New Student Application/Registration
2014-2015
We are happy that you are considering St. Barnabas for your child’s education. The information below will be helpful as you consider applying to our school. If you have questions about any of these processes, please let us know and we will be glad to assist you. Returning students may use this registration form to reapply.
- Please submit a copy of the first semester report card for the current academic year along with results from previously completed standardized or individual testing data.
- Please make an appointment for an interview with the principal. This provides an opportunity to discuss your child’s gifts, academic strengths and areas of challenge. It is a time for candid discussion to insure that your child’s placement at St. Barnabas will provide the best learning environment possible and establish a partnership between home and school.
- Students enrolling in 1st – 8th grades for the upcoming school year will take a placement test on May 12th- 15th at 3:15 PM. This testing session will last 1 hour. Please have your child bring notebook paper and a pencil to the test. We will assess ability in reading, math and writing skills. This test is used in conjunction with report cards, standardized tests and the information shared in the interview to determine if the applicant is accepted. Please bring a copy of your child’s 3rd Quarter report card to the test.
- The Scholarship for Kids application (see additional attachment) needs to be completed in its entirety for any consideration of financial assistance. School registration deadline is May 23, 2014. Scholarship deadline is June 15, 2014. Classroom availability is on a first come basis.
- Once you have completed the required paperwork, the interview and placement test you will receive a letter confirming your child’s acceptance to St. Barnabas School.
- For full pay students, once you are accepted and your tuition rate is finalized, you will register online for FACTS Tuition Management to schedule your tuition payments through automatic bank draft. Tuition payments begin in July and end in April. Your tuition rate is divided into equal monthly payments during these months. FACTS accounts must be established by June 1st.(There is a $40.00 setup fee from FACTS.)
ST. BARNABAS REGIONAL SCHOOL
2014-2015 REGISTRATION FORM
Student’s Name______Grade Entering______
Name called______Who does your child live with?______
Address ______City______Zip______
Home Phone______Date of Birth______Social Security #:______
Religion______If Catholic, indicate parish______
If Catholic, indicate Sacraments received: ( ) Baptism, ( )First Penance ( ) First Communion
Sex: male ___ female ____ Race: Asian___AmericanIndian___Black____White______
Hawaiian/Pacific Islander___Hispanic____Multi-Racial____
School Attended before St Barnabas, if applicable______
Public School your child is zoned to attend______
How did you find out about St. Barnabas? ______
Sibling(s) that attend St. Barnabas ______
Father’s Name:______
Address:______City______State_____Zip______
Employed by______Work Phone______
Cell Phone______Email Address:______
Religion of Father:______
Mother’s Name:______
Address: ______
City:______State ______Zip Code ______Home Phone:______
Employed by: ______Work Phone: ______
Cell Phone:______Email Address: ______
Religion of Mother: ______
EMERGENCY CONTACTS OTHER THAN THOSE LISTED ABOVE
- ______Relationship to Child______
Indicate Phone Numbers available (H)______(W)______(CELL)______
2.______Relationship to Child______
Indicate Phone Numbers available (H)______(W)______(CELL)______
Do both contacts have permission to pick up the student? YES______NO______
ST. BARNABAS REGIONAL SCHOOL
2014-2015 REGISTRATION FORM
Parent is responsible for notifying office if there is a change in any of this information. The office MUST be able to reach a responsible party in case of illness, accident or any other emergency.
MEDICAL INFORMATION
Name of Pediatrician______Phone Number: ______
Known Allergies: ______
Medications your child takes on a daily basis: ______
Please tell us anything about your child’s current health condition: ______
Children are not allowed to have any medications in their book bags, lockers, handbags, pockets or desks. Classroom teachers are not allowed to dispense any medications. The office personnel can dispense medications brought from home by the parent that includes COMPLETE instructions on how the medication is to be taken by the child. Tylenol, aspirin, and any other headache medications are NOT kept in the office. These must come from home with instructions for dispensing.
When medication is brought to the office, a permission form must be completed and turned in with the medication and updated every 7 days as long as the student continues to take the medication at school.
I understand that, if in the event of an illness or accident, St Barnabas Regional School is unable to reach me or my designated emergency contact, they will call my child’s doctor. I agree to allow the school to take this action and any other action or treatment deemed necessary to help my child. I understand and agree to the conditions under which my child receives medication at school and that my child is not allowed to have any medications on his/her person during school hours.
Signature of Parent/Guardian______Date:______
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OFFICE USE ONLY: NEW STUDENTS ONLY: (*Required)
( ) Registration Fee ______*( ) Immunization (blue) form
Date Paid: ______*( ) Last Report card
( ) Form Completed on both sides ( ) Standardized Test Scores
( )Free/Reduced Lunch App *( ) Birth Certificate
( ) Beacons of Hope App/Supporting Documentation *( )Carpool Number ______( )Free/Reduced Lunch Application * ( )Social Security Number
( ) Beacons of Hope Application/Supporting
Documentaton ( ) Acceptance Letter
St. Barnabas Regional School
7901 First Avenue North
Birmingham, Alabama 35206
(205) 836-5385 · Fax (205) 833-0272
Authorization Form
Please complete the form indicating your permission for the areas below. Unless revoked in writing, this authorization will be in effect for the 2014-2015 school year.
Student Name______
Grade______Phone ______
Photo/Marketing Release
I, the parent/legal guardian grant my expressed permission for Saint Barnabas Catholic School to exhibit photographs or likenesses of the above-named student.
(Please initial to indicate permission, write in “no” to indicate refusal.)
____School publications (parent memos, principal’s newsletters, photo albums, etc)
____Yearbook (student picture, name, class pictures)
____Press/media releases (newspaper articles/features, brochures, school profile)
____Saint Barnabas website (no last names will be included).
Name ______
Address______Cell Phone ______
Home Phone ______Email ______
Parent Signature ______Date ______
Mission Statement
In our Catholic tradition of promoting Gospel values, the mission of St. Barnabas Catholic School
is to provide a safe and welcoming environment where learning takes place.
St. Barnabas Catholic School forms students spiritually and academically to become leaders and productive citizens.
Registration Documents for Students
Student’s Name ______
____ Returning Student _____New Student
The following documents are required for registration and must be returned for re-enrollment to be complete:
____ New Students copy of Report Card & Social Security Card (Transferring students setup interview with principal)
____Copy of transcript from prior school
____ Registration Form with Emergency Contact and Medical Information Included
____ Original Alabama Blue Immunization Form – make sure your child’s immunizations are current (with measles booster verification, Chicken Pox verification, DTAP for students entering 6th grade, etc.)
____ Registration and School Fees ($275, non-refundable) Due at time of registration
Registration Fee for Beacons of Hope $125
- This fee covers the basic cost of textbooks, application process and administrative costs
- All students are required to complete registration by May 23rd. After this date, the registration fee will be $150.
School Fees $150
- Technology$60
- Teacher Supplies$60
- PTA membership fee$10
- PTA Class party fee$20
____ Permission for Photo release, Internet Usage, Directory Form
____ Parish Verification Form, if Catholic this is required
____ Confirmation of FACTS account rollover and/or set up verification, required of all families
____ Scholarship for Kids Application with 2013 1040 Tax Return, if eligible
____ Beacons of Hope Signed agreement
St. Barnabas Regional School
7901 First Avenue North
Birmingham, Alabama 35206
(205) 836-5385 · Fax (205) 833-0272
2014-2015
Dear Parents:
This letter informs you about our web-based parent-teacher communication tool--SchoolSpeak. This website will provide you with access to information about your child’s school experience including homework assignments, lunch menus, school announcements and activities, the school calendar andaccess to your child’s grades.
It is required that we have an email address for ALL families in our school. After acceptance you will be receiving an email with your username and password for SchoolSpeak.
SchoolSpeak will be the norm for weekly messages to guardians and parents. Much of the information that will be posted may not be sent home any other way but through SchoolSpeak. It is imperative that you set up an email account. Google, Yahoo, Hotmail are all free email services that can be set up. Most phones also carry this capability.
Please complete this form
_____My email account has been set up.
This is my email address ______
_____I do not have internet access at this time, and I understand that I may
miss important announcements. (ie. school closing information)
Parent Signature: ______
Child’s name: ______