Preschool Registration - saintals.org

Registration Fee: $125.00/student *Please Note: Filling out this form alone does not register your child. Once spots have been confirmed the school must receive payment, birth certificate, immunizations/medical forms before your child will be considered fully registered/re-registered. ▪ Preschool child must be independent in bathroom abilities ▪ We offer before school care beginning at 7:15 AM ▪ Questions, call Stephanie in the Preschool Office 513-587-3978

– Step 1 of 7

Student Information

I am Enrolling *

Will you be enrolling/re-enrolling more than one child? *

How many children in total are you enrolling/re-enrolling in our Preschool? *

Student Name *

First

Last

Applying for Entry into Grade *

3 Year Class Full Day Options *

	First Choice	Second Choice	Third Choice
M/W/F (7:45 – 2:30)	First ChoiceM/W/F (7:45 – 2:30) First Choice	Second ChoiceM/W/F (7:45 – 2:30) Second Choice	Third ChoiceM/W/F (7:45 – 2:30) Third Choice
T/TH (7:45 – 2:30)	First ChoiceT/TH (7:45 – 2:30) First Choice	Second ChoiceT/TH (7:45 – 2:30) Second Choice	Third ChoiceT/TH (7:45 – 2:30) Third Choice
M – F (7:45 – 2:30)	First ChoiceM – F (7:45 – 2:30) First Choice	Second ChoiceM – F (7:45 – 2:30) Second Choice	Third ChoiceM – F (7:45 – 2:30) Third Choice

Please Indicate First, Second & Third Choice

3 Year Class Half Day Options *

	First Choice	Second Choice	Third Choice
M/W/F (7:45 – 11:00)	First ChoiceM/W/F (7:45 – 11:00) First Choice	Second ChoiceM/W/F (7:45 – 11:00) Second Choice	Third ChoiceM/W/F (7:45 – 11:00) Third Choice
T/TH (7:45 – 11:00)	First ChoiceT/TH (7:45 – 11:00) First Choice	Second ChoiceT/TH (7:45 – 11:00) Second Choice	Third ChoiceT/TH (7:45 – 11:00) Third Choice
M – F (7:45 – 11:00)	First ChoiceM – F (7:45 – 11:00) First Choice	Second ChoiceM – F (7:45 – 11:00) Second Choice	Third ChoiceM – F (7:45 – 11:00) Third Choice

Please Indicate First, Second & Third Choice

4 Year Class Full Day Options *

	First Choice	Second Choice	Third Choice
M/W/F (7:45 – 2:30)	First ChoiceM/W/F (7:45 – 2:30) First Choice	Second ChoiceM/W/F (7:45 – 2:30) Second Choice	Third ChoiceM/W/F (7:45 – 2:30) Third Choice
T/TH (7:45 – 2:30)	First ChoiceT/TH (7:45 – 2:30) First Choice	Second ChoiceT/TH (7:45 – 2:30) Second Choice	Third ChoiceT/TH (7:45 – 2:30) Third Choice
M – F (7:45 – 2:30)	First ChoiceM – F (7:45 – 2:30) First Choice	Second ChoiceM – F (7:45 – 2:30) Second Choice	Third ChoiceM – F (7:45 – 2:30) Third Choice

Please Indicate First, Second & Third Choice

4 Year Class Half Day Options *

	First Choice	Second Choice	Third Choice
M/W/F (7:45 – 11:00)	First ChoiceM/W/F (7:45 – 11:00) First Choice	Second ChoiceM/W/F (7:45 – 11:00) Second Choice	Third ChoiceM/W/F (7:45 – 11:00) Third Choice
T/TH (7:45 – 11:00)	First ChoiceT/TH (7:45 – 11:00) First Choice	Second ChoiceT/TH (7:45 – 11:00) Second Choice	Third ChoiceT/TH (7:45 – 11:00) Third Choice
M – F (7:45 – 11:00)	First ChoiceM – F (7:45 – 11:00) First Choice	Second ChoiceM – F (7:45 – 11:00) Second Choice	Third ChoiceM – F (7:45 – 11:00) Third Choice

Please Indicate First, Second & Third Choice

5 Year Class Option *

Date of Birth *

Gender *

St. Aloysius of Gonzaga is a Catholic school. Faith is integrated into all aspects of the school’s activities. In the Catholic Faith, a person’s sexual identity is rooted in one’s biological identity as male or female. St. Aloysius considers the gender of all students as being consistent with their biological sex, including participation in school athletics and teams, school-sponsored dances, dress and uniform policies, the use of changing facilities, showers, locker rooms, sleeping accommodations on trips, titles, names and pronouns, and school records. By completion of this registration, you understand and agree to this policy.

Student 1 Name *

First

Last

Student 1 Applying for Entry into Grade *

Student 1 Date of Birth *

Student 1 Gender *

Student 2 Name *

First

Last

Student 2 Applying for Entry into Grade *

Student 2 Date of Birth *

Student 2 Gender *

Student 3 Name *

First

Last

Student 3 Applying for Entry into Grade *

Student 3 Date of Birth *

Student 3 Gender *

Religion *

Parish *

Public School District *

Public School Building (Name) *

Are you transferring from or currently enrolled in another school? *

Previous School Attended

Previous School Phone

Previous School Fax

Previous School Address

Address Line 1

Address Line 2

City

State

Zip Code

Family Information

Student Resides With *

Primary Guardian Name *

First

Last

Primary Guardian Relationship *

Primary Phone *

Primary Email *

Primary Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Occupation & Place of Employment *

Primary Work Phone

Secondary Guardian Name

First

Last

Secondary Guardian Relationship

Secondary Phone

Secondary Email

Secondary Address

Address Line 1

Address Line 2

City

State

Zip Code

Secondary Occupation & Place of Employment

Secondary Work Phone

Release/Emergency Contacts

Emergency Contact #1 *

First

Last

Phone *

Email *

Relation to Student *

Emergency Contact #2 *

First

Last

Phone *

Email *

Relation to Student *

Medical Providers

Physician Name *

Physician Phone *

Dentist Name *

Dentist Phone *

Insurance Provider

Policy #

Demographics

Hispanic? *

Ethnicity *

Primary Language *

Secondary Language

Academics

Has the student had any of the following academic testing/evaluations?

ADD/ADHD
Gifted/Talented
Math
Multifactored
Psychological
Reading
Speech/language

Which Child?

Upload Evaluation Documentation

Has the student *

had/has ISP/IEP
Been Retained
Prescribed Medication
None of the above

If you chose one or more options, please specify the area/give more detail below

I Plan to Enroll my Child in St. Aloysius Kindergarten Program after completing Preschool *

Registration Fee

Registration is $125.00 per child. Please contact goettke_s@saintals.org for payment options.