Application Booklet - Our Lady of Good Counsel High School

Application FormDATE RECEIVEDFOR OFFICE USE ONLYFEEAPPLICANT’S LEGAL NAME LAST FIRST MIDDLE INITIALMAILING ADDRESS STREET CITY STATE zIPCOUNTYPHONEBIRTH DATE AGE SEX ■ M ■ FRELIGIONPARISH (if Catholic)SCHOOL PRESENTLY ATTENDINGAPPLYING FOR GRADESCHOOL ADDRESS STREET CITY STATE zIPCheck the program for which you would like to be considered.(Note: Additional requirements for Ryken are outlined in the Ryken section.If not admitted to Honors, applicant will automatically be considered for College-Prep.)MR./DR.FATHER’S NAME LAST FIRST MIDDLE■ FATHER DECEASED■ NOT LIVING WITH FATHER■ Xaverian Honors■ College-Prep■ RykenOCCUPATION NAME OF EMPLOYER WORK PHONEWORK ADDRESS STREET CITY STATE zIP■ YES ■ NOFATHER A GOOD COUNSEL GRADUATE?IF YES, YEAR OF GRADUATIONMRS./MS./DR.MOTHER’S NAME LAST FIRST MIDDLE■ MOTHER DECEASED ■ NOT LIVING WITH MOTHEROCCUPATION NAME OF EMPLOYER WORK PHONEWORK ADDRESS STREET CITY STATE zIP■ YES ■ NOMOTHER A GOOD COUNSEL GRADUATE?IF YES, YEAR OF GRADUATIONAdditional immediate family members who have attended or are currently attending Good Counsel (include date of graduation and relationship to applicant)APPLYING FOR FINANCIAL AID? ■ YES ■ NO SUBMITTED A FINANCIAL AID APPLICATION? ■ YES ■ NO(e decision for acceptance is independent of financial aid application)