mother brunner catholic school new student checklist · mother brunner catholic school new student...
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Mother Brunner Catholic School New Student Checklist
Student Name: ______________________________ Grade 18/19 ________
All application forms must be turned in to school office to process your student’s application. Parents must call the school office to schedule a screening assessment appointment. There is a screening fee of $25 for students entering Grades 1-8 and is due before the screening appointment. Parents will be notified of admissions decision within 20 days of completing the application process.
Application Process:
Mother Brunner Catholic School Admissions Application
Principal/Teacher Recommendation Form
Mid-Year Release of Records Form
Copy of Most Recent Report Card
Copy of Most Recent Standardized Test Scores
Testing Fee - $25 per Student (Grades 1-8)
Birth Certificate – Copy of Official Birth Certificate
Baptismal Certificate – Copy (Catholic Only)
Immunization Records – Copy
Custody Papers – Copy (If Applicable)
School Records Release (White Form)
Tuition and Fees Commitment Form
Final Release of Records Form
Ohio EdChoice Scholarship paperwork (If Applicable) EdChoice Scholarship Request Form Proof of Address (Copy of current Utility Bill)
DPS Assignment Letter
Once notified of acceptance parents have 5 days to provide and complete registration to guarantee the student’s placement for the upcoming school year:
Payment of Family Registration Fee of $250 (Non-Refundable).
Mother Brunner Catholic School Admissions Procedure for New Applicants
1. Submit the completed the admissions application packet to the school office: • Student Admissions Application Form • Copy of Most Recent Report Card • Copy of Most Recent Standardized Test Scores • Principal/Teacher Recommendation Form • Mid-Year Release of Records Form • Annual Tuition & Fees Commitment Form • Final Release of Records Form
2. Admissions Screening Assessment:
• Call school office to schedule a screening assessment for your student entering grades K-8.
• Completed Admissions Application packet must be submitted to the school office prior to screening assessment appointment. A Screening Assessment fee of $25 per student is due on or before the scheduled screening date for students entering grades 1-8. (payment must be in the form of cash, check or money order)
3. Admission Decision/Confirmation:
• The administrators’ decision is based on the results of the screening, student’s academic and behavior records. Parents will be notified of the administrators’ decision usually within 20 days of completing the application process.
• Student must be in good financial standing with current school.
4. Accepted Students - Complete Registration Packet for Admitted Students • Pay Non-Refundable Family Registration fee of $250.00 • The registration process must be completed within 5 days of acceptance to
guarantee the student’s placement in the upcoming school year.
Student Name: _________________________________ Current Grade Level: __________________
Current School: _________________________________ Principal: ___________________________
School Address:_________________________________________ FAX #:_____________________
I give permission for my child’s’ current principal/teacher to complete this recommendation form. I
understand that it is a required component of the applications process.
_______________________________ _________________________
Parent/Guardian Signature Date
Please have current school complete the following and return to our school. Please answer the following questions in regards to the above named student: use reverse side if necessary.
Yes No
1. This student has received small group instructional assistance, LD remedial tutoring, or other
supplemental support services. If yes, please list areas and the year (s) in which the student received assistance:
2. This student is on an ISP, IEP, 504, action plan or building plan
If yes, please lists areas it covers:
Please forward a copy
3. This student’s family has taken care of their financial obligations to our school in a timely manner.
Circle one number per question. 1 = No, hardly ever 5 = Yes, almost always
1. This student consistently follows teacher’s instructions. 1 2 3 4 5
2. This student stays calm while accepting criticism. 1 2 3 4 5
3. This student is respectful and does not argue with authority. 1 2 3 4 5
4. This student puts forth effort in school. 1 2 3 4 5
5. This student completes homework with quality. 1 2 3 4 5
6. This student arrives to school on time. 1 2 3 4 5
7. This student gets along with other students. 1 2 3 4 5
8. This student’s parents have attended parent teacher conferences 1 2 3 4 5
and other required meetings.
9. This student exhibits recurring disciplinary concerns. Yes No
If yes, please explain (i.e. student has had excessive detentions, suspended or expelled)
Completed by ____________________________ Phone Number ________________ Date__________
School Official Name
Principal/Teacher Recommendation Form Mother Brunner Catholic School
4870 Denlinger Road, Dayton, Ohio 45426
Phone: 937-277-2291 Fax: 937- 277-2217
4870 Denlinger Road, Dayton, Ohio 45426 Phone: 937-277-2291 Fax: 937- 277-2217
www.brunnercatholicschool.org
Completion of this form gives your current school permission to forward your latest quarter’s
report card and standardized test scores to Mother Brunner Catholic School.
Upon completion, turn this form into your school office.
THE APPLICANT SHOULD NOT MAIL THIS FORM TO MOTHER BRUNNER.
Student Name ______________________________ Birth Date ____________________________
Address ________________________________________________________________________
Street City State Zip
I, __________________________, the parent/guardian of_________________________________,
Parent name Student name
request __________________________, _____________________________________________
School School phone
___________________________________________________________________
School address
to provide copies of school record information to Mother Brunner Catholic School. Such records
should include copies of all school records as defined by public law 93-380, and any amendments
thereto, including latest quarter report cards, State of Ohio Achievement Test Scores and any
current standardized test scores. In addition, if applicable forward copies of ISP’s., IEP, MFE’s, 504
& Building Plans. The purpose of these records is for consideration of admission only.
Parent/Guardian signature ____________________________ Date ___________________
Relationship to child ________________________ Phone number ____________________
School Administrator:
Please return the student recommendation form and all pertinent academic records requested
above to the Mother Brunner Catholic School.
Mid-Year Release of Records Request Mother Brunner Catholic School
4870 Denlinger Road, Dayton, Ohio 45426
Phone: 937-277-2291 Fax: 937- 277-2217