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St. Amelia School

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St. Amelia School
Online Registration
2025-2026

Please complete the Application for Enrollment form below, this is the first step in the enrollment process for your child. Please fill out a separate registration form for each student registering.

Required fields marked with an asterisk *

Which best describes your child? *

New Student (Current Family)

New Student (New Family)

Student Information:

First Name

Last Name

Birthday

Student Gender

Male

Female

Does student have an IEP or 504 plan?

IEP

504

None

Street Address

City

Zip Code

State

What grade is student entering for the 2025-2026 school year?

Home District of Student

Name of Previous School

What Public School would your child attend if not St. Amelia School:

Student Race (choose all that appy)

Am. Indian / Alaskan

Asian

Black / African American

Pac. Is / Native Hawaiian

White

Is student Hispanic? *

Yes

No

Please select which option applies best: *

Family Household

Lives with Relatives / Friends

Foreign Exchange Student

Other (shelter, motel, hotel, or car)

St. Amelia School Photo/Video Release:

Has permission to be included in school photos and videos

Does not have permission to be included in school photos and videos

Examples of what we use photos and videos for include but are not limited to: social media posts, marketing material, and local newspapers articles.

Religious Affiliation of student

Date and Location of Baptism

Catholic Parish Affiliation of Student

Date and Location of Penance

Date and Location of First Communion

Parent Information:

Parent / Guardian #1

Prefix *

Mr.

Mrs.

Miss

Ms.

First Name

Religious Affiliation

Last Name

Address

City

Zip Code

State

Email

Mobile Phone

Maiden Name

Work Phone

Occupation

I have financial responsibility for this child *

Yes

No

I have legal custody *

Yes

No

Are you a graduate of St. Amelia School? *

Yes

No

Is this a divorced/separated family household? *

Yes

No

Relationship to child

if other please explain

If yes, what year did you graduate?

Marital status of parents: *

Married

Separated

Divorced

Single

Parent/ Guardian #1 is a single parent or has sole reponsibility for student

Parent / Guardian #2

Prefix *

Mr.

Mrs.

Miss

Ms.

First Name

Religious Affiliation

Last Name

Address

City

Zip Code

State

Mobile Phone

Email

Work Phone

Maiden Name

Occupation

I have financial responsibility for this child *

Yes

No

I have legal custody *

Yes

No

Are you a graduate of St. Amelia School? *

Yes

No

Is this a divorced/separated family household? *

Yes

No

Relationship to child

if other please explain

If yes, what year did you graduate?

Marital status of parents: *

Married

Separated

Divorced

Single

Emergency Contact Information:

(Emergency Contact should be person(s) other than parent(s) listed above)

Emergency Contact 1

First Name

Mobile Phone

Last Name

Alternate Phone

In the event of an emergency, Emergency Contact 1 may pickup my child.

Relationship

Emergency Contact 2

First Name

Mobile Phone

In the event of an emergency, Emergency Contact 2 may pickup my child.

Last Name

Alternate Phone

Relationship

Physician's Information

Physician's Information

Physician Street Address

Physician City

Physician State

Physician Zip code

Physician Phone

The following person(s) may NOT pick up my child:

By signing below, I am agreeing that the information provided above is accurate.

Select a date

2025-2026 Capacity Limitations - please read carefully

Thank you for registering your child(ren) and your interest in St. Amelia School.

Determinations for new student acceptance will be determined on an ongoing basis. If we are unable to enroll your child(ren), any Registration and Technology fees will be refunded.

If you have any questions or concerns, please email Jillian Golinski, Director of Advancement at admissions@stameliaschool.org.

Confirmation Email

Please remember that your application is not considered complete until we have received your child(ren)'s required documentation and applicable fees. If any documentation is missing or incomplete, you will receive an email from the school.

Payment can be submitted to the school office at 2999 Eggert Rd.

A confirmation email will be sent shortly after submission to verify we have received your application.

Attach pictures of any documentation you would like to include at this time. Documents can also be brought to the main office or emailed.

Upload File

Upload supported file (Max 15MB)

I accept terms & conditions

Thanks for submitting!

© 2025 by St. Amelia School

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