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2017-2018 Registration/Tuition Form

Family Information

 My child will not be attending St. Clare Catholic School for the 2017-18 school year (Please see page 6)

Father/Guardian Information

Father/Guardian’s Name (Last, First, Middle)

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Home Address (Number, Street, City, State, Zip) Same as Student’s Address Billing address

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Home Phone

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Cell Phone

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Work Phone

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Email Address

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Employer

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Occupation

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Religion

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Parish

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Father/Guardian (Please check all that apply)

 Live with student        List Home/Cell Phone in School Directory  

 List email in School Directory     List Address in School Directory

Mother/Guardian Information

Mother/Guardian’s Name (Last, First, Middle)

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Home Address (Number, Street, City, State, Zip) Same as Student’s Address Billing address

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Home Phone

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Cell Phone

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Work Phone

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Email Address

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Employer

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Occupation

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Religion

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Parish

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Mother/Guardian (Please check all that apply)

 Live with student        List Home/Cell Phone in School Directory  

 List email in School Directory     List Address in School Directory

Marital Status                 Married         Single         Widowed          Divorced/Separated

If parents do not live together, is there a custody agreement on file?          Yes                 No

Bus service requested? (3K students are not able to ride the bus)         Yes                 No

Student Information

First Student Information

Grade Entering

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Current Age

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Student Name (Last, First, Middle)

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 Male  Female

Date of birth  

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What public school would your child attend? Click here to enter text.

Health (please describe any health conditions that the school should be aware of including allergies, ADD, ADHD, asthma, seizure, bee sting allergy, food allergies, etc.) 

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Ethnicity (for office use only)

 White, Non-Hispanic   Hispanic   Asian/Pacific Islander  Black/Non-Hispanic

 Multiracial   American Indian/Alaskan   Other

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Has student been baptized?  Yes   No

Baptism Date (if applicable)

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Baptism Location (if applicable)

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Has Student received First Holy Communion?  Yes   No

Date Click here to enter text.

Location Click here to enter text.

Second Student Information

Grade Entering

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Current Age

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Student Name (Last, First, Middle)

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 Male  Female

Date of birth  

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What public school would your child attend? Click here to enter text.

Health (please describe any health conditions that the school should be aware of including allergies, ADD, ADHD, asthma, seizure, bee sting allergy, food allergies, etc.) 

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Ethnicity (for office use only)

 White, Non-Hispanic   Hispanic   Asian/Pacific Islander  Black/Non-Hispanic

 Multiracial   American Indian/Alaskan   Other

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Has student been baptized?  Yes   No

Baptism Date (if applicable)

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Baptism Location (if applicable)

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Has Student received First Holy Communion?  Yes   No

Date Click here to enter text.

Location Click here to enter text.

Third Student Information

Grade Entering

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Current Age

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Student Name (Last, First, Middle)

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 Male  Female

Date of birth  

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What public school would your child attend? Click here to enter text.

Health (please describe any health conditions that the school should be aware of including allergies, ADD, ADHD, asthma, seizure, bee sting allergy, food allergies, etc.) 

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Ethnicity (for office use only)

 White, Non-Hispanic   Hispanic   Asian/Pacific Islander  Black/Non-Hispanic

 Multiracial   American Indian/Alaskan   Other

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Has student been baptized?  Yes   No

Baptism Date (if applicable)

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Baptism Location (if applicable)

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Has Student received First Holy Communion?  Yes   No

Date Click here to enter text.

Location Click here to enter text.

Fourth Student Information

Grade Entering

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Current Age

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Student Name (Last, First, Middle)

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 Male  Female

Date of birth  

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What public school would your child attend? Click here to enter text.

Health (please describe any health conditions that the school should be aware of including allergies, ADD, ADHD, asthma, seizure, bee sting allergy, food allergies, etc.) 

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Ethnicity (for office use only)

 White, Non-Hispanic   Hispanic   Asian/Pacific Islander  Black/Non-Hispanic

 Multiracial   American Indian/Alaskan   Other

Fill in below for new families only.

Has student been baptized?  Yes   No

Baptism Date (if applicable)

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Baptism Location (if applicable)

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Has Student received First Holy Communion?  Yes   No

Date Click here to enter text.

Location Click here to enter text.

Tuition Form

NOTE: One Tuition Form must be submitted per FAMILY

Early Registration FULL time 4K through 8th Grade Tuition (ENDS March 31, 2017)

*NON-PARISH MEMBER

1 Child

2nd Child

3rd Child

4th Child

5th Child

$2,300/$2,400*

$2,200/$2,300*

$2,100/$2,200*

$2,000/$2,100*

$1,900/$2,000*

FULL time 4K through 8th Grade Tuition (BEGINS April 1, 2017)

*NON-PARISH MEMBER

1 Child

2nd Child

3rd Child

4th Child

5th Child

$2,500/$2,600*

$2,400/$2,500*

$2,300/$2,400*

$2,200/$2,300*

$2,100/$2,200*

First Grade Discount

Students who were enrolled at St. Clare Catholic School for the full academic years of 4K in 2015-16 and kindergarten in 2016-17 will receive a $500 discount on 2017-18 first grade tuition.

 My child qualifies for this discount.

3K

Pre-K 3                       Tues. and Thurs. (7:55am-11:00am)                         $1,200/year parish member

                                                                                                                           $1,300/year non-parish member

4K

Option 1                 Mon./Weds./Fri. ALL DAY                                $1,900/year parish member

                                                                                                                          $2,000/year non-parish member

Option 2                 5 HALF days (7:55am-11:00am)                                $1,900/year parish member

                                                                                                                          $2,000/year non-parish member

Option 3                  5 FULL days                                           see 4K-8 tuition tables above

*ONLY Full time 4K students qualify for the multi-student discount

Payment Options (please check one)

Full Payment (if payment is received prior to           September 15th, tuition will be credited by $20/child)

 Semi-Annual payment

      (50% due September 15th and 50% due April 25th)

  Eight Monthly Payments (Must sign up for electronic funds transfer)

     (Beginning September 5th – ending April 25th)

2017-2018 Tuition

The per-student cost to educate each child is approximately $5,133. Tuition covers about 45% of the cost. The rest is covered through a parish subsidy and fundraising activities. Please look for opportunities to support the parish through sacrificial giving.

If you are able to assist the school with the additional per pupil cost, a payment in excess of your tuition would be acknowledged as a donation to the school. I would like to make a donation of $

Tuition Responsibility Page

NOTE: One Tuition Responsibility Page must be submitted for each family

I, Click here to enter text.(Parent/Guardian), am responsible for the payment of the registration fee and tuition for:

Student

Grade

Tuition

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Total Tuition Due

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 Please send information about the tuition grant program

All fees and tuition for the 2017-18 school year will be paid in full by April 25, 2018. If, for any reason, a change is required to the payment plan, a call to the school office must be made and a new form must be completed. By signing the tuition responsibility page, I understand and agree to fulfill my financial commitment and obligation to St. Clare Catholic School/Parish.

If tuition for the current 2016-2017 school year is not paid in full by May 1, 2017, a meeting with the business manager and/or pastor is required prior to the beginning of the 2017-2018 school year.  Your child will not be enrolled into St. Clare Catholic School for the 2017-2018 school year until this meeting has taken place and an acceptable resolution has been agreed upon.  Failure to follow this procedure will result in forfeiture of all registration fees.

St. Clare School Parent Involvement Statement: I have read and understood that as a parent of a student at St. Clare Catholic School, I am expected to contribute volunteer hours to support school activities and programs.

Signature of Parent/Guardian

Date

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Please attach the following documents to this registration form:

 Non-Refundable Registration Fee for 3K through 8th grade students. Checks should be made payable to St. Clare Catholic School.

                $   75/Student

                $ 150/Family

        For New Students to St. Clare Catholic School

         Copy of Birth Certificate

         Copy of Baptismal Certificate (If applicable)

         Copy of First Communion Certificate (If applicable)

For Office Use Only

Registration Fee

Birth Cert.

Baptismal Cert.

First Communion  Certificate

Date

Received

If you have chosen not to send your child to St. Clare, please let us know why by checking the boxes that apply.  

Student Name: Click here to enter text. 

 Financial

 Academics Click here to enter text.

 Faculty/staff Click here to enter text.

 Administration Click here to enter text.

 Other Click here to enter text.