DCC K-12 Student Application

• Child's Name, Last/First/Middle *

• Child Lives with: (Please Check) *

  Both Parents   Mother   Father   Other

• Legal Custody with (Must have court papers)

• Address- House No., Street, Apt.No., Lot No., City, State, Zip Code *

• Parent/ Guardian's Phone Number - Home, Cell, Work *

• Parent/Guardian's Email *

• Gender -Select one *

  Male   Female

• Child's Date of Birth *

• Birth Certificate Number *

• Place of Birth, City/State *

• Religion

• Baptism: Date, Church, Location, Certification Verified

• First Eucharist: Date, Church, Location, Certification Verified

• Public School District of Residence *

• Grade Child Would Be Entering *

  K   1st   2nd   3rd   4th   5th   6th   7th   8th   9th   10th   11th   12th

• School last attended: Name, Address, City, State, Zip *

• School last attended: Grade________to Grade________ *

• What influenced your decision to enroll this child at DCC - Please check only the most important one.

  personal contact with a Central student or family or staff memberthe DCC websitethe faith-based education offeredquality instruction -programs-activitiesattending school eventsthe local mediaCardinal Chatter or Social Mediachurch affiliationfamily traditionschool environmentOther - Please state below

• Other from the above question

• Did child ever repeat a grade? *

  No   Yes

• Has Your Child Ever Been Homeschooled?

  YesNo

• If so, for how many years?

• Has child previously been offered an Individual Education Program (IEP)? *

  No   Yes

• If yes, list date/grade

• What language(s) does the child speak? *

• What language(s) is spoken in the home? *

• Father: First/Last Name, Home Address, Home Phone, Employer's Name, Work Address, Work Phone, and Contributing Parishioner Of:

• Mother: First/Last Name, Home Address, Home Phone, Employer's Name, Work Address, Work Phone, and Contributing Parishioner Of:

• Step-Parent: First/Last Name, Home Address, Home Phone, Employer's Name, Work Address, Work Phone, and Contributing Parishioner Of:

• Step-Parent: First/Last Name, Home Address, Home Phone, Employer's Name, Work Address, Work Phone, and Contributing Parishioner Of:

• Other: First/Last Name, Home Address, Home Phone, Employer's Name, Work Address, Work Phone, and Contributing Parishioner Of:

• List Any School Activities in which the student has been or is now involved.

• List Any Outside of School Activities in which the student has been or is now involved.

 

A non-refundable $50 application fee is required.

If you do not hear back from the school in two business days, please call 814-371-3060.