Application Form

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Student Information

Please Choose Which Grade You Are Applying For:*Grade 7Grade 9Other

Please specify*

First Name*

Middle Name

Last Name*

Please upload a recent photo of Applicant*

(gif, jpeg, jpg, png)

Date*

Home Address*

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Home Phone - -

Emergency Phone* - -

Fax - -

Cell Phone - -

Age*

Date of Birth*

Place of Birth*

Social Security Number*

###-##-####

Religion*

Parish*

Ethnic Origin*

Name of Present School*

Grades Attended*

Address of Present School*

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Phone* - -

Former Schools
(List in order, beginning with most recent)

School Name

School Address

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Address 1:

City:

Country:

State/Province:

Postal Code:

Grades Attended

School Name

School Address

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Grades Attended

Financial Aid

Person responsible for payment of tuition:*FatherMotherGuardianOther

Payment Person's Name*

Payment Person's Address*

Use Google Smart Search for Address

Address 1:

City:

Country:

State/Province:

Postal Code:

Payment Person's Social Security Number*

###-##-####

Will you be applying for financial aid?*

*If yes, the application can be completed on the School Scholarship Service website at sssbynais.org. This information is completely confidential and in no way influences the admission decision.

Is this student the first in her family to be attending Villa Walsh Academy?*

Please list all relatives who have attended Villa Walsh Academy:*

Please include names, graduation year, and relationship.

Please list all siblings (include name, age, grade, and school for each):*

Optional Information

This information is not required, but will assist in providing the services required by a student. It will not influence the admission decision in any way.

Does the student have any restrictions due to illness or physical challenge?

Please describe:

Has the student been classified by a professional as having a learning disability?

Please describe:

Academic and Co-Curricular Information

(To be filled out by the Applicant)

Indicate scholastic honors and prizes you have received:*

List the books you have read during the past year. Star those which were required for class.*

Indicate significant school and community activities (e.g. dramatics, band, athletics, student government):*

Indicate special training you have received and length of time you have participated in that activity (e.g. piano - 4 years, ballet - 6 months)*

In which academic subjects are you particularly interested? Why?*

In which academic subjects are you least interested? Why?*

Indicate your hobbies and interests:*

Why do you wish to attend Villa Walsh Academy?*

Application Form

Student Information

Parent/Guardian Information

Financial Aid

Optional Information

Academic and Co-Curricular Information

Nurturing the gifts that God gives to each student
who graces our halls.

Application Form

Student Information

Parent/Guardian Information

Financial Aid

Optional Information

Academic and Co-Curricular Information

Nurturing the gifts that God gives to each student who graces our halls.

Nurturing the gifts that God gives to each student
who graces our halls.