St. Brendan Catholic Elementary School

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1 REGISTRATION FORM New Student Re-Registration Entering Grade for Student s Name Middle Address City State Zip Code Telephone No. Date of birth Place of birth Sex Religion Ethnicity Student Lives with: Both Parents Mother Father Guardian Mother/Stepfather Father/Stepmother Parent / Guardian Information Mother s Name Maiden Name Address if different from student Home Phone Name of Employer Address Work Phone No. Cellular Phone No. Religion Country of Origin Marital Status Father s Name Address if different from student Home Phone Name of Employer Address Work Phone No. Cellular Phone No. Religion Country of Origin Marital Status Please fill out if applicable Name of Stepmother Name of Employer Work/Cellular No. Address Name of Stepfather Name of Employer Work/Cellular No. Address If you are recipient of the McKay Scholarship provide the following information Name of Parent and S.S. # receiving funds on behalf of student S.S

2 TUITION AGREEMENT Name of Student(s): Address: Please read carefully and select your tuition payment option. Payment Plan Options: Option 1 One-Time Payment in Full To be paid in full by August 10, 2018 by either cash, check, money order, or credit card directly to St. Brendan Elementary Option 2 Installment Payment Plan through FACTS Management Please select the number of installments. Semiannual (due August and January) Monthly (Ten monthly installments from August 1, 2018 through May 1,2019) All installment payments must be processed and paid through FACTS Management Company by: Electronic Funds Transfer from a designated checking or savings account I acknowledge that I have read, understand and agree to the tuition and fee schedules and payment obligations detailed in my tuition statement. In exchange for the admission of my child(ren) in St. Brendan Catholic School, I hereby agree to pay, as scheduled, the net tuition due. At the end of each quarter, parents with past due tuition/fees balance will be notified by the school finance office of the past due amount and the minimum payment required. If all financial obligations are not current, the school will: Not allow the student to take mid-term/final exams. Block the online grade view for both the student and parent. Not issue report cards, diplomas and/or transcripts. Disenroll the student from the school. Family wishing to withdraw its child from the school in the middle of a quarter are required to pay tuition and fees through the end of the quarter. Grades will not be released until the tuition and fees have been paid in full. Furthermore, I agree to cooperate with the school in the interpretation and enforcement of the policies outlined in the Parent-Student Handbook. I also understand that the school has the ultimate authority over the administration of the school and the interpretation of the school s rules and policies. The administration reserves the right to terminate a student s enrollment at any time. Print Parent Name Parent Signature Date Print Parent Name Parent Signature Date

3 Commitment Letter I am fully aware of the following commitment as a parent of a student(s) of St. Brendan Catholic Elementary School: 1. My family will attend Mass every Sunday. 2. As a steward family we will participate in the faith life of the parish giving fully of our time, talent and treasure. 3. As parents, we will volunteer our services to the church and school, a minimum of 20 hours per year. 4. As a parent, we shall participate in an annual Spiritual Retreat, as recommended by our school Pastor. 5. I have read and fully understand the schedule of fees for the school year I agree to pay St. Brendan Elementary School the full annual tuition. I understand that payments will be divided in 10 equal monthly payments from August 1 st to May 1 st, if I so desire it. I agree to pay the full annual tuition regardless of whether the student(s) completes the school year. 7. I am aware that all students new to St. Brendan Elementary School in any grade level will be considered probationary for the first ninety school days. Name of Father Please Print Signature of Father Date Name of Mother Please Print Signature of Mother Date Name of Student Please Print Grade

4 :1 ipad PROGRAM 6 th -8 th Grade Students Only Student Name: Grade: Please indicate your preferences: I will be leasing a St. Brendan ipad for my son or daughter. I understand that there will be a $100 dollar NON-REFUNDABLE DEPOSIT and a $30 dollar monthly fee for 10 months beginning August 2018-May 2019.(The parents are responsible to buy a good ipad cover. Please see school website for some suggestions. If you damage the ipad you can get it fix at local store that fixes ipad screens.) ( th Grade Only) If this is the students 3 rd year renting the ipad for St. Brendan, you are eligible to purchase the ipad at the end of the school year for $1.00 dollar. My son or daughter will be using his or her currently-owned ipad. I understand that: o The device must be a 16GB 4 th edition (Lighting Connector) or better WITHOUT 3G OR 4G CAPABILITY. (NO ipad Mini or ipad Pro 12.9) o I must make my own arrangements to save any and all information or apps currently on the device before it is re-imaged (Wiped Clean) by St. Brendan Elementary for the downloading process of Apps and ebooks needed for instruction. o I understand that St. Brendan Elementary has full control over the ipad while on school property. o I will not hold St. Brendan Elementary responsible for any lost or damaged ipad. o If my ipad breaks I will pay a $30 dollar rental fee to the school until my ipad is fixed. o In order for all ipad to be ready for the beginning of the school year, ipads need to be turn in on or before Thursday, July 5 th, Parent Name: Date: Parent Signature: Student Signature:

5 Credit Card Authorization Form for Registration Fees Student s name: Grade: Card holder s name: Credit Card Number: Expiration Date: CVC#: Include Zip code: Please charge this credit card for my child(ren) s registration fees: $ amount on this date / / 2018 and $ amount on this date / / 2018 Signature: Date:

St. Brendan Catholic Elementary School

St. Brendan Catholic Elementary School REGISTRATION FORM New Student 2018-2019 Re-Registration Entering Grade for 2018-2019 Student s Name Middle Address City State Zip Code Telephone No. Date of birth Place of birth Sex Religion Ethnicity