2021-2022 Application for Admission

St. Josaphat School

Thank you for your interest in St. Josaphat School. Please complete the application form below no later than January 15, 2021. Upon submission, you will be directed to a link to pay you $150 Non-Refundable Application Fee.

A separate application and fee need to be submitted for each child when applying for multiple children.

Applications can not be saved on our system. Please have all required documents (birth certificates and baptismal certificates) ready to upload before you begin.

If you have any questions, please contact Mrs. Georgia Burke at admissions@stjosaphat.net.

Required fields marked *

Student Information

Last Name*

Answer Required

First Name, Middle Name*

Answer Required

Nickname

Answer Required

Date of Birth*

Answer Required

Gender*

Answer Required

Male

Female

Address (Number and Street)*

Answer Required

City, State, and Zip*

Answer Required

Grade Level For 2021-2022*

Answer Required

Parent Information

Mother's Name*

Answer Required

Mother's Email:*

Answer Required

Mother's Cell Phone:*

Answer Required

Mother's Occupation & Employer:*

Answer Required

Father's Name:*

Answer Required

Father's Email*

Answer Required

Father's Cell Phone*

Answer Required

Father's Occupation & Employer*

Answer Required

If child does not live with both parents, please indicate where the child resides:

Answer Required

Family Information

Are family members alumni of St. Josaphat School?*

Answer Required

Please provide the full names, date of birth and current school/grade of siblings:

Answer Required

Mother's Religion*

Answer Required

Father's Religion*

Answer Required

Student's Religion*

Answer Required

If Catholic, please complete the following:

Current Parish:

Answer Required

Date of Student's Baptism

Answer Required

Location of Student's Baptism (Parish, City, and State)

Answer Required

Educational Information for PreK-4 through 8th Grade Applicants

PreK-3 please fill in n/a for this section.

Student's Current School*

Answer Required

Contact Information for a Teacher or Administrator at Current School:

Name and Position*

Answer Required

Email*

Answer Required

Phone Number:*

Answer Required

Have you previously applied to St. Josaphat School? If yes, when?*

Answer Required

Background Information

Your complete answers to the following questions will help us best serve your child.

Has your child ever received an educational or psychological evaluation?*

Answer Required

Yes

If yes, please explain.

Answer Required

Has your child ever received educational support or therapy?*

Answer Required

Yes

If yes, please explain.

Answer Required

Are there any medical concerns of which we should be aware?*

Answer Required

Yes

If yes, please explain.

Answer Required

Please describe your child's strengths and interests:*

Answer Required

Why are you interested in St. Josaphat School?*

Answer Required

How will your family contribute time and/or talent to the St. Josaphat School community?*

Answer Required

Other Information

The following information will be used for statistical purposes only.

Which race best describes your child?*

Answer Required

Language spoken at home if other than English:*

Answer Required

How did you learn about St. Josaphat School? Please select all that apply.*

Answer Required

Personal referral

St. Josaphat Parish/Church bulletin

St. Josaphat Tots Group

Tour and Coffee

School website

Facebook/Twitter

Publications - eg. NPN, Red Tricycle, Chicago Parent

Other:

If referral, which family referred you?

Answer Required

Are you applying to other schools? If so, which schools?*

Answer Required

What is the local public school your child would attend?

Answer Required

Supplemental Information

The following items must be submitted with the application:

Answer Required

$150 non-refundable application fee

Copy of birth certificate

Copy of baptismal certificate

Please upload birth certificate and baptismal certificate here:

Answer Required

Choose a file or drag it here.

Signature

I hereby declare that the information I have provided above is true and accurate:

Parent Signature*

Answer Required

Confirmation Email

Answer Required

Please fix the highlighted areas below before submitting.

Application for 2021-2022 School Year

2021-2022 Application for Admission

St. Josaphat School