Student Information

I am Enrolling *

Do you have any siblings currently enrolled? *

Please list name(s) of enrolled sibling(s)

Last Name of Student *

First Name of Student *

Middle Initial

Nickname

Date of Birth *//

Upload Birth Certificate

Gender *

St. Vivian School abides by the teachings and rules of the Catholic Church, and Faith is integrated into all aspects of the school’s activities. According to the Catholic Faith, a person’s sexual identity is rooted in one’s biological identity as male or female. St. Vivian 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. As an applicant/registrant and/or parent/guardian for admission to St. Vivian School, I understand and agree to this policy. By filling and submitting this form you understand and agree to this policy.

Religion *

Parish *

Upload Baptismal Certificate

Upload Certificate of First Reconciliation

Upload Certificate of First Communion

Upload Certificate of Confirmation

Applying for Entry into Grade *

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

Upload Previous Report Card(s)

Do you want to apply for bus service? *

Access the scholarship form here: https://online.factsmgt.com/signin/3XF84

Will you be applying for an Ohio EdChoice Scholarship? *

Access the scholarship form here: https://online.factsmgt.com/signin/3XF84

Which Program?

Access the scholarship form here:

https://online.factsmgt.com/signin/3XF84

Income eligibility guidelines:

http://education.ohio.gov/getattachment/Topics/Other-Resources/Scholarships/EdChoice-Scholarship-Program/FederalPovertyGuidelines.pdf

Family Information

Student Resides With *

Upload Court/Custody Documents

Primary Guardian Name *

First

Last

Primary Guardian SSN *

If you do not have a SSN, please enter all 0's. You will be contacted by our Business Office to gather supporting documents. Not providing your SSN will delay your child's acceptance or push them to a waiting list.

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 SSN

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?

Upload Evaluation Documentation

Has the student been enrolled in any special programs in or out of school?

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

Registration Form

Student Information

Family Information

Release/Emergency Contacts

Medical Providers

Demographics

Academics

Upcoming Events

Open House

Catholic Schools Week

PTA Meeting

Confirmation Retreat

St. Francis Food Program – Grade 4