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Regina Angelorum Academy
105 Argyle Road, Ardmore, Pennsylvania 19003, Phone: 610.649.1730
Name _______________________________________________________________________________________________
Last         First         Middle
Social Security # ________________________________________Country of Citizenship ___________________________
Date of Birth ___________________________________________Place of Birth __________________________________
Month/Day/Year
Applicant Current Grade in School __________________________seeks to enroll in grade __________________________
Pre-K and Kindergarten ONLY choose: (5 day or 3 day) and (full day or half-day): Â Â Â _______________________________
In what district does the student reside? ____________________________ If available, is bus transportation needed? _____
Religion ______________________________________ Parish ________________________________________________
Date of Baptism _______________Date of First Holy Communion _______________Date of Confirmation _____________
FAMILY
Parent’s Full Name _________________________________
(Mr., Mrs., Ms., Dr.)
Home Address _____________________________________
Street
_________________________________________________
City         State   Zip
(Â Â Â Â Â ) ___________________ (Â Â Â Â Â ) ____________________
Home Telephone                  Business Telephone
Employer _________________________________________
Occupation/Title ___________________________________
Business Address __________________________________
Street
_________________________________________________
City         State   Zip
Secondary Schools, Colleges Attended; Degrees Held:
_________________________________________________
Parent’s Full Name _________________________________
(Mr., Mrs., Ms., Dr.)
Home Address _____________________________________
Street
_________________________________________________
City         State   Zip
(Â Â Â Â Â ) ___________________ (Â Â Â Â Â ) ____________________
Home Telephone                  Business Telephone
Employer _________________________________________
Occupation/Title ___________________________________
Business Address __________________________________
Street
_________________________________________________
City         State   Zip
Secondary Schools, Colleges Attended; Degrees Held:
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SIBLINGS
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Name               School               Age
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Name               School               Age
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Name               School               Ag
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Name               School               Age
SCHOOLS (Applicant)
Present School _________________________________________________________Present Grade _____________________
School Address _________________________________________________________________________________________
Street
_____________________________________________________________Telephone (Â Â Â Â Â Â Â Â Â Â Â Â )Â ________________________
City         State      Zip
Name of School Principal _________________________________________________________________________________
Name               Title
Previous Schools Attended:
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School Name         Address         Dates         Grades Attended
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School Name         Address         Dates         Grades Attended
OTHER
Please tell us how you heard about Regina Angelorum Academy (specify name or publication if possible).
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To what other schools are you considering applying?
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Does applicant take any special medications? If so, explain.
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Does applicant have any special needs? If so, explain.
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Does applicant suffer from any illness, which may interfere with his or her studies? Please indicate [e.g. dyslexia, etc.] And please explain.
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Please list any educational programs with which the applicant has been involved for the past three years of school. [e.g. honors programs, 766, Title I, tutoring, remedial programs, etc.]
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Please explain your hopes and goals for your child’s spiritual and intellectual formation. Describe how you see the mission of Regina Angelorum Academy assisting you in fulfilling those goals.
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PARENT’S SIGNATURE
It is understood that this application is made subject to terms of admission and tuition rates in effect at the time of entrance to
Regina Angelorum Academy.
Signature of Parent or Guardian _______________________________________________________ Date _________________
Please return the completed application with the $40 non-refundable fee, payable to Regina Angelorum Academy.
Mail to: Regina Angelorum Academy, 105 Argyle Road, Ardmore, PAÂ 19003.
Tel:Â 610.649.1730Â Â Â Fax:Â 610.649.1731Â Â Email.
A recent passport-size photograph of applicant is strongly encouraged, but not required.
Regina Angelorum Academy values diversity and seeks to attract talented students from varied backgrounds, RAA does not discriminate on the basis of race, color, religion, creed, or national or ethnic origins in the administration of any of its practices and policies
For office use only:
Assessment results:
Faculty comments:
Faculty grade recommendation:
Headmaster’s comments and final recommendations:
Regina Angelorum Academy
2008-2009
Application for Admission
(To be completed by the parent/guardian)
APPLICANT
Name__________________________________________________________________________________________________
Last         First         Middle      Nickname
Address________________________________________________________________________________________________
Street
______________________________________________________________ Telephone (Â Â Â Â Â Â Â ) _________________________
City      State      Zip
Fax: ________________________________________________Â Â Â Email: ___________________________________________
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Admissions Application
