Admissions Application 1 Student Information2 Parent/Guardian Information3 Family Information4 Student History5 St. James Statement Student's Name* First Middle Last Prefers to be Called Date of Birth Date Format: MM slash DD slash YYYY Gender*FemaleMaleCheck All That Apply Member of St. James Sibling of Current Student Sibling of Former Student Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Languages Spoken at HomeHas Applicant Applied to St. James Before?*YesNoWho does the applicant spend most of his or her day with?MotherFatherGrandparentNannyOtherApplying to Grade*Two Half-Day Preschool (3yrs by 12/31)Three Half-Day Preschool (3yrs by 9/1)Five Half-Day Preschool (3 yrs by 9/1)Three Full-Day Preschool (3 yrs by 9/1)Five Full-Day (3yrs by 9/1)Junior Kindergarten 5 day (4yrs by 9/1)Junior Kindergarten 3 day (4yrs by 9/1)Kindergarten (5yrs by 9/1)FirstSecondThirdFourthFifthSixthSeventhEighthCurrent School School Name Grade/Program Attended Since (mo/yr) Marriage Status of ParentsMarriedDivorcedSeparatedSingle ParentOtherIf parents are not married, who is the custodial parent?Parent/Guardian Name First Last Parent/Guardian Name First Last Relationship to ApplicantRelationship to ApplicantAddress If Different Than Applicant Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Address If Different Than Applicant Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*PhoneEmail Email Occupation/PositionOccupation/PositionPlace of EmploymentPlace of EmploymentNature of BusinessNature of BusinessCollege Education (School Name, Degree Earned)College Education (School Name, Degree Earned)Active Church MembershipActive Church MembershipDenominationLutheranCatholicPresbyterianEvangelicalEpiscopalBaptistEastern OrthodoxOtherDenominationLutheranCatholicPresbyterianEvangelicalEpiscopalBaptistEastern OrthodoxOther Applicant's Siblings Name Age School Name Age School Name Age School Applicant's GrandparentsPaternal Grandparents First Last First Last Maternal Grandparents First Last First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code School and Activity InformationAside from Current School, Other Schools Attended in the Last Three Years Name Address Director/Principal Dates Attended Name Address Director/Principal Dates Attended Name Address Director/Principal Dates Attended Please list any activities outside of school the applicant has participated in. Medical InformationPediatrician First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Does your child have any medical conditions that he/she is currently being treated for?YesNoIf yes, please describe.Church InformationChurch Applicant Attends Most FrequentlyBaptizedYesNoChurchDate Date Format: MM slash DD slash YYYY First CommunionYesNoChurchDate Date Format: MM slash DD slash YYYY ConfirmedYesNoChurchDate Date Format: MM slash DD slash YYYY What characteristics of St. James interest your family, and why is our school a good match for the applicant?St. James StatementSt. James Lutheran School enrollment is open to students of any race, color or ethnic or national origin. Acceptance to a class is determined by the Admissions Committee on the basis of the optimum class profile. Members of the St. James fellowship, returning students and siblings of current students are given priority int he admission process. Admissions is subject to St. James being able to meet the educational needs of a student.Deposits are applied to tuition when a student is accepted into a program. Deposits will be returned if a child is not accepted. A deposit will be forfeited if our acceptance is declined for any reason.* I have read the St. James Statement and understand the policies as described. Birth CertificatePlease upload a copy of the applicant's birth certificate.Report CardIf applying to grades 1-8, please upload a copy of the applicant's most recent report card.
