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St. Mary Academy - Request for Information
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Parent/Guardian First Name
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Your answer
Parent/Guardian Last Name
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Your answer
Email Address
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Your answer
Home Street Address
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Your answer
City
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Your answer
State
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Your answer
Zip Code
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Your answer
Primary Contact Phone Number
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Your answer
Student First Name
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Your answer
Student Last Name
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Your answer
Student Birth Date
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Your answer
Male or Female?
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Male
Female
Name of child's current school?
Your answer
Current Grade Level
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Choose
P3
PK
K
1
2
3
4
5
6
7
8
Other
Grade Level Interested
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Choose
P3
PK
K
1
2
3
4
5
6
7
8
Other
Projected School Year of Entry
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Choose
2019-2020
2020-2021
2021-2022
2022-2023
2023-2024
What is your child's primary exceptionality?
Your answer
Does your child have an IEP?
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Yes
No
Does your child have a PLSA or McKay Scholarship?
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PLSA
McKay
Neither
If you are not eligible to receive the McKay Scholarship, have you filed for 'Step up for Students' scholarship?
Yes
No
How did your hear about St. Mary Academy?
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Choose
Friend
Family
Newspaper
Magazine
Internet Search
TV
Word of Mouth
Radio
Do you have another child interested in our school?
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Yes
No
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