Online Application – Day & U.S. Boarding Students Admissions - Online Application PROGRAM REQUESTSelect Your Program*Day StudentBoarding - U.S.Session Year*2021 - 20222022 - 20232023 - 2024Applying for Grade*7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeSTUDENT INFORMATIONStudent - First Name* Student - Middle Name or Initial Student - Last Name* Student - Preferred Name Student's Social Security Number* Student's Birthday*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Student's T-Shirt Size*Youth - SmallYouth - MediumYouth - LargeYouth - XLargeAdult - SmallAdult - MediumAdult - LargeAdult - XLargeStudent PhotoMax. file size: 256 MB.Please upload a most recent photo.ADDRESS INFORMATIONMailing Address (where all school mailings will be sent)* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code DEMOGRAPHIC INFORMATIONStudent's Religion*BaptistBuddhistCatholicChristianEpiscopalianHinduJehovah's WitnessJewishLutheranMethodistMormonMuslimNo religious identityNon-DenominationalOtherPentecostalPresbyterianProtestantIf "Other" - Please Name Your Religion* Name of Church / Parish Student Presently Resides With*Mother & FatherAdoptive Parents - Mother & FatherFatherFather & StepmotherGodparentsGrandparentsGuardianMotherMother & StepfatherOtherSeparate Households - Equal Time Between ParentsIf "Other" - Please Indicate Who Student Resides With* Native Language*ArabicBengaliChineseEnglishFrenchGermanHindiJapaneseKoreanOtherPortugueseRussianSpanishVietnameseIf "Other" - Please Indicate Native Language* Country of Birth*United StatesOtherIf Other, Identify Country of Birth Country of Citizenship*United StatesOtherIf Other, Identify Country of Citizenship Requires Visa* Yes No HiddenFamily RelationshipPotential StudentSTUDENT EDUCATION INFORMATIONCurrent Grade*6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade12th GradeCurrent School* Start Date of Present School*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Grades Attended (Select All That Apply)* K 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade Current School Contact (principal, headmaster, counselor, etc)* Current School Contact Email Address Current School Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Current School Phone Number*FAMILY INFORMATIONPRIMARY PARENT / GUARDIANSalutation*Dr.Mr.Mrs.Ms.Prof.Rev.Name* First Last Relationship to Student*AuntCousinFatherGrandfatherGrandmotherGuardianMotherOtherStepfatherStepmotherUncleCustody*YesNoIf Other, Identify Relationship* Email* Phone*Employer Occupation Work PhoneSECONDARY PARENT / GUARDIANSalutationDr.Mr.Mrs.Ms.Prof.Rev.Name First Last Relationship to StudentAuntCousinFatherGrandfatherGrandmotherGuardianMotherOtherStepfatherStepmotherUncleIf Other, Identify Relationship* CustodyYesNoEmail PhoneEmployer Occupation Work PhoneSAINT STANISLAUS CONNECTION(S)Name - Connection #1 First Last RelationshipBrotherCousinCoworkerFatherFriendGrandfatherOtherUncleIf Other, Identify Relationship* Class Of Name - Connection #2 First Last RelationshipBrotherCousinCoworkerFatherFriendGrandfatherOtherUncleIf Other, Identify Relationship* Class Of Name - Connection #3 First Last RelationshipBrotherCousinCoworkerFatherFriendGrandfatherOtherUncleIf Other, Identify Relationship* Class Of STUDENT ACADEMIC & DISCIPLINE HISTORYHas the student ever been placed on probation, suspended, expelled, or not allowed to return to any school?* Yes No Has the student ever been placed on probation by a court?* Yes No Does the student have any type of substance abuse record?* Yes No If you answered "yes" to any of the previous 3 questions, please explain here:Has the student been diagnosed with a learning difference?* Yes No If "yes", please explain here:If "yes", please attach a copy of an official evaluation / diagnosis to this application that is no more than three years old.Max. file size: 256 MB.Has the student skipped or repeated a grade?* Yes No Is there anything else about the student's schooling that we need to know?EXTRACURRICULAR INTERESTSATHLETICSBaseball Yes Basketball Yes Cross Country Yes eSports Yes Football Yes Golf Yes Lacrosse Yes Sailing Yes Soccer Yes Swimming Yes Tennis Yes Track & Field Yes HiddenAthletics Baseball Basketball Cheer Cross Country eSports Football Golf Lacrosse Sailing Soccer Swimming Tennis Track & Field CLUBSAmateur Radio Club Yes Arts & Ceramics Yes Band & Music Yes Board Games Yes Campus Ministry Yes Chess Yes Drama Club Yes Environmental Club Yes Key Club Yes Magic Club Yes Mu Alpha Theta Yes Natl Honors Society Yes Radio Club Yes Robotics Yes Yearbook Yes Youth Legislation Yes HiddenClubs Amateur Radio Club Band Drama Club Environmental Club Fellowship of Christian Athletes International Club Key Club Magic Club Mu Alpha Theta Radio Control Club Robotics Student Ministry Varsity Quiz Bowl Yearbook PARENT STATEMENTHow do you hope that Saint Stanislaus can help your son and your family?*What do you believe your son might contribute to the Saint Stanislaus school community?*If there are additional details or comments you wish to share with us about your son, please do so here.RECOMMENDATIONSName of Reference #1* First Last Please share two school officials who can complete recommendation forms for your son.School* Title* Email* Phone*Name of Reference #2* First Last School* Title* Email* Phone*RELEASE OF INFORMATIONI, the undersigned, do hereby request that you release to Saint Stanislaus an unofficial copy of the following school records for my son.Student's Name* First Last Please supply as much of the following information as possible: *Grades and credits received for the current year and all previous years while enrolled; *Discipline record for the current year and all previous years while enrolled; *Standardized test scores; *Recommendation form filled out by a teacher, counselor, or principal; *Special Needs Recommendation if applicable (IEP, 504, etc.).I also authorize Saint Stanislaus to contact you by phone, email, fax, or mail to request other information about my son's academic and discipline history.A prompt response to this request is appreciated. First and Last Name of Parent/Guardian* First Last Date* MM slash DD slash YYYY Electronic Signature AgreementBy selecting the "I Consent" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide Saint Stanislaus or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and Saint Stanislaus. Consent* I do hereby request that you release to Saint Stanislaus my son's school records including courses and grades, test scores, written evaluations, attendance records, and other requested documents. I also authorize Saint Stanislaus to contact you by phone, email, fax, or mail to request other information about my son's academic and discipline history.