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Request for Admission

- Admissions
  - Request for Admission

Thank you for your request for admission to St. Mary's School Early Learning Center.

Please fill out the form below and a member of our Admissions Team will reach out to you shortly!
The maximum number of form submissions has been reached. This form is currently not available.
- Student Information
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Sex: Male Female
  
  Age as of September 1st REQUIRED Please fill out this field. Please enter valid data.
- Grade Level Information
  
  Please select one REQUIRED 2.9 Year Old Preschool 3 Year Old Preschool 4 Year Old Preschool Kindergarten Please fill out this field.
- Parent/Guardian 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- Parent/Guardian 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
- Siblings at St. Mary's REQUIRED Please fill out this field.
  
  Siblings 1
  
  Name Please enter valid data.
  
  Grade
  
  Siblings 2
  
  Name Please enter valid data.
  
  Grade
- Notes/Comments
- Voluntary Demographic Survey (Please select one) Caucasian African American Asian Hispanic Other (if other, please specify below)
- If other, please specify here. Please enter valid data.
- How did you hear about us?
  
  Please check all that apply: Alumnus/a Current family referral Word of mouth School webpage School Facebook page School flyer or banner
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