Admissions Guidelines Pre-Kindergarten - 4 year old Program

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Admissions Guidelines 2016-2017 Pre-Kindergarten - 4 year old Program Program and Hours Saint Pius X Catholic School is dedicated to providing a Christ-centered community that creates a family atmosphere that is uniquely warm and welcoming. The program will run Monday through Friday from 8:15 am until 3:10 pm. The goal of the Pre-Kindergarten curriculum is to facilitate the student to become more independent, self-directed, and adept at problem solving, while gaining the readiness skills necessary for the formal learning of later years. The school calendar for Pre-Kindergarten will follow the Saint Pius X School calendar for grades K-8. Application Procedures Admissions will continue until all seats are filled. Priority placement is given to students according to the following classifications: Students currently attending the school Siblings of current students currently attending the school, including the following: a) Catholic students currently attending the school; b) Catholic students who had attended the school and currently attend the Catholic High School; c) Non-Catholic students currently attending the school or the Catholic High School who had been attending the school on September 1. Children of parishioners teaching in that particular parish school. Members of the parish of the school. Members of a parish that do not have a school. Siblings of non-catholic students currently attending the school who were not attending school on September 1. Members of a parish that have a school, but the student has applied to another school. Children of non-participating parishioners and non-catholics. In all cases involving Catholic students, their pastor must certify (with his signature on the enclosed Parish Participation Voucher) that they are participating Catholics in order to have priority placement and be eligible for the Catholic tuition rate. In order to be eligible for the participating parishioner tuition rate, Catholic families transferring into the Greensboro area may provide a letter from the pastor at their current parish stating that they are participating parishioners. Additional Considerations Pre-Kindergarten applicants for the 2016-2017 school year must be 4 years old on or before August 31, 2016. No exemptions will be made. The child s age must be verified by a birth certificate. Saint Pius X Catholic School admits students of any race, color, sex, religion, national and ethnic origin to all programs and activities generally accorded or made available to students at the school. School Health Services All students are required by NC General Statute 130A-154 to have appropriate required immunizations in order to attend school (all public and private schools). Students must provide proof of immunization and be in compliance with North Carolina immunization requirements prior to admission into the school. All new students must provide proof of physical examination (completed no more than 12 months prior to anticipated date of school entry). Parents are responsible for providing these records during the application process. Application Fee 2016-2017 A non-refundable $150 per student application fee is due at the time of application.

Pre-Kindergarten Application School Year Entering - Please complete this application and return it to the SPX School office with the following: $150 non-refundable application fee to initiate admissions process, payable to St. Pius X School Copy of student s Baptismal Certificate (if Catholic) and Birth Certificate Proof of Immunizations Parish Participation Voucher (enclosed) No admission decision can be made until ALL documents listed above have been received. Student Information SPX OFFICE USE ONLY Check #: Amount: Date: Full NamePreferred Name Address City State Zip Home Phone Date of Birth Place of Birth: City State Gender: Male Female Catholic: Yes No Baptism Date: Student s Race: Hispanic: Yes No Gender, race, and religion are gathered for school demographics and not for admissions purposes. Family Information Student resides with: Both parents Mother Father Other If Catholic, we are registered in Parish Father Step-Father Guardian Mr. Dr. Mother Step-Mother Guardian Ms. Mrs. Dr. First Name Last Name First Name Last Name Home Address (if different than student) Home Address (if different than student) Home Phone Cell Phone Home Phone Cell Phone E-mail address Business Phone E-mail address Business Phone Religion Parish Religion Parish Occupation Place of Employment Occupation Place of Employment Complete other side

Siblings Siblings applying for admission Yes, Grade/s No Siblings currently enrolled in St. Pius X School? Yes No Please list siblings names, and birth dates: Current Preschool/Daycare Information Last Preschool or Daycare Attended: School Address City State Zip Director s Name School Telephone: ( ) Student History Is your child completely potty-trained and providing for own bathroom needs? Yes No Is English the primary language spoken at home? Yes No Has the applicant ever received auxiliary services such as outside tutoring, psychological or educational testing, speech/language assistance, or professional counseling? Yes No If yes, please provide a copy of any test results. If yes, explain Has the applicant been hospitalized for significant medical treatment? Yes No If yes, please describe: Is your child currently receiving physician prescribed medicine? Yes No If yes, list medication and possible side effects_ Does your child have any food allergies: List any other health or learning considerations needed for this child: Other Information How did you hear about St. Pius X Catholic School Name and address of person (s) responsible for payment of tuition and fees (if other than parents: These statements are true and accurate to the best of my knowledge. I have enclosed a $150.00 check for the application fee, payable to Saint Pius X Catholic School. Signature of Parent or Guardian: Date: Please bring or send the completed form, along with required documents and fee to: St. Pius X Catholic School 2200 N. Elm Street Greensboro, NC 27408 Revised: 12/1/15

Application Fee Participating Catholic Tuition* 2016-2017 Pre-Kindergarten Fee & Tuition Rates $150.00 per Pre-K student $5,400 (8:15am-3:10pm) $416.67/mo. (12 months) $400.00 tuition deposit is due at the time of acceptance. Remaining payments will be drafted June 2016 to May 2017. $400.00 tuition deposit is due at the time of acceptance. Remaining payments will be drafted June 2016 to May 2017. Non-Participating Catholic* and $7,000 (8:15am-3:10pm) Non-Catholic Tuition $550.00/mo. (12 months) *A Parish Participation Voucher must be signed by the student s home parish pastor annually to verify Participating Catholic status. Families with children currently enrolled in Gr. K-8 will receive a 10% discount on a child in the Pre-Kindergarten Program. 2016-2017 Kindergarten 8 th Grade Tuition Rates One Child Two Children Three Children Four Children Participating Catholic* $5,748 Annual $479/mo. (12 mos.) $10,092 Annual $841/ mo. (12 mos.) $14,088 Annual $1174/mo. (12 mos.) $17,268 Annual $1,439/mo. (12 mos.) Non-Participating Catholics and Non-Catholics $8,376 Annual $698/mo. (12 mos.) $16,368/Annual $1,364/mo. (12 mos.) $24,216 Annual $2,018/mo. (12 mos.) $32,148 Annual $2,679/mo. (12 mos.) *A Parish Participation Voucher must be signed by the student s home parish pastor annually to verify Participating Catholic status. 2016-2017 Kindergarten 8 th Grade Student Fees New Student New Sibling of Current Student Current SPX Student Per Family Application Fee $100.00 $50.00 Registration Fee $375.00 $375.00 Re-registration Fee (annual) $300 (if paid by 3/4/16) $350 (after 3/4/16) ABC Screening Fee $72.00 Triad Capital Fee (one per family annually) $995 annually $83/mo. (12 mos.) Capital Fee This fee is assessed on school families by the Diocese and is paid to the Catholic School where the youngest child is enrolled. ALL TUITION AND FEES ARE NON-REFUNDABLE Revised:2/12/17

Saint Pius the Tenth Catholic Church Parish & Stewardship Participation A significant portion of St. Pius the Tenth s resources go to support the Ministry of Catholic Education. This support includes substantial subsidies to St. Pius X Catholic School and 3.5% of our total offertory which is sent to Bishop McGuinness High School. Families directly benefitting from the Ministry of Catholic Education are expected to assist the parish in its obligations to these institutions and to our Diocese. A Triad Area Catholic Schools Parish Participation Voucher must be signed each year by all parishioners to assure that Catholic families are active participants of their parish. This voucher is signed upon registration/re-registration. A review of participation will be held periodically to determine if the household is eligible for the subsidized Catholic rate of tuition. Should it be determined that the household is not eligible for the parish subsidy, it is the responsibility of the family household to pay the non-participating Catholic rate of tuition. (Taken from the SPX Student Handbook) The support of one s parish is a precept of the Church. The faithful also have the duty of providing for the material needs of the Church, each according to his abilities. (Paragraph 2043, Catechism of the Catholic Church.) As Christian stewards, we receive God s gifts gratefully, cultivate them responsibly, share them lovingly in justice with others, and return them with increase to the Lord. (The U.S. Bishop s Letter on Stewardship.) St. Pius the Tenth may subsidize tuition for active members who are described as being not only registered at St. Pius, but actively involved. Active membership is determined by living up to the basic responsibilities of stewardship, giving of your time, talent and treasure. We ask that all families who benefit from the Ministry of Education at St. Pius X seriously consider their commitment to Stewardship. Each active member household of St. Pius should complete and return their Stewardship Commitment Form. If you would like to meet with parish administration to discuss your commitment to Stewardship, this can be arranged. We, as Catholic, believe that the Eucharist is the source and summit of our spiritual life, empowering our ministries and forming us more perfectly in the life and love of Christ. Thus, the Church expects Catholics to manifest their commitment and devotion to this great Sacrament by regular attendance at Mass on Sundays and Holy Days. Families need to illustration their active presence by utilizing their envelopes at liturgies.

Parish & Stewardship Participation Voucher Please complete, and submit to Pastor for signature. FAMILY INFORMATION (Please print or type all information) Family Name: Address: City: State: Zip: Phone: Previous Parish: STUDENT INFORMATION Student Name: Entering Grade: Student Name: Entering Grade: School: School: CATHOLIC STEWARDSHIP In addition to our own parish, Saint Pius the Tenth Catholic Church, the school is also supported by the following sending parishes: Holy Cross, Holy Infant, St. Benedict s, St. Mary s, and St. Paul s. The support and contribution of parishioners from each of these parishes represents their commitment to the mission of Catholic education. As Catholic Christians we also have an obligation to practice stewardship, and are asked to fulfill our commitment through our time, talent, and treasure. In order to receive the Catholic tuition rate, please state your stewardship involvement below. Active, Participating Parish Member An active, participating parish member is defined as a registered parishioner who is active in both the sacramental life of the church, especially in the weekly celebration of the Eucharist, and in their contribution of TIME, TALENT, AND TREASURE, (envelope, check, automatic draft) to the faith community. During the past year, I/We, regularly contributed financially with an identifiable gift to Parish, by envelope # or, by bank draft Please list the ministries/activities in which you have been involved during the past year with the parish. If you are a Saint Pius the Tenth parishioner and have not had the opportunity to participate in our ministries, go to our website at www.stpiusxnc.com to review the opportunities and obtain a form to sign up. Without a signed voucher from your Pastor, your family will be classified as a non-participating parishioner and charged the corresponding rate. Parent/Guardian Signature: Date: I certify, as pastor of the above-designated parish, that the listed family is an active, participating parishioner. Pastor Signature: Date:

Tuition Assistance Application 2016-2017 School Year A tuition assistance plan exists to assist families with identified financial need. These funds are distributed on a sliding scale need basis. Families who are enrolling or are currently enrolled at St. Pius X Catholic School may be eligible for financial assistance to attend St. Pius X Catholic School. A full refund of the capital fee and any tuition payments will be available if St. Pius X Catholic School is notified of the student withdrawal within 10 days of receiving the decision concerning tuition assistance. The application fee and registration fee are non-refundable. All requested information must be provided before the application will be processed. Note: Applications are due on April 15, 2016. For currently enrolled families, all tuition and capital fee payments must be current in order for an application to be considered. All items listed on the checklist below, must be submitted in order for the application to be considered. A new application must be completed each year. Application Checklist: Completed application Copy of 2015 Federal Tax Return (with associated W-2 s and form 1099 s attached) CONFIDENTIAL

Tuition Assistance Application Form 2016-2017 Date of application: Father s Name: SS# Current Home Address: City: State: Zip: Home Phone: Work Phone: Mother s Name: SS# Current Home Address: City: State: Zip: Home Phone: Work Phone: Marital Status: Married Widow/Widower Divorced/Separated If Divorced Date of Divorce If Separated Date of Separation Student(s) Name, Age, and Grade (Year in which assistance is given) for whom assistance is requested: Name: Age Grade: Name: Age Grade: Name: Age Grade: What parish are you a Registered Member of? Are your children for whom assistance is requested, baptized Catholic? List all dependents ages, school attending, grade and tuition obligations for each: Total number of students for whom assistance is requested: Total number of dependents (including self): 1 Parent s annual income (as reported on most recent tax returns):

FATHER MOTHER TOTAL Wages, salary,tips Dividends/interest Other taxable income Social security income Child support income Welfare, other Parents assets and liabilities: Home: (if owned or being purchased) Year Purchased Purchase Price Present Market Value Mortgage Bal/Debt Home Other real estate Investments(stocks, bonds) Business or Farm Vehicles Cash, savings and/or checking account: Amount: Name of Bank(s): Credit Card Outstanding Debt: Educational Loans: Car Loans: Outstanding Balance: Year/make of car: Other outstanding debts (specify): Estimated Monthly Expenses: House payment/rent car maintenance/gas Utilities car insurance Food/Clothing medical/dental Insurance(med./life) tuition Car payments entertainment Contributions other Total Monthly Expenses: Total Monthly Take Home Pay (including child support): If parents are separated or divorced, which parent is responsible for paying tuition? Which parent claimed the student on their 2015 tax return? 2

**NOTE: If tuition is shared and parents are divorced, each parent must fill out a separate tuition application and attach separate tax returns*** A Copy of your 2015 Federal Tax Return and associated W-2 and 1099 forms MUST be attached to this application. If returned without these forms, your request will be automatically rejected. If you cannot pay full tuition, how much do you estimate you can pay? Please give any other information concerning the financial assets and obligations of your family which may be helpful in assessing your financial needs for the funds requested. Amount of tuition assistance requested: PARENTAL AGREEMENT: To provide accurate and complete information on this form and to inform the St. Pius Pastor immediately if there is a change in the family financial situation which would enable the family to assume a greater portion or all of the tuition. ST. PIUS X TUITION COMMITTEE AGREEMENT: To keep in confidence all information on this form and to provide the tuition assistance agreed upon if this request has been approved by the Tuition Committee. Parental agreement signature: Pastor s signature: Date approved and signed: 3