Student Application - Good Shepherd Catholic School

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Applicant's Information
Today's Date*
Which best describes you?*
- New Student
- Mother Seton Applicant
Grade Entering*
New Student Application Fee
Price:
Mother Seton Application Fee
Price:
Please indicate if you have been awarded any of the below mentioned scholarships:*
- Step Up For Students (FTC)
- Family Empowerment Scholarship
- Gardiner Scholarship
- McKay Scholarship
- None
Family Last Name*
Persons responsible for student’s financial obligations
Student's Name*
First Middle Last
Social Security Number*
Date of Birth*
MM slash DD slash YYYY
Place of Birth*
Are you a U.S. Citizen?*
- Yes
- No
If not U.S. Citizen, indicate Visa type:*
Sex:*
- Male
- Female
Religion:*
Sacraments:*
- Baptism
- Communion
- Confirmation
- N/A
Immigration Naturalization Services requires that a student holds a student visa (F-1) before they are allowed to attend classes in a school in the United States. A school is not allowed to admit a child who is in the country on a Tourist (B-1 or B-2) Visa.
Student lives with:*
- Both Parents
- Mother
- Father
- Guardian
- Mother/Stepfather
- Father/Stepmother
If parents are divorced, which parent has custody of student?*
- Mother
- Father
- Both
- Not Applicable
Custody documents must be provided with this application.
Name of person student lives with:*
Home Address*
Street Address City State Zip / Postal Code
Home Phone Number*

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Parent Information
Mother's Name:*
First Last
Email Address:*
Cell Phone #:*
Occupation*
Place of Employment:*
Work Phone #:*
Father's Name:*
First Last
Email Address:*
Cell Phone #:*
Occupation:*
Place of Employment:*
Work Phone #:*

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Siblings
How many siblings does the student have?*
Sibling 1*
Sibling 2*
Sibling 3*
Sibling 4*
Sibling 5*

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Academic History
Prior Schools*
Please list name(s) and address (es) of school(s) that applicant has attended within the past five years and how long he/she attended each.
Has student applied to Good Shepherd previously? If so, what year?*
Has this student ever been dismissed from any school? If answer is yes, please explain.*
What language is spoken at home?*
Has this child ever been tested for a learning disability?*
- Yes
- No
If answer is yes, copy of test results must be provided with this application.
Has this child ever been tested for giftedness?*
- Yes
- No
If answer is yes, copy of test results must be provided with this application.
Have behavior, adjustment, or psychiatric case or psychological-educational studies been made on this applicant?*
- Yes
- No
If answer is yes, please explain.*
Please supply copy of documentation.

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I HEREBY ATTEST THAT THE INFORMATION PROVIDED IN THIS APPLICATION IS TRUE AND SUBMIT THIS APPLICATION FOR ADMISSION OF MY CHILD TO GOOD SHEPHERD CATHOLIC SCHOOL.
Mother’s Signature*
Father’s Signature*
Date*
MM slash DD slash YYYY
Document List
The following documents must be submitted to the school office once the application has been completed.
- Copy of Birth Certificate
- Copy of Baptismal Certificate
- Copy of First Communion Certificate (if applicable)
- Standardized Test Scores (if applicable)
- Latest Report Card
- Copy of Report Card showing promotion to next grade level
- Health Form/Immunization Form
- Athletic Consent Form (2nd-8th Grade Only)
- Immigration Paperwork (if applicable)
- Custody documents (if applicable)
- Step Up For Students Award Letter (if applicable K-8)
- Wallet size picture of your child
- Recommended By:

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Good Shepherd Catholic School

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14187 SW 72nd St. Miami, FL 33183

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(305) 385-7002

305-385-7026 (Fax)

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