9925 Mason Avenue, Chatsworth, CA 91311

(818) 341-1454

APPLICATION FORM

Date of Application ________________________________ Application for Grade __________________

Please PRINT and COMPLETE all information

Child’s Name: __________________________________________________ Gender: £ Male £ Female

(First) (Last)

Address ______________________________________________________________________________________________

(Street Address) (City) (State) (Zip Code)

Date of Birth Place of Birth ____________________________________

Date of Baptism _____________________________________ Church _________________________________________

Date of First Communion _____________________________Church _________________________________________

Father’s Name _______________________________________________________ Religion _______________________

(First) (Last)

Mother’s Name ______________________________________________________ Religion _______________________

(First) (Last)

Parents: £ Married £ Married in Catholic Church £ Divorced £ Separated £ Widowed

Home Phone _______________________ Work Phone _____________________ Cell Phone _____________________

Previous School(s) Attended ____________________________________________________ Grade(s) _____________

School Now Attending __________________________________________________________ Grade _______________

Is your child attending St. John Eudes Religious Education Classes? _______________________________________

How long has your child attended Religious Education Classes? __________________________________________

Do you belong to St. John Eudes Parish? ____________________ If yes, for how long? ___________________________________

Are you registered? ___________________ Do you use church envelopes? ________________ Envelope No. ________________

Do you belong to another church/parish? ________ If yes, which church/parish? _______________________________________

Are you applying for other grades in SJE? ___________________ If yes, which grades? __________________________________

If your other child/ren is not accepted, would you still want this child (applicant) to attend SJE? ________________________

Are you involved in any Parish Ministry? _________ If yes, which ministry? _____________________________________________

OFFICE USE ONLY: Application Fee ___________ Date Pd. _____________ Cash OR # _____________ Check No. _____________

9925 Mason Avenue, Chatsworth, CA 91311

(818) 341-1454

www.school.stjohneudes.org

APPLICATION FOR GRADES 1-8

2009 – 2010

Deadline: FRIDAY, FEBRUARY 13, 2009

Thank you for your interest in St. John Eudes School. Please return the following with your application:

1. Copy of Birth Certificate

2. Copy of Baptismal Certificate

3. Copy of First Communion Certificate (if applicable)

4. Immunization Records

5. St. John Eudes Church Envelope No. (for Registered Parishioners)

6. Copy of Current or Last Year’s Progress Reports

7. Current Achievement Scores

8. $50 Application Fee per Student (non-refundable)

All of the above items have to be returned with the filled out application form before the applicant’s assessment and family interview can be scheduled. You will be notified of the date and time for the assessment and interview.

Attached to this application is an ACADEMIC AND CHARACTER REFERENCE FORM. Please fill out ONLY the upper portion of the form with your child’s name and give the form to your child’s teacher or principal. The lower portion of the form should be filled out ONLY by the teacher or principal in your child’s current school, and they should mail the form directly to St. John Eudes School in an officially sealed school envelope.

Based upon placement assessment, priority will be given to applicants who:

1. Have siblings in other grades

2. Registered parishioners of SJE

3. Out of Parish families

4. Non-Catholic

Students entering Grade 1 MUST be six years old before September 1.

APPLICATION DOES NOT GUARANTEE ACCEPTANCE