Challenging the Mind, Nurturing the Heart,

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Online Application for New Families
Admission for 2019-2020

Thank you for applying to enroll at Mother of Providence.
Welcome to our online application system. Please complete the form below. The application fee is due at the time of application. Applications for new students will be accepted and reviewed on a rolling admissions basis. You will be notified of acceptance within 2 weeks after applying online.

Order for enrollment acceptances:
Current students are offered spots first if applying prior to Catholic Schools Week, then:
- Catholic, participating parishioners from Nativity BVM and St. John Chrysostom parishes (our participating parishes)
- Catholic, participating parishioners from other parishes without schools
- Catholic, participating parishioners from other parishes with parish or regional schools
- Non Catholic families
PLEASE USE THIS FORM ONLY IF YOU ARE A NEW FAMILY APPLYING TO MOTHER OF PROVIDENCE

CURRENT FAMILIES SHOULD USE THE ONLINE RE-REGISTRATION FORM
(CLICK HERE)
Online Application for Admission: Mother of Providence
The maximum number of form submissions has been reached. This form is currently not available.
- Number of students you are enrolling REQUIRED Please fill out this field.
  
  Student Information 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.
  
  Grade in 2019-2020 REQUIRED Please fill out this field.
  
  Birthdate REQUIRED
  mm/dd/yyyy
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Grades PreK 3 and PreK 4: Check one
  
  Child Resides With REQUIRED Please fill out this field.
  
  If you answered "Other", please explain
  
  If the parents are divorced, separated, or not married, the school must have a copy of the custody agreement papers
  
  Language(s) Spoken REQUIRED Please fill out this field. Please enter valid data.
  
  Last School Attended REQUIRED Please fill out this field. Please enter valid data.
  
  Resides in which School District REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date Please enter a date.
  
  Baptism Place Please enter valid data.
  
  First Communion Date Please enter a date.
  
  First Communion Place Please enter valid data.
  
  Ethnicity REQUIRED Please fill out this field.
  
  Race (Please select) REQUIRED Please fill out this field.
  
  Has child ever been in an early intervention program for special needs or help? REQUIRED Yes No Please fill out this field.
  
  If "yes" please explain:
  
  Has child been given an Individualized Education Plan (IEP)? REQUIRED Yes No Please fill out this field.
  
  IEP paperwork must be submitted to Mother of Providence at the time of registration.
  
  Student Information 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.
  
  Grade in 2019-2020 REQUIRED Please fill out this field.
  
  Birthdate REQUIRED
  mm/dd/yyyy
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Grades PreK 3 and PreK 4: Check one
  
  Child Resides With REQUIRED Please fill out this field.
  
  If you answered "Other", please explain
  
  If the parents are divorced, separated, or not married, the school must have a copy of the custody agreement papers
  
  Language(s) Spoken REQUIRED Please fill out this field. Please enter valid data.
  
  Last School Attended REQUIRED Please fill out this field. Please enter valid data.
  
  Resides in which School District REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date Please enter a date.
  
  Baptism Place Please enter valid data.
  
  First Communion Date Please enter a date.
  
  First Communion Place Please enter valid data.
  
  Ethnicity REQUIRED Please fill out this field.
  
  Race (Please select) REQUIRED Please fill out this field.
  
  Has child ever been in an early intervention program for special needs or help? REQUIRED Yes No Please fill out this field.
  
  If "yes" please explain:
  
  Has child been given an Individualized Education Plan (IEP)? REQUIRED Yes No Please fill out this field.
  
  IEP paperwork must be submitted to Mother of Providence at the time of registration.
  
  Student Information 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in 2019-2020 REQUIRED Please fill out this field.
  
  Birthdate REQUIRED
  mm/dd/yyyy
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Grades PreK 3 and PreK 4: Check one
  
  Child Resides With REQUIRED Please fill out this field.
  
  If you answered "Other", please explain
  
  If the parents are divorced, separated, or not married, the school must have a copy of the custody agreement papers
  
  Language(s) Spoken REQUIRED Please fill out this field. Please enter valid data.
  
  Last School Attended REQUIRED Please fill out this field. Please enter valid data.
  
  Resides in which School District REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date Please enter a date.
  
  Baptism Place Please enter valid data.
  
  First Communion Date Please enter a date.
  
  First Communion Place Please enter valid data.
  
  Ethnicity REQUIRED Please fill out this field.
  
  Race (Please select) REQUIRED Please fill out this field.
  
  Has child ever been in an early intervention program for special needs or help? REQUIRED Yes No Please fill out this field.
  
  If "yes" please explain:
  
  Has child been given an Individualized Education Plan (IEP)? REQUIRED Yes No Please fill out this field.
  
  IEP paperwork must be submitted to Mother of Providence at the time of registration.
  
  Student Information 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Grade in 2019-2020 REQUIRED Please fill out this field.
  
  Birthdate REQUIRED
  mm/dd/yyyy
  Please fill out this field. Please enter a date.
  
  Gender REQUIRED Please fill out this field.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Grades PreK 3 and PreK 4: Check one
  
  Child Resides With REQUIRED Please fill out this field.
  
  If you answered "Other", please explain
  
  If the parents are divorced, separated, or not married, the school must have a copy of the custody agreement papers
  
  Language(s) Spoken REQUIRED Please fill out this field. Please enter valid data.
  
  Last School Attended REQUIRED Please fill out this field. Please enter valid data.
  
  Resides in which School District REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Date Please enter a date.
  
  Baptism Place Please enter valid data.
  
  First Communion Date Please enter a date.
  
  First Communion Place Please enter valid data.
  
  Ethnicity REQUIRED Please fill out this field.
  
  Race (Please select) REQUIRED Please fill out this field.
  
  Has child ever been in an early intervention program for special needs or help? REQUIRED Yes No Please fill out this field.
  
  If "yes" please explain:
  
  Has child been given an Individualized Education Plan (IEP)? REQUIRED Yes No Please fill out this field.
  
  IEP paperwork must be submitted to Mother of Providence at the time of registration.
- Transportation to and from school Bus Car Walk Other
- Siblings not enrolled at MPRCS: List Name, Grade and School
- Billing Information:
  For two parent families, both parents/guardians must submit their information
- Number of Parents/Guardians REQUIRED 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.
  
  Relationship to Student REQUIRED Please fill out this field.
  
  Marital Status REQUIRED Please fill out this field.
  
  If "Other" please explain:
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Employer Please enter valid data.
  
  Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Billing Address
  
  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.
  
  Preferred Email REQUIRED Please fill out this field. Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Parish Where Registered Please enter valid data.
  
  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.
  
  Relationship to Student REQUIRED Please fill out this field.
  
  Marital Status REQUIRED Please fill out this field.
  
  If "Other" please explain:
  
  Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Employer Please enter valid data.
  
  Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Billing Address
  
  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.
  
  Preferred Email REQUIRED Please fill out this field. Please enter an email address.
  
  Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Parish Where Registered Please enter valid data.
- Second/Split Billing Information Please send a copy of tuition bill to second party address
- Billing Name Please enter valid data.
- Relation to Student Please enter valid data.
- Home/Cell Phone Number Please enter a phone number.
- Work Phone Number Please enter a phone number.
- Billing Street Address Please enter valid data.
- City Please enter valid data.
  
  State
  
  Zip Please enter a zip code.
- Preferred Email Please enter an email address.
- Enrollment Fee of $150 must be submitted with application
  A non-refundable fee per family is required at time of enrollment. This fee is not applied to tuition.
- Tuition Information
  I have read and understand the tuition information and policies as listed on the website
  I Agree Please select this field.
- Parent/Guardian Signature - Please type below REQUIRED Please fill out this field. Please enter valid data.
- 2nd Parent/Guardian (If applicable) I agree
- Parent/Guardian Signature- Please type below Please enter valid data.
- How did you hear about us? Referred by Current Family Parishioner of Nativity or St. Johns Post Card Mailing Facebook/Social Media Internet Search Other
- If Referred by Current Family or Other (please explain) Please enter valid data.
- Enrollment Fee (per family)150.0
Total:

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Online Application for New Families Admission for 2019-2020

Tuition Information

Online Application for New Families
Admission for 2019-2020