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Date*

For School Year*

Grade Applying For*

Parent or Guardian Contact Email *

Applicant's First Name*

Last Name*

Middle Name

Preferred Name

Address*

City*

State*

Zip*

Sex*

Date of Birth*

Birthplace

Social Security Number*

Ethnicity (US Government and Accreditation Agency Required Data)Afro AmericanAsian AmericanCaucasianNative AmericanHispanic/LatinoMiddle East AmericanMulti RacialMulti National

Sibling(s) At St. Andrew's

Other Students Applying To St. Andew's

Has Applicant Applied to St. Andrew's Prior to This Year?*YesNo

If Yes, What Year?

Father's Name

Address (if different from child)

City

State

Zip

Home Phone

Cell Phone

Work Phone

Email Address

Occupation

Job Title

Employer

Employer Address

City

State

Zip

Mother's Name

Address (if different from child)

City

State

Zip

Home Phone

Cell Phone

Work Phone

Email Address

Occupation

Job Title

Employer

Employer Address

City

State

Zip

Stepfather's Name (If Applicable)

Phone

Stepmother's Name (If Applicable)

Phone

With Whom does the child live with (Please check all that apply)*Guardian/OtherFatherMotherBoth ParentsStepfatherStepmotherParents Divorced/SeparatedFather DeceasedMother Deceased

Preferred Mailing Name & Address*

Preferred Directory Information: *

Student's Present School*

Neighborhood School*

School Address

City

State

Zip

School Phone

Head Administrator

Schools Attended in the past 3 years

School

Grade

Address

Administrator

School

Grade

Address

Administrator

School

Grade

address

Administrator

Has the student had a professional, educational, or psychological evaluation?*

Dates

Please attach a copy of the most recent report (if Applicable)

In what way, if any, has a member of the applicant's family been previously associated with St. Andrew's?

Were you referred by a current St. Andrew's Family? *

If yes, List Just one Family

How did you learn About St. Andrew's?*

Are you interested in applying for Financial Aid?*

For Students Entering 1st grade or above, please List 2 teacher references

Name

Address

Phone

Name

Address

Phone

List all Children of family in birth order

Name

sex

age

school

Name

sex

age

school

Name

sex

age

school

Name

sex

age

school

Grandparents

1. Grandparent's Name

Address (if different from child)

City

State

Zip

2. Grandparent's Name

Address (if different from child)

City

State

Zip

3. Grandparent's Name

Address (if different from child)

City

State

Zip

4. Grandparent's Name

Address (if different from child)

City

State

Zip

Signature of Parent(s) or Guardian(s)

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DEAR LORD, GOD ABOVE, OUR FATHER AND PROTECTOR:

Bless Saint Andrew’s Episcopal School, and bless the children in it. Protect them as they grow up into men and women. Guide them to the light, and show them your way. You, Lord, are the Light and the Way. Bring happiness and joy to our wonderful school. In Jesus’ almighty and powerful Name, we pray. AMEN.

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