Application For Admission Form - Diocese Of Arlington

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Diocese of Arlington
Application for Admission
Name of School
School Year
Applying for Grade
Saint Rita School, Alexandria, VA 22314
STUDENT DATA
Legal Name:
Last
First
Middle
Nickname
Sex
M
F
/
/
Date of Birth
City & State of Birth
(mm/dd/yyyy)
Country of Birth (if outside United States of America)
Home Address
City
State
Zip
-
-
Home Telephone
Public School System in which student resides
Public School Child Would Attend
Email where official school communication can be sent
Check all that apply:
Only Child at this school?
yes
no
Oldest Child at this school?
yes
no
If not oldest, name of oldest sibling at school
Grade
Previous Schools Attended:
Name of School
Dates
Grades Location
Telephone
-
-
-
-
-
-
Religion:
Baptized?
yes
no
For Catholic Applicants:
Date
Church
City and State
/
/
Baptism
/
/
Reconciliation
/
/
First Eucharist
/
/
Confirmation
Family Background
Mother
Father
Full Name
Maiden Name
Country of Birth (if outside USA)
Home Address
Home City, State, ZIP
Home Phone
Cell Phone
Work Phone
Work Email
Occupation
Employer
Religion
Parish
Primary language spoken in the home
1
Diocese of Arlington Office of Catholic Schools 2009
Page

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