Parkersburg Catholic High School

PARKERSBURG CATHOLIC HIGH SCHOOL

3201 Fairview Avenue

Parkersburg, WV 26101

304-485-6341  Fax 304-485-4697

Date of Application______

Enrollment For ______School Year

Student’s Name______
Last First Middle
Address______
City______State ______Zip Code ______
Home Phone ______SS#______Gender ____M ___ F
Date of Birth______City/State of Birth______
Number of Children in Family______Boys______Girls______
Any Other Children Including Applicant Enrolled at PCHS or PCES______
Student’s Religion______Church Attended______
Public School Your Child Would Have Attended______Grade Entering______
Optional (Please check all that apply) Asian______Black (Afro-American)______Caucasian(Non Hispanic)______
Hispanic______Native American______Other______

RECEPTION OF SACRAMENTS (Catholic Students Only)

Baptism Date______Church/City/State______
First Eucharist Date______Church/City/State______
Confirmation Date______Church/City/State______

PREVIOUS SCHOOL ATTENDED

Name______
Address______City______State______Zip Code______
Last Report Card G.P.A.______Estimated G.P.A. (Last Two Years)______
NOTE: Please attach test reports, transcripts, report cards, attendance, immunization record, birth certificate, and health history forms from past school years.

FAMILY BACKGROUND

Father’s Name______
Address (If different from student)______
Employer______Occupation______
Cell Phone______Work Phone______
Email ______Religion______
Level of Education: High School______2 Year College______4 Year College______Master’s Degree______Ph. D.______
Mother’s Name (Include Maiden) ______
Address (If different from student)______
Employer______Occupation______
Cell Phone______Work Phone______
Email ______Religion______
Level of Education: High School______2 Year College______4 Year College______Master’s Degree______Ph.D.______
Step Parent’s Name______
Address (If different from student)______
Religion______Occupation______
Employer______Work Phone______
Level of Education:High School______2 Year College______4 Year College_____ Master’s Degree______Ph.D.______
Has your child received any special services or been involved in any of the items listed below? (Please check below)
Physical Therapy______Gifted-Talented______Speech Therapy______Learning Disabilities______
Counseling______Medical Trauma______Other Health Impaired______Other______
If any of the above are answered yes, please explain______
______
Does he/she have an IEP? Yes_____ No_____ If yes, please attach it.
Does he/she have a 504 Plan? Yes____ No_____ If yes, please attach it.
Does your child have any physical or emotional conditions which warrant special consideration? Yes______No______
Please explain______
______
______
Any medication prescribed? Yes____ No____ If yes, what?______
______

PARKERSBURG CATHOLIC HIGH SCHOOL REGISTRATION FORM Page 2 of 3

Do you need financial aid information? Yes______No______
Has your child ever been expelled or suspended from any previous school? Yes______No______
If yes, please explain______
______
______
Are you aware of W.V.S.S.A.C. rules regulating participation in extra-curricular activities for the students transferring from one school to another school?
Yes___ No____
Has the student ever been arrested or convicted of a crime? Yes______No_____
Under the jurisdiction of the court? Yes______No______
If yes, please explain______
______
______
Is there anything else that we need to know or that you want to tell us about your child that would help us educate him/her? ______
______
______
What are your expectations for your son/daughter at PCHS? ______
______
______

REGISTRATION FEE

The non-refundable registration fee is $100

By signing below, I am acknowledging that I/we must sign up for a FACTS tuition plan.

Signature of Parent or Legal Guardian______Date______

PARKERSBURG CATHOLIC HIGH SCHOOL REGISTRATION FORM Page 3 of 3

Philosophy

Parkersburg Catholic High School is a diocesan coeducational Catholic faith community whose basic goal is the development of individual students as Christian social beings. The school offers a curriculum designed to prepare students for college and other post-high school educational opportunities. To provide a quality education, PCHS strives to make effective use of various educational enhancements offered by parents, parishes, other educational institutions, and business/community programs. All educational efforts are directed toward the formation of the total person -- intellectually, morally, socially, physically, and spiritually.

A Catholic school, PCHS stresses the development and practice of Christian values. All aspects of the school emphasize the individual value of the student. Following Christian tradition, the school is open to students of all religions, races, national origins, and academic needs.

Mission Statement

Parkersburg Catholic High School, in partnership with the Diocese of Wheeling-Charleston, the community and the parishes, is committed to serve all students spiritually, academically, culturally, technologically, and physically, and to provide them with a wide variety of activities that meet the highest standards of educational excellence.

We believe that all students can learn; therefore, the mission of Parkersburg Catholic High School is to provide effective instruction in basic skills, to develop the potential of all students, to nurture a sense of individual worth, to build a foundation for lifelong learning in a changing world, and to teach students how to fully live their faith.

BE IT KNOWN TO ALL WHO ENTER HERE THAT CHRIST

IS THE REASON FOR THIS SCHOOL, THE UNSEEN BUT EVER PRESENT TEACHER IN ITS CLASSES, THE MODEL OF ITS FACULTY, THE INSPIRATION OF ITS STUDENTS.

Thank you for choosing Catholic education for your child