2021-22 New Family and Student <div> Admission Application </div>

2021-22 New Family and Student
Admissions Application

This Application form is for planning purposes. It is not a contract. If any information is falsified or omitted, admittance into this school may be terminated.

All students enrolled in the Archdiocese of Mobile’s PreK-12 Catholic schools, daycare centers, summer camps, and Mother’s Day out programs will be required to be immunized. A student may be exempt from immunization for medical reasons if the student presents the school with a medical exemption card from the Alabama Department of Health.

Date REQUIRED Please fill out this field. Please enter a date.

Name of Person Completing Application REQUIRED Please fill out this field. Please enter valid data.

Telephone Number of Person Completing Application REQUIRED Please fill out this field. Please enter valid data.

STUDENT INFORMATION

Full Legal Name of Student (First, Middle, Last) REQUIRED Please fill out this field. Please enter valid data.

Preferred Name REQUIRED Please fill out this field. Please enter valid data.

If PreK 3, please select Half Day or Whole Day REQUIRED Half Day (7:45 AM-11:45 AM) Whole Day (7:45 AM-2:45 PM) N/A Please fill out this field.

Date of Birth (MM/DD/YY) REQUIRED Please fill out this field. Please enter valid data.

Place of Birth (City, State) REQUIRED Please fill out this field. Please enter valid data.

Gender REQUIRED Male Female Please fill out this field.

Ethnicity REQUIRED Hispanic Non-Hispanic Please fill out this field.

Race REQUIRED American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Multiracial Please fill out this field.

Native Language REQUIRED Please fill out this field. Please enter valid data.

Student Lives With REQUIRED Both Parents Mother Father Legal Guardian * Please fill out this field.

Name of Legal Guardian, if applicable Please enter valid data.

Mailing Address Please enter valid data.

City Please enter valid data.

State

Zip Please enter a zip code.

Religious Affiliation REQUIRED Catholic Non-Catholic Please fill out this field.

Parish Currently Registered (if Catholic) Please enter valid data.

If Catholic, please complete a Pastor Recommendation form and submit to your home parish.

If Catholic, Date of Baptism, Name of Church, City and State (a copy of the Baptismal Certificate is required upon an Offer of Enrollment into CTKCS))

First Reconciliation Date, Name of Church, City and State

First Communion Date, Name of Church, City and State

Name of Current School or Last School Attended (please include mailing address and telephone number) REQUIRED Please fill out this field.

Is there any disability that may interfere with academic studies or extracurricular activities? REQUIRED Yes No Please fill out this field.

If yes, please explain (e.g. Asthma, Dyslexia, Learning Disability, ADD, etc.).

Is their documentation to verify any of the above diagnosis? REQUIRED Yes No N/A Please fill out this field.

Will the student require an evaluation to participate in our FLEX program? REQUIRED Yes No N/A Please fill out this field.

Has the student ever received/or is currently receiving any type of therapy services? (e.g. Physical Therapy, Speech Therapy, Occupational Therapy, Feeding Clinic) REQUIRED Yes No N/A Please fill out this field.

If yes, please explain.

Has your student ever been in an Early Intervention Program? REQUIRED Yes No N/A Please fill out this field.

If yes, please list when the student received this service and at what facility.

Has the student ever been suspended or expelled? REQUIRED Yes No Please fill out this field.

Has the student ever been retained? REQUIRED Yes No Please fill out this field.

If yes the student has been retained, what grade? Please enter valid data.

Please list any health information such as allergies and/or medications, or state N/A. REQUIRED Please fill out this field. Please enter valid data.

A current State of Alabama Health Immunization Record will be required upon acceptance into Christ the King Catholic School.

All students enrolled in the Archdiocese of Mobile’s PreK-12 Catholic schools, daycare centers, summer camps, and Mother’s Day out programs will be required to be immunized. A student may be exempt from immunization for medical reasons if the student presents the school with a medical exemption card from the Alabama Department of Health.

Additional notes you would like to submit about this student.

FATHER'S INFORMATION

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number (000-000-0000) REQUIRED Please fill out this field. Please enter a phone number.

Place of Employment REQUIRED Please fill out this field. Please enter valid data.

Occupation REQUIRED Please fill out this field. Please enter valid data.

Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.

If Catholic, please complete a Pastor Recommendation form found on this page, and submit to your home parish.

MOTHER'S INFORMATION

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Maiden Name Please enter valid data.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number (000-000-0000) REQUIRED Please fill out this field. Please enter a phone number.

Place of Employment REQUIRED Please fill out this field. Please enter valid data.

Occupation REQUIRED Please fill out this field. Please enter valid data.

Religious Affiliation REQUIRED Please fill out this field. Please enter valid data.

If Catholic, please complete a Pastor Recommendation form found on this page and submit to your home parish.

ADDITIONAL INFORMATION ABOUT YOUR FAMILY

PARENT OR LEGAL GUARDIAN INFORMATION

Title (Mr. & Mrs., Dr. Ms.) REQUIRED Please fill out this field. Please enter valid data.

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Suffix (Jr. Sr. II) Please enter valid data.

Mailing Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Please list any siblings other than the applicant(s). If applicable, please include their grade level and name of the school they are attending in 2021-22.

Please list first and last name of CTKCS alumnus, and graduation year, if known. (Parent(s) or Guardian(s), Sibling(s), Grandparent(s) related to student(s) only)

We like to keep Grandparents "in the loop" about special events such as Grandparent's Day, First Holy Communion and Graduation as well as volunteer opportunities such as our Book Fair, Grandparent Sponsored Jr. High Lunch, and PTO activities. Grandparents are a great asset to our school and love to know what their grandchildren are up to at CTKCS. We send a monthly Constant Contact to their email just for them! If you would like to add grandparents to our contact list for this monthly email, please submit their email address. Our Grandparent Constant Contact will only be sent to enrolled students.

Maternal Grandparent Name Please enter valid data.

Maternal Grandparent Email Address Please enter valid data.

Paternal Grandparent Name Please enter valid data.

Paternal Grandparent Email Address Please enter valid data.

2021-22 New Family and Student
Admission Application

This Is Where It Begins

2021-22 New Family and Student
Admissions Application

2021-22 New Family and Student Admission Application

2021-22 New Family and Student Admissions Application

2021-22 New Family and Student
Admission Application

2021-22 New Family and Student
Admissions Application