Joliet Catholic Academy

Application for Incoming Freshmen

Eighth (8th) graders wishing to take the December 7, 2024 Entrance Exam are required to submit this Application for Admission and Parent Authorization Form along with the $30 application fee to the JCA Admissions Office. All incoming freshmen must take JCA's Entrance Exam. There will be a makeup Entrance Exam on Saturday, December 14, 2024. Both exams begin at 8 a.m. and will end at approximately 11:30 a.m.
Parent/Guardian must complete the entire application.

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Qty

Description

Amount

Total

Application Fee

$30.00

---

Total: $0.00

Student Information

Student First Name: *

Student Last Name: *

Gender: *

Home Address:

City:

State:

Zip Code:

Home Phone: *

Student Email:

Student's Cell Phone: *

Date of Birth: *

Place of Birth: *

(city, state, county)

Name and Phone: *

Please list the name and phone number of a person other than an immediate family member that knows your address and phone number:

How did you hear about JCA? *

Other:

Electronic Signature

As a parent/legal guardian of the above named child, my permission is given to release to Joliet Catholic Academy my student’s school records, including, but not limited to confidential academic, special education and disciplinary information, and records concerning my child. I also grant permission for Joliet Catholic Academy to dialogue openly with appropriate parties at my child’s current school about matters related to admissions and placement.

I understand JCA will not accept a transfer student if he/she is suspended or expelled from his/her current high school.

Parent/Guardian Name: *

Date of Application: *

Student’s Name: *

I certify that the information provided on this application is accurate and true. I understand that falsified or incomplete information may result in the denial of admission and/or termination of enrollment at Joliet Catholic Academy.

Educational Status

Grade you plan on entering into when you become a student: *

Name of the grade school you are currently attending: *

Name(s):

List the names of any high schools where you have already taken an entrance exam or placement test

Public high school district (number) you live in: *

High school in that district you would attend: *

Special Education Information

Do you have a current IEP, ISP or 504 Plan? *

If yes, from what district?

Accommodations/Services

Check the accommodations/services below that you are currently receiving or have been recommended to receive:

Title I Reading

Title I Math

Learning Disabilities

Behavior Disorders

Speech Pathology

Specialized Instruction

Other (please specify):

Religious Information

What is your religious affiliation? *

Other (please list):

Name of your parish/church/synagogue:

City:

State:

Zip Code:

Ethnic Background

Check the background with which you most closely identify:

Caucasian

Black (not of Hispanic origin)

Hispanic

American Indian or Alaskan Native

Asian or Pacific Islander

Family Information

Student lives with: *

Father/Stepfather/Guardian Information

Please choose: *

Please choose:

First Name:

Last Name:

Living

Deceased

Religion:

Occupation:

Company Name:

Company Phone:

E-mail Address:

Cell Phone:

DLS/JCHS/JCA Alumus?

Mother/Stepmother/Guardian Information

Please choose: *

Please choose:

First Name:

Last Name:

Living

Deceased

Religion

Occupation:

Company Name:

Company Phone:

E-mail Address:

Cell Phone:

SFA/JCA Alumna?

Parent/Guardian to receive test score

Additional Family Information

List the names of any brothers or sisters currently attending Joliet Catholic Academy

Name:

Current Year:

List the names of any younger brothers or sisters

Name:

School Attending:

Current Grade:

List the names of other family members who are alumni of SFA, DLS, JCHS, or JCA

Name:

Relationship:

Class Year:

Parent/Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone: *

E-mail: *

A receipt will be e-mailed to this address.

Comments:

Your Payment Information

Name on Card: *

Card Number: *

Security Code: *

Expiration Date: *