Online Application for New Students - Holy Angels Regional School

Holy Angels Regional School

Application Form for New Admission (PK-8th) 2025/2026

Dear New Families,

Welcome to Holy Angels! It is our hope that your child’s enrollment here will be a wonderful, faith-filled experience. Submittance of this application indicates that you have read and will comply with these important policies.

1. All school and health records, included documentation of immunization must be sent to the school before September 1, 2025. No student will be able to attend classes on the first day of school without this documentation.

2. All students are on probation for the first 60 days of school. This is done to ensure placement at Holy Angels is mutually acceptable to all.

3. Tuition is to be paid according to schedule. If there is any unforeseen situation that may arise, it is the parent’s responsibility to contact the Business Office immediately.

Student Information

Grade Entering REQUIRED Please fill out this field. Please enter valid data.

(For Pre-K Only) (PLEASE SEE NOTE ABOVE) 3 Day 5 Day

First Name REQUIRED Please fill out this field. Please enter valid data.

Middle Name (if no Middle Name, type "None") REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Gender REQUIRED Male Female Please fill out this field.

Date of Birth REQUIRED Please fill out this field. Please enter valid data.

Birthplace City, State REQUIRED Please fill out this field. Please enter valid data.

Country of Birth REQUIRED Please fill out this field. Please enter valid data.

Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Student Lives with REQUIRED Please fill out this field.

Other (please specify)

Public School District in which the student resides REQUIRED Please fill out this field.

Other (please specify)

Home Parish (parish that you are registered with/attend) REQUIRED Please fill out this field. Please enter valid data.

Student's Religion REQUIRED Please fill out this field. Please enter valid data.

If the student is Catholic, please complete the following:

Baptism - If not applicable, type "N/A"

Church (please include City, State) REQUIRED Please fill out this field. Please enter valid data.

Baptismal Date Please enter valid data.

Reconciliation - If not applicable, type "N/A"

Church (please include City, State) REQUIRED Please fill out this field. Please enter valid data.

Reconciliation Date Please enter valid data.

First Eucharist - If not applicable, type "N/A"

Church (please include City, State) REQUIRED Please fill out this field. Please enter valid data.

First Eucharist Date Please enter valid data.

Confirmation - If not applicable, type "N/A"

Church (please include City, State) REQUIRED Please fill out this field. Please enter valid data.

Confirmation Date Please enter valid data.

Ethnic Background of Student: (this information is used to complete the New York State Educational Data Systems report that all public and nonpublic schools are required to submit). REQUIRED American Indian/Native Alaskan Asian Black/African American Hispanic or Latino Native Hawaiian/Pacific Islander White Mutli-Racial All Others Please fill out this field.

What is the Students Race? REQUIRED American Indian/Native Alaskan Black/African American White Asian Native Hawaiian/Pacific Islander Please fill out this field.

Current School or Pre-School/Grade Please enter valid data.

Reason For Leaving

Physician Name REQUIRED Please fill out this field. Please enter valid data.

Physician Phone Number REQUIRED Please fill out this field. Please enter valid data.

Dentist Name REQUIRED Please fill out this field. Please enter valid data.

Dentist Phone Number REQUIRED Please fill out this field. Please enter valid data.

Emergency Contacts (Please include three (3))

Emergency Contact 1

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Relationship REQUIRED Please fill out this field. Please enter valid data.

Home Phone Please enter valid data.

Work Phone Please enter valid data.

Cell Phone Please enter valid data.

Emergency Contact 2

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Relationship REQUIRED Please fill out this field. Please enter valid data.

Home Phone Please enter valid data.

Work Phone Please enter valid data.

Cell Phone Please enter valid data.

Emergency Contact 3

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Relationship REQUIRED Please fill out this field. Please enter valid data.

Home Phone Please enter valid data.

Work Phone Please enter valid data.

Cell Phone Please enter valid data.

Family Background: Mother Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Relationship REQUIRED Please fill out this field. Please enter valid data.

Home Address (if different) Please enter valid data.

Religion Please enter valid data.

Country of Birth Please enter valid data.

Date of Entry into USA Please enter valid data.

Education Completed Please enter valid data.

Occupation Please enter valid data.

Employer Please enter valid data.

Employer Address, City Please enter valid data.

Home Phone Please enter valid data.

Work Phone Please enter valid data.

Cell Phone Please enter valid data.

Home Email REQUIRED Please fill out this field. Please enter valid data.

Work Email Please enter valid data.

Family Background: Father Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Relationship REQUIRED Please fill out this field. Please enter valid data.

Home Address (if different) Please enter valid data.

Religion Please enter valid data.

Country of Birth Please enter valid data.

Date of Entry into USA Please enter valid data.

Education Completed Please enter valid data.

Occupation Please enter valid data.

Employer Please enter valid data.

Employer Address, City Please enter valid data.

Home Phone Please enter valid data.

Work Phone Please enter valid data.

Cell Phone Please enter valid data.

Home Email REQUIRED Please fill out this field. Please enter valid data.

Parent/s Marital Status REQUIRED Please fill out this field.

Work Email Please enter valid data.

Parent/s Marital Status REQUIRED Please fill out this field.

Child/ren live with REQUIRED Please fill out this field.

Other (please specify) Please enter valid data.

Note: Both parents have a right to school information regarding the student unless one parent presents a legal document that does not permit this.

Custody: This school assumes that both parents have full parental and residential custody. If this is not the case, it is the responsibility of the parents to provide the school with that portion of the divorce decree or separation agreement that articulates parental and residential custody. Should any changes occur during the year, please inform the school

Please check here if the school should expect a custody agreement Custody agreement

In case of divorce or separation, please complete the following:

Applicant lives with: Mother Father Other

Legal Custody: Joint Mother Father Other

Correspondence should be sent to: Please enter valid data.

If remarried, name of stepfather Please enter valid data.

If remarried, name of stepmother Please enter valid data.

A copy of the Court Orders should be on file in the school office if custodial rights are restricted.

Academic Information:

Unofficial copies of transcripts and reports have been requested or are attached for admission purposes. Acceptances are not final until records have been reviewed by the principal.

Does the student have a Behavioral Intervention Plan? REQUIRED Yes No Please fill out this field.

If yes, what are the terms of that plan? Please specify below:

Does the student require any particular accommodations to facilitate his or her participation in the educational program offered by the school other than what has been indicated in the question above? REQUIRED Yes No Please fill out this field.

If yes, what are those accommodations? Please specify below:

Has the student ever been tested for learning problems? REQUIRED Yes No Please fill out this field.

Has testing for learning problems ever been suggested? REQUIRED Yes No Please fill out this field.

Does the Student have an IEP or IESP? REQUIRED Yes No Please fill out this field.

Does the student have a 504 Accommodation Plan? REQUIRED Yes No Please fill out this field.

Please use the Authorization for Release of Information form for these documents to be sent to the school.

It is the parent's responsibility to provide any special needs files for the student prior to acceptance. Failure to do so may result in the student being denied acceptance. If it is discovered, after the student has been admitted, that records were withheld, the student may be asked to withdraw.

Health Information:

Is the student currently taking medications? Yes No

If yes, please specify:

Will the school have to administer medication? Yes No

If yes, please specify:

Does the medication need to be administered during the school day? Yes No

If yes, when?

Provide explanation if your child has any serious health concerns or allergies

List any disabilities or special needs your child may have (physical, behavioral, emotional or academic)

Indicate any diagnostic evaluations (educational or psychological) that have been administered to your child

Explain the reasons if your child has been suspended, dismissed from, or not allowed to return to any school

To be considered for admission, the following documents, including a non-refundable application fee ($200.00), must accompany this application (Registration Fee: $150.00 Early Bird Discount through February 14, 2025:

1. Completed Student Application
2. Copies of Birth Certificate and Baptismal Certificate
3. Immunization Record: Must be completed and signed by physician before child is accepted.
4. Current report card including comments and two previous academic year's report cards before acceptance is considered.
5. Signed Authorization For Release of Information (Grades 1-8)
6. Registered Online with FACTS Management Co. ~ https://online.factsmgt.com/signin/3LZDZ
7. Bus Transportation: Bus Transportation is provided by district of residence. It is the paren'ts responsibility to contact the school district in order to complete necessary forms by April 1, 2025.
8. Textbooks: All families must be district verified in order to pick up textbooks.
9. Tuition Agreement: must be completed by each family as part of the registration process and returned to Holy Angels. These forms may be obtained through your rectory if you are a member of a regional parish, or through Holy Angels for non-regional and non-Catholic families.