Last

First

Middle

Male

Female

Social Security #

Place of Birth

Date of Birth

9101112

Applying for Grade

For the Academic Year

Religious Affiliation

Parish/Church

Native American
Hispanic/Latino

Pacific Islander
Caucasian/White

Asian

African American

Street

City

State

Zip Code

Phone

E-mail

Both Parents

Father

Mother

Guardian

Other

Mother Deceased
Parents Seperated

Father Deceased
Parents Divorced

Both Parents

Father

Mother

Guardian

Other

Last

First

Middle

Home
(if different from student's)

Cell

Business

Street

City

State

Zip Code

Name

Position

Religious Affiliation

Birthplace

Yes

No

Last

First

Middle

Home
(if different from student's)

Cell

Business

Street

City

State

Zip Code

Name

Position

Religious Affiliation

Birthplace

Yes

No

Last

First

Middle

(if different from student's)

Street

City

State

Zip Code

Religious Affiliation

Yes

No

Name

89101112

Grade

Street

City

State

Zip Code

Dates Attended	Name & Address of School

Yes

No

Church of Baptism

City

Year Baptized

Religion

All applicants should provide a copy of your Baptismal Certificate (if applicable)

City

Yes

No

Yes

No

Dates Attended	Name of School

Name

Name

# of brothers

Older

Younger

# of sisters

Older

Younger

Parent(s)/Guardians

Student

Referral by SC Parent or Alumni
Advertising in local media
Mini Open House & Info Night

Other

Santa Clara Open House
8th Grade Class Visit
High School Fair

SC Decision Influence