Has your child received special services from a professional (e.g. counselor, speech therapist, special education teacher)? |
No
Yes , Briefly describe the type of service, length of service, and if it discontinued, a reason for discontinuation: |
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Does your child need accommodations to be successful in school?
No
Yes |
If yes, please explain briefly (other forms will be required) |
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Does your child need any particular academic enrichment in order to successful in school?
No
Yes , Please list : |
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Does your child have any diagnosed allergies?
No
Yes |
If yes, please list (other forms will be required) |
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Will your child require medication to be administered during the school day?
No
Yes |
If yes, please explain briefly (other forms will be required): |
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Medical Diagnosis: Please check all that apply: |
No known medical conditions |
Diagnosed Condition (specify) |
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Physical Disability |
No existing physical disability |
Identified Disability (specify): |
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Learning Disorder: |
No existing physical disability |
Identified Disability (specify): |
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I/We, the undersigned parent(s), understand and acknowledge that in the event that an Archdiocesan Catholic
elementary school receives more qualified applicants than it has the capacity to accommodate, students shall be
admitted in the following priority: Catholic students in the order in which they submit completed applications prior
to the posted deadline; non-Catholic students in the order in which they submit completed applications prior to the
posted deadline; all other students in the order in which they submit completed application after the posted deadline.
I/We understand and acknowledge that all applicants shall follow all applicable policies and procedures regarding
school-based entrance requirements, including, but not limited to, health examinations and immunizations, before
admission may be finalized. Upon admission, all students in Catholic schools in the Archdiocese are to be immunized
in accordance with the immunization requirements and the guidelines of the Archdiocese. Exemptions are provided
only on a temporary basis to those with a physician-documented medical contraindication.
I/We understand and acknowledge that the admission, instruction and retention of students with disabilities,
students with special needs, and students who are English Language Learners cannot be guaranteed. Whether
reasonable accommodations can be made for such students is determined on an individual basis and is in the sole
discretion of the school’s chief administrator (principal) in consultation with the Catholic Schools Office.
I/We understand and acknowledge the Roman Catholic religious nature of the school to which our child is applying.
I/We will not publicly repudiate the teachings and traditions of the Roman Catholic Church, and I/we will respect
and support the unique identity that the school derives from its Catholic faith. As the primary educator(s) of the
applicant, I/We will not act in ways that contradict the Catholic nature of the school. I/we shall cooperate fully
with the school and the applicant shall participate in all required school programming, including instruction in the
Catholic faith and attendance at Mass. As the primary educator(s) of the applicant, we agree to act in ways that
promote the best interests of the church and school and will comply with the policies of the Archdiocese of
Washington and Saint Augustine Catholic School. I/We hereby confirm that the following documents, required
to be considered for admission, including the non-refundable application fee of $375.00, accompany this application: |