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Student Application for 2016-2017
St. Timothy Middle School Application for Admissions
Applying for Grade
Student Last Name
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Student First Name
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Student Middle Name
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Gender
Student's Street Address
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Town/City
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State
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Zip Code
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Home Phone (xxx-xxx-xxxx)
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Date of Birth
MM
/
DD
/
YYYY
Place of Birth
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Applicant's Current School
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Applicant's Current Grade
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Has your child been designated as a Special Education student (504, IEP, etc.) at any time during at any time during his/her educational history?
Required
If so, may we have access to these records?
Students resides with
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Mother's Name (Last, First)
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Mother's Cell Phone (xxx-xxx-xxxx)
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Mother's Occupation
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Mother's Employer
Your answer
Father's Name (Last, First)
Your answer
Father's cell Phone (xxx-xxx-xxxx)
Your answer
Father's Occupation
Your answer
Father's Employer
Your answer
Mother's Primary Email
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Mother's Secondary Email
Your answer
Father's Primary Email
Your answer
Father's Secondary Email
Your answer
Religious Information - Student's Religion
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Mother's Religion
Your answer
Father's Religion
Your answer
Parish Name with Town and State
Your answer
Are any of the applicant's parents or siblings or other family members a graduate of St. Timothy?
Your answer
Please List Student's Siblings: Name, Current School and grade
Your answer
How did you hear about St. Timothy School?
To the Parent/Guardian: Please state briefly why you wish to have your child attend St. Timothy Middle School.
Your answer
To the student: Please describe yourself as a student. What are your best qualities? On what areas would you like to work during your middle school years?
Your answer
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