirá una porción del costo de su educación secundaria. Afirmo que comprendo que la participación total de los padres y representantes es necesaria para cumplir los requisitos de la escuela. La admisión a la Escuela Secundaria Cristo Rey Columbus está sujeta al recibo de un certificado académico oficial que demuestre que el aspirante completó satisfactoriamente el grado actual y completar satisfactoriamente nuestro programa de entrenamiento profesional de verano obligatorio. Las decisiones de admisión e inscripción se realizan exclusivamente a discreción de la administración de Cristo Rey Columbus. Certifico que la información proporcionada en esta aplicación es completa y precisa. Y, además, afirmo que si proveo información falsa, la admisión de mi hijo(a) será perjudicada. Mi firma indica mi autorización para emitir los archivos de mi hijo(a) a la Escuela Secundaria Cristo Rey Columbus. Firma del Estudiante Fecha Firma del Padre Fecha

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