Cristo Rey Columbus High School

Application for Admission

2018-2019 School Year

Admission for 2018-2019 School Year

Deadlines for Applications

Early Admission Deadline………………..………Tuesday, November 21, 2017

*Applications will be accepted after November 21until we have filled all available seats. To have the best chance at being accepted we encourage completing the application as early as possible.

Part 1- Application

In order for your application to be processed, we must receive the following items.

Application for Admission (this packet)

Student must be eligible to work in the United States

The following information from your student’s current school. Turn in the Request for Records/Teacher Recommendation packets to your school office:

Completed Recommendation Form from English Teacher
Completed Recommendation Form from Math Teacher
Completed Recommendation Form from School Leader

Copy of Report Cards, discipline records, and attendance records from current and previous grade
Copy of Standardized Test scores from current and previous grade
IEP/ISP records, if applicable

Financial Application

FACTS Grant and Aid Online Application (must include $30 processing fee)

Part 2- Entrance Exam

Applicants will also take the Cristo Rey Columbus High School Entrance Exam on one of the dates below. Please call (614) 223-9261 x12009 or text to (614) 352-7851 to reserve a space.

Entrance Exam………………………...... Saturday, October 14, 2017, 9am-11:30am

Entrance Exam……………………….….Saturday, November 11, 2017 9am-11:30 am

*More dates may be added if needed.

Part 3- Interview

Applicants who completetheir applications may move into the second phase of the admissions process. Applicants who have the potential to meet the criteria to be a Cristo Rey Columbus student will be invited to interview with the Director of Admissions or other school representative.

Student and Parent/Guardian interview with the Director of Admissionsor other school

representative

For Accepted Students only

Part 4- Registration

Students will receive notification of admission to Cristo Rey Columbus High School via mail. Students who are accepted and plan to attend Cristo Rey Columbus must register to secure their placement in the class.

APPLICATION INSTRUCTIONS / OFFICE USE ONLY

Please type or print clearly.
Use blue or black ink.

Fill in all blanks provided.

/ Date Received ______
Staff Receiving ______

SECTION A: STUDENT’S PERSONAL DATA

Full Name (as on Birth Certificate):

LastFirstMiddle Initial

CurrentSchool: Grade: ______

Birth Date://Religion(optional):

Month DayYearChurch name (optional): ______

Please mark racial and/or ethnic identity(optional)

Black or African American Caribbean Islander Hispanic or Latino Multiracial

Asian White Other ______

Home Address:

AddressApt.City StateZip

Home Phone: -- Birth Place:

Gender: Male Female Currently receiving Ed Choice Scholarship? Yes No

Language spoken at home: Other Languages Spoken:

Student’s Cell Phone (optional): - -

Student Lives With: (Check all that apply.)

Mother only Father only Both Parents Grandmother Grandfather Aunt or Uncle

Foster Care Provider Other–Relationship: ______

Parent/Guardian’s Current Marital Status: (Check all that apply.)

Single Parent Parents Married Parents Together Divorced Separated Mother Remarried

Father Remarried Mother Deceased Father Deceased Under DYFS Custody

SECTION B: STUDENT QUESTIONNAIRE

This must be completed in student’s own handwriting, without parental assistance. If needed, use additional paper or the back of this page.

Student Name: ______Date: ______

Explain why Cristo Rey Columbus is a good fit for you, and why you are a good fit for Cristo Rey:

______

Do you know any current Cristo Rey students? If so, who? ______

______

How did you hear about Cristo Rey Columbus? (check all that apply)

☐ Cristo Rey Representatives visited my school☐ Cristo Rey Representatives visited my church
☐ Friend, neighbor, or relative ☐ Teacher, counselor, or clergy ☐ Community event (festival, fair, etc.)

☐ Received something in the mail ☐ Received a phone call ☐ Newspaper Article

☐ Word of mouth (family, friend, etc.)

What school district do you live in?

What publichigh school would you be assigned to?

SECTION C: FAMILY INFORMATION (to be completed by parent or guardian)

Personal Data of Parent or Guardian 1

Full Name:

LastFirstMiddle Initial

Gender: Male FemaleEnglish Speaker: Yes No

If no, list preferred spoken language: ______

Relationship to Student: Legal Guardian? Yes No

Highest Level of Education: some HS HS diploma some college Associate’s (2 year degree)

Bachelor’s (4 year degree) Master’s or higher

Home Address:

AddressApt.City State Zip

Home Phone: - -

Work Phone: --

Employer: Occupation:

Parent Cell Phone: --

Please check the best way to contact you.

______Work Phone ______Home Phone ______Cell Phone ______Text Message ______Email

If email is a preference, please write your email address: ______

Personal Data of Parent or Guardian 2

Full Name:

LastFirstMiddle Initial

Gender: Male FemaleEnglish Speaker: Yes No

If no, list preferred spoken language: ______

Relationship to Student: Legal Guardian? Yes No

Highest Level of Education: some HS HS diploma some college Associate’s (2 year degree)

Bachelor’s (4 year degree) Master’s or higher

Home Address:

Apt./StreetCity StateZip

Home Phone: - -

Work Phone: --

Employer: Occupation:

Parent Cell Phone: --

Please check the best way to contact you.

______Work Phone ______Home Phone ______Cell Phone ______Text Message ______Email

If email is a preference, please write your email address: ______

SECTION D: PARENT QUESTIONNAIRE (to be completed by parent or guardian)

List all schools the student has attended in the last THREE years:

(1)

Current SchoolCity, StateYear(s) Attended

(2)

SchoolCity, StateYears(s) Attended

(3)

SchoolCity, StateYears(s) Attended

(4)

SchoolCity, StateYear(s) Attended

Learning and Medical Profile

Has the student been diagnosed with a learning disability? Yes No

Has the student been diagnosed with ADD or ADHD? Yes No

Has the studentnow or ever been enrolled in special education classes? Yes No

Has the student now or ever been enrolled in gifted classes? Yes No

Has the studentbeen enrolled in English as a Second Language (ESL) classes? Yes No

Does the studentcurrently have, or ever had, an Individual Education Plan (IEP)? Yes No

If “yes”, a copy of the IEP must be included with the application.

If you answered YES to any of the questions above, please explain below.

Why do you want your son or daughter to attend Cristo Rey Columbus?

Why do you believe he or she would do well here?

Household Income

How many adults live in your house? ______Relationship(s) to child: ______
How many children live in your house? ______Relationship(s) to child: ______

Please check the most appropriate range of your total household income.

Less than $20,000 $20,001-40,000 ______$40,001-60,000

$60,001-80,000 _____ Higher than $80,000

* All applicant families are required to complete the FACTS Financial Application before receiving an official admissions decision from Cristo Rey Columbus.

IMPORTANT NOTE TO STUDENTS, PARENTS AND GUARDIANS:

Please review carefully and sign below.

I understand that Cristo Rey Columbus High School is an academically challenging, Catholic school with a code of mandatory attendance, dress, and conduct. The hallmark of the school is its Professional Work-Study Program in which the students work one full day each week and a fifth day approximately every four weeks of the school year, excluding holidays and days when school is closed. I understand the student’s earnings will be used to fund a portion of the cost of their high school education. I further understand that full participation of parents and guardians is necessary in order to fulfill requirements of the school.

Admission to Cristo Rey Columbus High School is subject toour receipt of an official transcript demonstrating successful completion of the applicant’s current grade and satisfactory completion of our mandatory summer business training program.Admission and enrollment decisions are made at the sole discretion of Cristo Rey Columbus administration. I certify that the information furnished in this application is complete and accurate. Furthermore, I understand that if I knowingly provide false information, my child’s admissions may be jeopardized.

Cristo Rey Columbus High School does not discriminate on the basis of race, color, national or ethnic origin.

My signature indicates my permission for the release of my child’s school records to Cristo Rey Columbus High School.

Student SignatureDate

Parent/Guardian SignatureDate

NOTA IMPORTANTE PARA ESTUDIANTES, LOS PADRES Y REPRESENTANTES:

Por favor revise cuidadosamente y firme a continuación.

Comprendo que la Escuela SecundariaCristo Rey Columbus es una escuela católica con un riguroso programa académico que posee un código de asistencia obligatoria, vestimenta y conducta. La marca que diferencia esta escuela es su Programa Profesional de Trabajo-Estudio en el cual los estudiantes trabajan un día entero cada semana y un quinto día cada cuatro semanas del año escolar aproximadamente, con excepción de los días feriados y los días en que no haya clase. Comprendo que lo que gane el estudiante cubrirá una porción del costo de su educación secundaria. Afirmo que comprendo que la participación total de los padres y representantes es necesaria para cumplir los requisitos de la escuela.

La admisión a la Escuela SecundariaCristo Rey Columbus está sujeta al recibimiento de un certificado académico oficial que demuestre que el aspirante completó satisfactoriamente el grado actual y a la conclusión satisfactoria de nuestro programa de entrenamiento profesional de verano obligatorio. Las decisiones deadmisión e inscripción se realizan exclusivamente a discreción de la administración de Cristo Rey Columbus. Certifico que la información proporcionada en esta aplicación es completa yprecisa. Y, además, afirmo que si proveo información falsa, la admisión de mi hijo(a) podría ser perjudicada.

Cristo Rey Columbus High School no discrimina pormotivo de raza, color, nacionalidad uorigen étnico.

Mi firma indica mi autorización para emitir los archivos de mi hijo(a) a la Escuela Secundaria Cristo Rey Columbus.

Firma del EstudianteFecha

Firma del PadreFecha