Greensburg Central Catholic Jr/Sr High School

NEW STUDENT APPLICATION

Applying to Greensburg Central Catholic Junior/Senior High School is a simple, straightforward process, and the following will help guide you through the steps.

CAMPUS VISIT
Arrange for a campus visit by calling the school office at 724-834-0310. A visit may be scheduled prior to submitting an application or at any time during the admissions process.

APPLICATION
Please complete all sections and the parent questionnaire for students. Complete the student questionnaire for students.

The non-refundable fee of $100.00 is applied to the school.

If you wish to pay by personal check, please PRINT a copy of the New Student Application Form and send it along with your check to:

Greensburg Central Catholic Junior-Senior High School
911 Armory Drive
Greensburg, PA 15601

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Qty

Description

Amount

Total

Application Fee

$100.00

Total: $100.00

STUDENTS INFORMATION

First Name: *

Middle Name: *

Last Name: *

Full Name:

Nickname:

Home Address: *

Address 2:

City: *

State: *

Zip Code: *

Home Phone: *

Cell Phone:

Date of Birth: *

Age as of Sept 1 of upcoming year: *

Gender: *

Applying for Grade: *

Beginning September (year): *

Public School District (where you live): *

Religion: *

If Catholic, please select your diocese:

If Greensburg Diocese, please select the parish where the student is registered:

If Pittsburgh Diocese, please indicate the parish (name and town):

where the student is registered

Has the applicant ever attended another Catholic School? *

If yes, please list school and address:

Race: *

Ethnicity: *

Does applicant have any special educational or medical needs? *

If yes, please explain:

How did you hear about Greensburg Central Catholic? *

PARENT/GUARDIAN INFORMATION

Parent/Guardian (1) Full Name: *

Relation to Applicant: *

Religion:

If Catholic, parish where registered:

Home Address:

(If different from student)

Address 2:

City:

State:

Zip Code:

Home Phone: *

Cell Phone: *

Email: *

If employed, complete all applicable fields.

Employed by:

Job Title:

Work Address:

Address 2:

City:

State:

Zip Code:

Work Telephone:

Parent/Guardian (2) Full Name: *

Relation to Applicant: *

Religion:

If Catholic, parish where registered:

Home Address:

(If different from student)

Address 2:

City:

State:

Zip Code:

Home Phone: *

Cell Phone: *

Email: *

If employed, complete all applicable fields.

Employed by:

Job Title:

Work Address:

Address 2:

City:

State:

Zip Code:

Work Telephone:

Student resides with: *

Check All Those That Apply: *Required*

Parents Married

Parents Not Married

Parents Separated

Single Parent Family

Parents Divorced

Mother Remarried

Father Remarried

Mother Deceased

Father Deceased

Are there any special custody circumstances? *

If yes, please describe:

Is there a custody agreement? *

CUSTODY NOTE: A copy of the legal custody agreement stating guardianship must be provided to the school in cases of divorce, adoption, physical/shared custody.

CURRENT SCHOOL

Required for those transferring in grades 7-12

Name:

Phone:

School Address:

Address 2:

City:

State:

Zip Code:

Date Entered:

Current Grade:

TUITION INFORMATION

Name of Individual Responsible for Tuition: *

Relation to Applicant: *

Address:

(if not a parent)

Address 2:

City:

State:

Zip Code:

SACRAMENTAL INFORMATION

Complete as applicable

Baptism Date:

Parish Name and Address:

Reconciliation Date:

Parish Name and Address:

First Holy Communion Date:

Parish Name and Address:

Confirmation Date:

Parish Name and Address:

SIBLINGS

Name:

Age:

School:

RELATIVES
PLEASE LIST ANY RELATIVES WHO HAVE ATTENDED OR ARE NOW ATTENDING Greensburg Central Catholic Jr./Sr. High School

EMERGENCY CONTACTS

Name: *

Relationship to student: *

Phone: *

Name:

Relationship to student:

Phone:

Name:

Relationship to student:

Phone:

Statement of Nondiscriminatory Acceptance Policy: Greensburg Central Catholic Jr./Sr. High School will not discriminate on the basis of race, gender, or national origin. Students seeking acceptance and enrollment to the school will be considered based on religion, academic performance, and learning needs, attendance, character, morality and conduct consistent with Catholic doctrine and applicable payment history within a Catholic or private/nonpublic school. The school maintains the right to give preferential acceptance and enrollment to Catholic students. The student is not permitted to attend this school if she or he has an outstanding payment balance at another Catholic School within the Diocese of Greensburg. Your signature below indicates that you understand and accept the content and provisions of this application.

Parent/Guardian Signature: *

PARENT QUESTIONNAIRE
ALL APPLICANTS

Parents or Guardians
The success of your child is important to us. Please complete the following questionnaire so that we may learn more about your child.

First Name of person completing this form: *

Last Name: *

Relationship to Applicant: *

How did you hear about Greensburg Central Catholic? *

What factors contributed to the decision to apply to Greensburg Central Catholic Jr./Sr. High School *

What words or phrases come to mind when describing your child? *

Please comment on what you consider to be your child’s greatest strengths *

What do you hope your child will gain by attending Greensburg Central Catholic Jr./Sr. High School? *

Any special circumstances that may have affected the educational progress of your child. *

STUDENT QUESTIONNAIRE
APPLICANTS ENTERING GRADES 7-12

STUDENT INSTRUCTIONS (students entering grades 7-12 only)

Please take a moment to complete this questionnaire so we may learn more about you.

Your Name:

Last Name:

Applying for Grade:

What is your favorite subject or activity in school? Explain.

Tell us about some of your extracurricular activities.

Describe an accomplishment of which you are particularly proud.

Is there anything else you would like the Admissions Committee to know about you?

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: *

Phone number to contact in case of questions

E-mail: *

A receipt will be e-mailed to this address.

ALL MAJOR CREDIT CARDS ACCEPTED

Please Note:
You may pay with a credit or debit card at the PayPal screen even if you don't have an account.

Please click Proceed to Confirmation below to pay with a credit card on the next page. No PayPal account is required.

ENTER YOUR PAYMENT INFORMATION ON THE NEXT SCREEN

Click 'Proceed to Confirmation' to pay with PayPal on the next page.