UPPER SCHOOL (6-12)

PHOTO SAINT LOUIS SCHOOL (Recommended) APPLICATION FOR ADMISSION “Where boys who want to change the world become the men who do”

Please type or print clearly STUDENT INFORMATION Today’s Date: ______Current Grade: ______Applying to Grade: ______ESL: Yes No

Applicant’s Name: Last First Middle Preferred to be called by:

Age: Date of Birth: Birth City/State:

Current School

We will be applying for financial aid for the 2021-2022 school year: Yes No Applying for financial aid does not affect your ability to be considered for acceptance.

Are you a recipient of the Kipona Scholarship Program? Yes No

Applicant is registered/intends on registering to take the Computer-Based SSAT at Home. (Register at SSAT.org) October November December January February March April May

Preferred contact for all correspondence regarding this application:

Name/Relationship to Applicant

Address City State Zip Code

Email Address

Cell Phone Work Phone Home Phone

Religion: Date of Baptism: Parish:

Citizenship Country of Citizenship: United States Other (please specify) ______Country of Birth if other than U.S. ______Do you require an I-20/VISA to study in the U.S.? Yes No For students previously issued an I-20: SEVIS ID # Language spoken at home: English Other (please specify)

Ethnic Background (Circle all that apply) A. Native American E. Part-Hawaiian I. Hispanic M. Tongan B. African American F. Japanese J. Samoan N. Caucasian C. Chinese G. Korean K. Other Pacific Islander O. Other D. Filipino H. Portuguese L. Laotian, Vietnamese, etc.

For reporting purposes, list the one ethnic background you most identify with: ______Were any of your ancestors Hawaiian? Yes No Are you registered with the Ho’oulu Hawaiian Data Center? Yes No

N.B. The Catholic School Department must report to the National Catholic Education Association, Federal and local agencies summary data on the gender and ethnic backgrounds of our students. Therefore, it is required that each person applying for admission to a Catholic school indicates his or her gender and ethnic background on the application form. This information does not affect determination of admission. The ethnic designations are used to indicate a general group to which a person appears to belong or identifies with.

PARENT/GUARDIAN INFORMATION Primary Household (Include relationship to applicant)

Father’s Name/Other: Mother’s Name/Other Last First Last First Home Address: Street City State Zip Code Cell Phone: ( ____ ) ______Cell Phone: ( )

Work Phone: ( ) Work Phone: ( )

Email Address: Email Address:

Employer: Employer:

Occupation: Occupation:

Business Address: ______Business Address: Street Address Street Address

City State Zip Code City State Zip Code

Secondary Household (If Applicable) (Include relationship to applicant)

Father’s Name/Other: Mother’s Name/Other Last First Last First Home Address: Street City State Zip Code Cell Phone: ( ____ ) ______Cell Phone: ( )

Work Phone: ( ) Work Phone: ( )

Email Address: Email Address:

Employer: Employer:

Occupation: Occupation:

Business Address: ______Business Address: Street Address Street Address

City State Zip Code City State Zip Code

Legal Guardian Information (If Applicable)

Last First Relationship to Student Home Address: Street City State Zip Code Cell Phone: ( ) Work Pho ne: ( )

Email Address:

Applicant resides with: Both Parents Mother Only Father Only Guardian Mother & Step Parent Father & Step Parent

Parent(s) are deceased: Mother Father

High School Father Attended Year Graduated College Father Attended High School Mother Attended Year Graduated College Mother Attended

FAMILY INFORMATION Siblings: Name School/College Grade Applying to SLS? ______

List related alumni who have graduated from Saint Louis School: Name Relationship to Applicant Year Graduated ______

Military Branch: Air Force Army Coast Guard Marines Navy Foreign Military

Military Status: Active Duty Reserves Retired

Base/Command Location: Camp Smith Hickam Kaneohe Kunia Pearl Harbor Schofield Tripler

OTHER INFORMATION List all previous schools the applicant attended, beginning with the most recent: School Name Grade(s) Attended

______

Has applicant ever attended Saint Louis School? Yes No Year/Grade(s) ______

Has applicant ever applied to Saint Louis School? Yes No Year/Grade(s) ______

APPLICANT’S INTERESTS/EXTRA-CURRICULAR ACTIVITES:

Academics (Robotics, Speech & Debate Team, Science Club, etc)

Fine Arts (Dance, Musical Instrument, Drama Club, Band, Performing Arts, etc)

Sports (Football, basketball, golf, bowling, etc)

Community Involvement (Boy Scouts, JPO, etc)

Answered by the Applicant: (Please include a separate sheet of paper if you require additional space)

RECOGNITION/AWARDS: Have you received any recent awards or recognition in school, sports, fine arts, or the community? If so, please explain: ______

Why have you decided to apply to Saint Louis School? Please explain: ______

What Most Influenced Your Decision to Apply to Saint Louis School? (check all that apply)

School Visit Saint Louis Alumni Saint Louis Student/Parent Website Radio Television Print Advertisement Social Media Other ______

Is there someone that referred you to Saint Louis School?

Name______Email/Contact Number ______

MEDIA/PHOTO RELEASE As the legal parent/guardian I allow Saint Louis School to use his photo(s) for publications, school website, social media, publicity, and advertising that pertain to the school. This is my written consent and permission that releases the use of his photo(s).

Yes No

By signing below, we acknowledge that all information provided is true & correct.

SIGNED: ______Date: ______Applicant Signature SIGNED: ______Date: ______Father/Guardian Signature SIGNED: ______Date: ______Mother/Guardian Signature

Application must be submitted with the NON-REFUNDABLE fee of $60 ($100 for International Students) (please make checks payable to “Saint Louis School”)

A Catholic Marianist School For Young Men 3142 Waialae Avenue, , 96816-1579 Phone (808) 739-4832, Fax (808) 739-4711 www.saintlouishawaii.org