Registration Forms for the School Year

Transcription

1 4433 Douglas Avenue Racine, WI Registration Forms for the School Year These forms can also be found on-line at the school website: Welcome to St. Rita Catholic School! We are glad to have you as a part of our community. Our goal at St. Rita s is to provide your family with an excellent and well-rounded experience of Catholic education by living, loving and learning our faith! Please find the following required forms in the registration packet. Complete and turn into the school office. 1. Enrollment Contract (required by all families) 2. Automated Tuition Payment (optional) 3. Family Information Sheet (required by all families) 4. *Student Information Sheet (one per new student registering at St. Rita) 5. *Verification of Birth Certificate Form (one per new student). The child s original birth certificate must be presented and verified at the time of registration. 6. *Permission for Entrance Testing (one per new student) 7. *Records Release Form (one per new student grade 1 and above) 8. Letter regarding 4K program enrollment. Explanation of Registration Fee/Tuition Rates A non-refundable registration fee of $ per child is required at the time of enrollment (grades 5K-8). This fee covers the cost of books, materials and other equipment (i.e. roller skates) provided by the school for the students use. A $30.00 registration fee per child enrolling in 4K is required at the time of enrollment (this fee is refundable in the event that less than 12 students enroll). The total cost of educating a student is $ Reserves Discount. All school families are asked to participate in annual fundraising and school events which generate funds for the school. For this reason the monies raised during such events are being made available during the school year as an option to all families to off-set the cost of tuition. $ is allotted per child if the family prefers to utilize the discount. Parish Subsidy Discount. St. Rita Parish offers a subsidy of up to $ per child to Catholic families who belong to and support a Catholic Parish. This discount may be applied to eligible families. Multiple Child Discount. Families requiring a multi-child discount when enrolling more than one student at St. Rita School may submit a written request for up to $ per additional student if needed. Please attach the request to your enrollment paperwork when registering.

2 St. Rita School Enrollment Contract p.1 This document is a contractual commitment for tuition payment that requires your signature. A $ per child registration fee is due with this contract. The registration fee for 4K is $30.00 due with this form. Multiple checks for multiple children may be post-dated one month per child. Your commitment to Catholic Education at Saint Rita School: Faith Formation the school is a function of our Catholic Parish. Parents/Guardians are to model positive moral and religious values. Catholic parents assist in religious/sacramental education, including weekend liturgy. All students participate in religious activities. Time, Service and Support Parents/Guardians are encouraged to put in at least 20 service hours per year, should plan to participate in school fundraising, and must support the school staff and policies. Financial Commitment Tuition payment must be kept up to date. The automated tuition program is preferred. Catholics must provide support to their parish according to their means. Penalty for non-payment of tuition or other money owed is to deny direct access to report cards and on-line gradebook and can include termination of enrollment. Family Registration Status (Check One) Our family is registered and is supporting St. Rita Parish. Our family is registered and supporting another Catholic Parish: (name) Our family is non-catholic or is not affiliated with a Catholic Parish. Student Enrollment (Print all information neatly) Name Date of Birth Grade Level Name Date of Birth Grade Level Name Date of Birth Grade Level Tuition Chart (Complete the chart below to arrive at your family s tuition commitment see cover for explanation of discounts.) Cost of Education $ x Students = Subtract Reserves Discount (optional) $ X Students = -- Subtract Parish Subsidy Discount (optional) $ X Students = -- Subtract Multi-Child Discount (optional) x Students = -- TOTAL TUITION DUE School Year Tuition total due for the above named students during the school year (to be paid in 10 monthly payments beginning in July 2017, ending in April 2018) Registration $ per child due with this form Signature of Parent/Guardian (Print Neatly) First and Last Names of Parent(s)/Guardian(s) Address City, Zip Phone Address for all communication For Office Use Registration Date: Check #: Initials: Additional financial assistance is available to Parish families. Contact the principal or business manager for further information.

3 St. Rita School Automated Tuition Payment Contract (optional) p.2 Sign-up Deadline: June 15, 2017 except by special arrangement. An attached voided check is required. Instructions and Conditions: 1. This system to pay tuition is encouraged each year but is not required. 2. This contract for AFT is good for only one school year and must be renewed annually. 3. Funds transfer begins in July The last transfer is in April If any payment does not go through successfully, your bank may charge you a fee. St. Rita Parish/School will not be responsible for any such fee. Any non-sufficient funds fees will be passed on to your family as tuition owed. 5. Your personal information will remain confidential with the parish office. 6. Tuition will be withdrawn on the 20 th of each month, or the first business day thereafter. 7. SCRIP credits, if applicable, will be deducted from the final April payment. School Family Information (print clearly) Family Name Address City, State, Zip Required Banking Information (print clearly) Name(s) on Account Bank/Financial Institution Name Bank Address/City/State/Zip Bank Account Number circle one: Bank ABA Routing Number savings checking This contract is good for the school year. Amount to be withdrawn per month** $ **This amount should equal one-tenth of the total tuition owed, to be transferred in ten monthly payments, as shown on the enrollment contract. I have read the instructions and conditions of this plan and agree to abide by them. Signature Date Attach a Voided check to this form.

4 St. Rita School Family Information p.3 This is the school office record of your registration and it must be accurate and complete. The information is used for student records, our parent alert system and the family directory. If any information should be withheld from the family directory please note it below. Student(s) Enrolled Use first and last names of each child and indicate grade level for the school year. Name Grade Date of Birth Male Female Religion Baptized? Yes No Received 1 st Reconciliation? Yes No 1 st Eucharist? Yes No Ethnicity: Native American Asian African American Pacific Islander White Hispanic Multiple Name Grade Date of Birth Male Female Religion Baptized? Yes No Received 1st Reconciliation? Yes No 1st Eucharist? Yes No Ethnicity: Native American Asian African American Pacific Islander White Hispanic Multiple Name Grade Date of Birth Male Female Religion Baptized? Yes No Received 1st Reconciliation? Yes No 1st Eucharist? Yes No Ethnicity: Native American Asian African American Pacific Islander White Hispanic Multiple Father/Male Guardian Name Home Address City,Zip Mother/Female Guardian Name Address (if different) City/Zip (if different) Phone # Phone # Family Phone (for Directory) Primary (for Directory) Permissions & Choices Family Directory: I permit the above information to be published in the Family Directory (for school families ONLY!). Family Directory Limitation: The above information, if any, should not appear in the directory: Gr : My address may be shared with Archdiocese High Schools for recruitment purposes. Our family agrees to review the Student Handbook on-line ( and abide by its policies and guidelines. Our family agrees that information from the Family Directory will not be shared with those outside of school families. Check here if two families share custody. Use the back of this form to add additional family information for communications. THIS CONFIDENTIAL INFORMATION IS REQUIRED BY LAW, FOR PROTECTION OF CHILDREN. Please complete only if parents are(circle all that apply): Divorced Separated Remarried Widowed Unmarried Name(s) of adults whom the child(ren) primarily live(s). Relationship to child(ren): If there has been a separation or divorce, is there full shared custody? Yes No Are there any court mandated restrictions with respect to any person s parental rights? Yes No If yes, what restrictions?. If the child(ren) live with an adopted parent, has the parent s spouse legally adopted the child(ren) Yes No Note: A copy of any court order for custody restrictions is to be kept in a confidential file at school. Signature of Parent/Guardian Date

5 St. Rita School New Student Information Form p.4 This form goes into the student s school cumulative file. Each new student must have a separate form. Date Enrolling in Grade Student s Name (first, middle, last) Nickname? Student s Address (street, city, zip) Birth Date (month, day, year) Gender: male female Birthplace (city, state, country) Ethnicity: Native American Asian African American Pacific Islander White Hispanic Multiple Religion Sacramental Information (Catholics) Month/Year Church Name, City, State Baptism First Reconciliation First Eucharist Father/Male Guardian Name Religion Place of Employment Occupation Mother/Female Guardian Religion Maiden Name Place of Employment Occupation Names and Ages of other children in the family: Name age Name age Name age Name age School Attended Previous to registration at St. Rita School (if applicable): Name City, State Official Certificate of Birth: must be presented and verified at time of registration Immunization Record: required by the first day of school Baptismal Certificate: required to receive First Reconciliation and Eucharist (Grade 2)

6 Verification of Certified Birth Certificate p.5 For Enrollment at St. Rita School, Racine, WI In the state of Wisconsin a photocopy of a birth record cannot be used as a legal proof of birth. An abstractor (principal or secretary) of St. Rita School must verify specific information, listed below, that is on the legal certified copy, before accepting it as a legal proof of date of birth for school records. The original certified record is kept by the parent or guardian once this verification is completed. (The school may make a photocopy to keep with the verification form.) Please copy the exact information from the certified birth certificate in the boxes below. Present both this form and the original birth certificate to the principal or secretary for verification. The ORIGINAL will have a registrar s raised seal and signature, date of issue, watermark, or other evidence of authenticity. 1.Child s Name (first name) (Full Middle Name) (Last Name) (Title, e.g., Jr.) 2.Date of Birth 3.Gender Male Female 4.Name of Mother Listed (First Name) (Middle Name) (Last Name) 5.Name of Father Listed (First Name) (Middle Name) (Last Name) 6.Place of Child s Birth USA or specify: Country State City, Village, Town County VERIFICATION OF BIRTH FACTS (TO BE COMPLETED BY SCHOOL SECRETARY OR PRINCIPAL 7.Certified copy of Birth Certificate was issued by: State Registrar s Office U.S. Department of State (FS 240 or DS Date this Document was issued: (Month, Day, Year) Local Registrar s Office Other(Foreign Country: 9.Date that Certified copy of Birth Certificate was presented at: St. Rita School (Month, Day, Year) 10.Full Name of Person presenting Birth Certificate CERTIFICATION STATEMENT I affirm that, to the best of my knowledge and belief, I have verified that all the information above is abstracted from a certified copy of the birth certificate which was presented to me as proof of identity for the above-listed child, and I have returned the certified copy to the person who presented it. Signature of St. Rita School Secretary or Principal Date of Signature (Month, Day, Year)

7 St. Rita School Request for Records p.6/7 Please release all school records for the child or children named below, who will be attending St. Rita School Please include: All academic records, report cards, other assessments Health and Immunization records: originals, please Achievement Testing results Paperwork/reports pertaining to referral for special needs assessment, IEP, 504, adaptations, or differentiation plans Confidential file contents, especially any pertinent to new placement Any other information relevant to the student s admission to our school. Thank you for your assistance. If you have a question about this transfer, please call our school office. ( ) As Parent or Legal Guardian for Send records to: St. Rita School 4433 Douglas Avenue Racine, WI I give authorization for the school listed below to release to St. Rita School all of the above listed school records. Name of School Currently or Last Attended School Address, City, Zip Signature of Parent/Guardian Date Permission for Student Testing (as needed) The school will administer a screening test to all entering kindergartners to assure readiness for the program. Grade level placement of other new students is initially based on records and reports from the previous school, but St. Rita s requests the right to administer readiness / placement testing, if needed, for any new student, any time within the first school year of attendance, if there is a question about correct placement. The parent or guardian is requested to provide permission for this testing by signing below. Note: we will not disclose the content of any placement test ahead of time; preparation is not needed or encouraged. Results of the kindergarten screening, or testing at other grade level, are available for review afterwards upon request. STUDENT(S) ENTERING ST. RITA SCHOOL : Student Name (print) Grade Student Name (print) Grade Student Name (print) Grade I grant my permission for screening or any other needed placement testing for the above named child(ren). Name of Parent/Guardian (print) Signature Date

8 p Douglas Avenue Racine, WI February 8, 2017 Dear Families, We are reaching out to you today to inform you that St. Rita School has decided to move forward in opening a 4K program for the school year. The program will be overseen by the school principal, will be held to Archdiocesan standards for the grade level, and taught by a certified, licensed teacher. The St. Rita 4K program will be a full day, five days per week academically, socially and developmentally appropriate program that will follow the regular school year calendar. Students must be 4 years old by September 1, 2017 to enroll. A $30.00 registration fee is due along with the registration paperwork (this is the same paperwork filled out for all students enrolling at St. Rita School and can be found on-line and is also available in the school office), tuition for the 4K will be the same as for all other grade levels. The implementation of 4K is contingent on registration of at least 12 students for the school year. In the event that 12 students do not enroll the registration fee will be refunded. Enrollment is due by March 3, 2017; families will be notified by mid-march as to the status of the program. Please do not hesitate to contact us in the school office with questions. Mr. Mark Quinn Principal quinnm@st-ritas.org Mrs. Courtney Heide School Secretary heide@st-ritas.org