Althoff Catholic Freshman Application
Transfer Inquiries Please Contact Ali Jeffers 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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