Application Form
for
St. Joseph's Parish School
695 Stevens Avenue
Portland, ME 04103
Phone: (207) 797-7073
 
Please print out this form and bring or send it to our school office. You must also include a copy of the child's
birth certificate and baptisimal record (if applicable).
 
There is a $200 application fee due when submitting this form to our school office. The $200 fee is a one-time,
per-family application fee that will be applied to the tuition contract. The application fee is only refundable if there
is no space available. If the student is accepted, this fee is applied to the contract/registration fee.
 
 
Present Date:__________________ Grade for which you are applying:______ School Year:_________________
 
NAME:______________________________________________________ _________________SEX:_______

 (last)

 (first)

  (middle)
 
ADDRESS:____________________________________ CITY:________________ STATE:____ ZIP:_______
 
MAILING ADDRESS (if different):_____________________________________________________________
 
TELEPHONE (day):_____________ (eve.)____________ DATE & CITY/STATE OF BIRTH:____________________
 
FATHER
 
NAME:_______________________________ RELIGION:____________ Phone:_______________________
 
Occupation/Place of Work:___________________________________________ Work Phone/pager:_________
 
 
MOTHER
 
NAME:_______________________________ RELIGION:____________ Phone:_______________________
 
Occupation/Place of Work:___________________________________________ Work Phone/pager:_________
 
Important: What Parish are you a member of?________________________________________
 
SCHOOL & ADDRESS LAST ATTENDED (if applicable):__________________________________________
 
____________________________________________________________________________________________
 
Whom may we contact in case of emergency, if parents aren't available?
Name & Relationship _________________________________telephone___________________cellphone/pager___
 
_____________________________________________________________________________________________
 
_____________________________________________________________________________________________
 
_____________________________________________________________________________________________
 
 
In case of accident and the school is unable to contact anyone, what is your hospital preference?__________________
Is your child covered by insurance?_______
Are you a graduate of St. Joseph's School?______ If yes, year of graduation:_______
Are there any other siblings at home? If yes, what are their ages?___________________________________________