Althoff Catholic Freshman Application
Transfer Inquiries: Please Contact Lauren Haukapp 618.235.1100 ext. 116
Student's Last Name *
Ex. Williams
Your answer
Student's First Name *
Ex. Riley
Your answer
Student's Middle Name *
Ex. Joe
Your answer
Student's Date of Birth *
MM
/
DD
/
YYYY
Student's Gender *
Student's Home Phone
Primary Residence XXX-XXX-XXXX
Your answer
Student's Cell Phone
Primary Residence XXX-XXX-XXXX
Your answer
Student's Street Address *
Primary Residence Ex. 5401 West Main Street (No Abbreviations)
Your answer
Student's City of Residence *
Primary Residence Ex. Belleville (Capitalize First Letter)
Your answer
Student's State of Residence *
Student's Zip Code of Residence *
Your answer
Student's Ethnicity *
Specify Student's Ethnicity *
Student's Religion *
Student's Mother's Maiden Name *
Please indicate N/A if unknown.
Your answer
With Whom Does The Student Live *
Primary Residence
Is The Student's Mother or Father Deceased
Please specify below
Your answer
Student's Most Recent School Attended *
Your answer
Does the Student have an IEP *
Does the Student have a disability (504) *
If student has an IEP or 504 please breifly describe accomodations needed.
Your answer
Grade School Attended *
If selected 'Other' please indicate the Grade School Name below:
Your answer
Grade School District *
If selected 'Other' please indicate the Grade School District below:
Your answer
High School District *
If selected 'Other' please indicate the High School District below:
Your answer
Is This Student The Oldest Sibling In The Family *
Please Select Your Parish *
If selected 'Other' please indicate the Parish Name below:
Your answer
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