DATE APPLICATION RECEIVED: _________________ APPLICATION FOR GRADE:__________

Our Lady of Guadalupe School

40374 Fremont Blvd.

Fremont, CA 94538

(510) 657-1674 Office

(510)657-3659 Fax

Child’s Name: ____________________________________________________________ Present Grade: ________________

Last First Middle

Birthplace: ____________________________________ Birth Date: ____/____/____ Religion: ______________________

Address: ________________________________________________ Telephone: ______________________________

_________________________________________________

MOTHER: FATHER:

Maiden Name: _______________________________________ Name: _____________________________________________

Address: ______________________________________________ Address: ____________________________________________

______________________________________________ ____________________________________________

Telephone: ___________________ Religion: _________________ Telephone: __________________ Religion: ______________

Birthplace: ___________________ Marital Status: ____________ Birthplace: __________________ Marital Status: __________

U.S. Citizen: __________________ Nationality: _______________ U.S. Citizen: ________________ Nationality: _____________

Occupation: ____________________________________________ Occupation: _________________________________________

Business Name: _________________________________________ Business Name: ______________________________________

Address: _______________________________________________ Address: ____________________________________________

_______________________________________________ ____________________________________________

Business Phone: ______________ Cell Phone: ________________ Business Phone: ______________ Cell Phone: ________________

Your Catholic Parish: ___________________________________ Language spoken at home: _____________________________

Name of person who has legal custody of this child: __________________________________________________________________

Home Conditions: ____child lives with both natural parents ____child lives with grandparents

(Check all that apply) ____child lives with only natural mother ____child lives with only natural father

____mother is remarried ____father is remarried

____child is in contact with both natural parents

____child is in contact with only one parent (which parent)___________

____child lives with one natural parent and a step-parent

Other children (brothers, sisters, cousins, etc.) presently living at home with this child

NAME AGE SEX SCHOOL ATTENDING

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Transferring or Previous School including preschool:

Name of School: _________________________________ Year(s) attended: _______________________________

Address: ________________________________________ Phone Number: ________________________________

Name of School: _________________________________ Year(s) attended: _______________________________

Address: ________________________________________ Phone Number: ________________________________

If your child has been attending public school, has he/she attending religious education classes (CCD) regularly in the past school year?

YES _________ NO_________

Why do you want your child/children to attend Our Lady of Guadalupe School?

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

____________________________________________________________________________________________________________

Sacraments received by your child:

Baptism Date: ___________ Church: _______________________ City & State: ___________________

First Communion: Date: ___________ Church: _______________________ City & State: ___________________

Reconciliation: Date: ___________ Church: _______________________ City & State: ___________________

Please attach copies of the following:

Birth Certificate

Baptismal Certificate (Catholics Only)

Proof of First Communion and Reconciliation (Catholics Only)

Report Card (most recent)

Please attach a check or money order for $40.00

Payable to OUR LADY OF GUADALUPE SCHOOL

PLEASE BE SURE THAT ALL SECTIONS ARE COMPLETE AND ALL REQUESTED ITEMS ARE ATTACHED.

THANK YOU FOR APPLYING TO OUR LADY OF GUADALUPE SCHOOL