Mother Brunner Catholic School New Student Checklist

Student Name: ______________________________ Grade 18/19 ________

All application forms must be turned in to school office to process your student’s application. Parents must call the school office to schedule a screening assessment appointment. There is a screening fee of $25 for students entering Grades 1-8 and is due before the screening appointment. Parents will be notified of admissions decision within 20 days of completing the application process.

Application Process:

Mother Brunner Catholic School Admissions Application

Principal/Teacher Recommendation Form

Mid-Year Release of Records Form

Copy of Most Recent Report Card

Copy of Most Recent Standardized Test Scores

Testing Fee - $25 per Student (Grades 1-8)

Birth Certificate – Copy of Official Birth Certificate

Baptismal Certificate – Copy (Catholic Only)

Immunization Records – Copy

Custody Papers – Copy (If Applicable)

School Records Release (White Form)

Tuition and Fees Commitment Form

Final Release of Records Form

Ohio EdChoice Scholarship paperwork (If Applicable) EdChoice Scholarship Request Form Proof of Address (Copy of current Utility Bill)

DPS Assignment Letter

Once notified of acceptance parents have 5 days to provide and complete registration to guarantee the student’s placement for the upcoming school year:

Payment of Family Registration Fee of $250 (Non-Refundable).

Mother Brunner Catholic School Admissions Procedure for New Applicants

1. Submit the completed the admissions application packet to the school office: • Student Admissions Application Form • Copy of Most Recent Report Card • Copy of Most Recent Standardized Test Scores • Principal/Teacher Recommendation Form • Mid-Year Release of Records Form • Annual Tuition & Fees Commitment Form • Final Release of Records Form

2. Admissions Screening Assessment:

• Call school office to schedule a screening assessment for your student entering grades K-8.

• Completed Admissions Application packet must be submitted to the school office prior to screening assessment appointment. A Screening Assessment fee of $25 per student is due on or before the scheduled screening date for students entering grades 1-8. (payment must be in the form of cash, check or money order)

3. Admission Decision/Confirmation:

• The administrators’ decision is based on the results of the screening, student’s academic and behavior records. Parents will be notified of the administrators’ decision usually within 20 days of completing the application process.

• Student must be in good financial standing with current school.

4. Accepted Students - Complete Registration Packet for Admitted Students • Pay Non-Refundable Family Registration fee of $250.00 • The registration process must be completed within 5 days of acceptance to

guarantee the student’s placement in the upcoming school year.

Student Name: _________________________________ Current Grade Level: __________________

Current School: _________________________________ Principal: ___________________________

School Address:_________________________________________ FAX #:_____________________

I give permission for my child’s’ current principal/teacher to complete this recommendation form. I

understand that it is a required component of the applications process.

_______________________________ _________________________

Parent/Guardian Signature Date

Please have current school complete the following and return to our school. Please answer the following questions in regards to the above named student: use reverse side if necessary.

Yes No

1. This student has received small group instructional assistance, LD remedial tutoring, or other

supplemental support services. If yes, please list areas and the year (s) in which the student received assistance:

2. This student is on an ISP, IEP, 504, action plan or building plan

If yes, please lists areas it covers:

Please forward a copy

3. This student’s family has taken care of their financial obligations to our school in a timely manner.

Circle one number per question. 1 = No, hardly ever 5 = Yes, almost always

1. This student consistently follows teacher’s instructions. 1 2 3 4 5

2. This student stays calm while accepting criticism. 1 2 3 4 5

3. This student is respectful and does not argue with authority. 1 2 3 4 5

4. This student puts forth effort in school. 1 2 3 4 5

5. This student completes homework with quality. 1 2 3 4 5

6. This student arrives to school on time. 1 2 3 4 5

7. This student gets along with other students. 1 2 3 4 5

8. This student’s parents have attended parent teacher conferences 1 2 3 4 5

and other required meetings.

9. This student exhibits recurring disciplinary concerns. Yes No

If yes, please explain (i.e. student has had excessive detentions, suspended or expelled)

Completed by ____________________________ Phone Number ________________ Date__________

School Official Name

Principal/Teacher Recommendation Form Mother Brunner Catholic School

4870 Denlinger Road, Dayton, Ohio 45426

Phone: 937-277-2291 Fax: 937- 277-2217

4870 Denlinger Road, Dayton, Ohio 45426 Phone: 937-277-2291 Fax: 937- 277-2217

www.brunnercatholicschool.org

Completion of this form gives your current school permission to forward your latest quarter’s

report card and standardized test scores to Mother Brunner Catholic School.

Upon completion, turn this form into your school office.

THE APPLICANT SHOULD NOT MAIL THIS FORM TO MOTHER BRUNNER.

Student Name ______________________________ Birth Date ____________________________

Address ________________________________________________________________________

Street City State Zip

I, __________________________, the parent/guardian of_________________________________,

Parent name Student name

request __________________________, _____________________________________________

School School phone

___________________________________________________________________

School address

to provide copies of school record information to Mother Brunner Catholic School. Such records

should include copies of all school records as defined by public law 93-380, and any amendments

thereto, including latest quarter report cards, State of Ohio Achievement Test Scores and any

current standardized test scores. In addition, if applicable forward copies of ISP’s., IEP, MFE’s, 504

& Building Plans. The purpose of these records is for consideration of admission only.

Parent/Guardian signature ____________________________ Date ___________________

Relationship to child ________________________ Phone number ____________________

School Administrator:

Please return the student recommendation form and all pertinent academic records requested

above to the Mother Brunner Catholic School.

Mid-Year Release of Records Request Mother Brunner Catholic School

4870 Denlinger Road, Dayton, Ohio 45426

Phone: 937-277-2291 Fax: 937- 277-2217