ATCHISON CATHOLIC ELEMENTARY SCHOOL REGISTRATION FORM 2008-2009

STUDENT’S NAME_________________________________________________________________________

                                    First                                                 Middle                                       Last

GRADE________                      SEX________                   BIRTHDATE__________________________          

CATHOLIC FAMILIES:  Parish To Which You Contribute Financial Support ___________________

▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬▬

Parent/Guardian_____________________________________________ Home Phone___________________

May We List Your Home Telephone Number In Our School Directory?     YES      NO

Address___________________________________________________________________________________

Father’s Full Name___________________________________________ Religion_____________________­­__

Father’s Place Of Employment_________________________________ Work Phone____________________

Mother’s Full Name__________________________________________ Religion________________________

Mother’s Place of Employment_________________________________Work Phone_____________________

Parent’s Marital Status______________ Mother’s Cell __________________Dad’s Cell__________________

Email Address______________________________________________________________________________

May We List Your Email Address In Our School Directory?                           YES      NO

Racial Group Of Which Registered Student Is A Member (Optional)

____White    ____African American    ____Hispanic    ____Native American    ____Asian

IN CASE OF EMERGENCY:  Please list the name and telephone number of your doctor and 3 other people we could contact in case you cannot be reached. (relative, babysitter, friend)

****For Safety Reasons - anyone NOT listed, as an emergency contact will not be allowed to pick up your child without parent permission.

Doctor_______________________________________________        Phone________________________

1. _________________________ Home Phone______________ Cell Phone ______________________

2. _________________________ Home Phone______________ Cell Phone ______________________

3. _________________________ Home Phone ______________Cell Phone ______________________              

PLEASE LIST ANY HEALTH PROBLEMS/ALLERGIES YOUR CHILD MAY HAVE TO WHICH WE SHOULD BE ALERTED:

PLEASE DO NOT WRITE ON THIS SIDE OF THE REGISTRATION FORM

OFFICE USE ONLY

FEES:                                                                                                                                                            PAID

KINDERGARTEN: REGISTRATION FEE                                                        $ 40.00                   _________

      (DUE AT KINDERGARTEN ROUNDUP FEB. 22, 2008; NON-REFUNDABLE)

GRADES K-8:  STUDENT FEE (PER CHILD)                                                          $165.00        _________

       *****EARLY BIRD RATE*****  IF PAID BY MAY 1^ST, 2008          ** $140.00                          _________

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Tuition for a non-parishioner student attending Atchison Catholic Elementary School (ACES) for the 2008-09 school year is $3,800, or $422.22 per month for nine months.  If two or more students from the same non-parishioner family attend ACES, the annual tuition for each added student is $3,420, or $380 per month for nine months.

Should payment not be made by the first of the month, a reminder notice will be sent.  If payment is not made, your child(ren) will not be permitted to attend ACES beginning the first of the following month.

I agree to abide by this tuition payment plan for my children for the 2008-09 academic year.

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RECORDS ON FILE:

________Birth Certificate                                              

________Baptismal Certificate (Catholic Students)