Application Form 2012 13 1

Topics: High school, Family, Middle school Pages: 2 (415 words) Published: December 3, 2014

Application Form

dATE rECEIVEd
FOr OFFICE UsE ONLY

FEE

APPLICANT’s LEgAL NAMELAsTFIrsTMIddLE INITIAL

MAILINg AddrEsssTrEETCITYsTATEzIP

COUNTY PHONE

BIrTH dATEAgEsEXM F

rELIgIONPArIsH (if Catholic)

sCHOOL PrEsENTLY ATTENdINgAPPLYING FOR GRADE

sCHOOL AddrEsssTrEETCITYsTATEzIP

Check 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.)

Xaverian Honors College-Prep ryken

Mr./dr.
FATHEr’s NAME
LAsT
FIrsT
MIddLE
FATHEr dECEAsEd
NOT LIVINg wITH FATHEr

OCCUPATIONNAME OF EMPLOYErwOrk PHONE

wOrk AddrEsssTrEETCITYsTATEzIP

YEsNO
FATHEr A gOOd COUNsEL grAdUATE?IF YEs, YEAr OF grAdUATION

Mrs./Ms./dr.
MOTHEr’s NAME
LAsT
FIrsT
MIddLE
MOTHEr dECEAsEd
NOT LIVINg wITH MOTHEr

OCCUPATIONNAME OF EMPLOYErwOrk PHONE

wOrk AddrEsssTrEETCITYsTATEzIP

YEsNO
MOTHEr A gOOd COUNsEL grAdUATE?IF YEs, YEAr OF grAdUATION

Additional immediate family members who have attended or are currently attending good Counsel (include date of graduation and relationship to applicant)

APPLYING FOR FINANCIAL AID?YEsNO SUBMITTED A FINANCIAL AID APPLICATION?YEsNO (e decision for acceptance is independent of financial aid application)

17301 Old Vic Boulevard I Olney MD 20832 I 240-283-3235 I www.olgchs.org Application Form continued

List any organizations, clubs and activities with the school or community in which the applicant has participated during the last two years. Mention any awards received in these activities.

Essay
Our Lady of good Counsel’s philosophy states: “In today’s world, the loving good person, even alone, can make a difference.” In 250 words or less, describe how you plan to make a difference in the good Counsel...
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