SHA Application for Admission (Transfers)

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Thank you for your interest in Sacred Heart Academy!

This form must be submitted with a $25 non-refundable application fee. Please proceed to payment after completing this form to enter your debit/credit card information.

Student Last Name*

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Student Middle Name*

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Student First Name*

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Student Preferred Name

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Applying For*

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9th

10th

11th

Street Address*

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City*

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Zip/Postal*

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Home Phone*

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Student Cell*

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Student Email*

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Birth Date

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Student SSN

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Race/Ethnic Origin

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Religion

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Parish/Church Membership

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Reason for Transfer*

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Is student a U.S. citizen?

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Yes

If no, please give status.

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Current citizenship visa status and date of expiration.

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Family Information (Check all that apply)

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Parents Married To Each other

Parents Separated

Parents Divorced

Father Remarried

Mother Remarried

Father Single

Mother Single

Father Deceased

Mother Deceased

Father Last Name

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Father First Name

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Street Address

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City

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Zip/Postal

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Father Cell

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Father Email

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Employer

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Position

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Mother Last Name

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Mother First Name

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Street Address

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City

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Zip/Postal

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Mother Cell

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Mother Email

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Employer

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Position

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Stepfather Last Name

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Stepfather First Name

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Street Address

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City

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Zip/Postal

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Stepfather Cell

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Stepfather Email

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Employer

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Position

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Stepmother Last Name

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Stepmother First Name

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Street Address

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City

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Zip/Postal

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Stepmother Cell

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Stepmother Email

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Employer

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Position

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Please list all siblings and step siblings.

Name

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Age

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Current School

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Current Grade

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Name

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Age

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Current School

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Current Grade

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Name

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Age

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Current School

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Current Grade

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Name

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Age

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Current School

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Current Grade

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Present/Prior School Information

Present School

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Address

Street Address

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City

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Zip/Postal

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Grade/Middle School (If not present school)

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Address

Street Address

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City

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Zip/Postal

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Please list family members who have attended Sacred Heart Academy, Angela Merici or Ursuline Academy.

Name

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Relationship

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School Attended

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Year Graduated

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Name

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Relationship

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School Attended

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Year Graduated

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Name

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Relationship

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School Attended

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Year Graduated

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Educational Information

Student's Academic Strengths and Interests

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Student's Co-curricular and Extra-curricular Interest and Activities

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Has the student tested for a Learning Difference?

Answer Required

Yes

Diagnosis

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Does the applicant have any physical or medical limitations?

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Yes

Please Explain

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Has the student had disciplinary problems or been dismissed from a school?

Answer Required

Yes

Please Explain

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There is a $25 non-refundable application fee.*

Price: $25.00

Please fix the highlighted areas below before submitting.

SHA Application for Admission (Transfers)