Upload
others
View
1
Download
0
Embed Size (px)
Citation preview
APPLICATION FOR ADMISSION
Student Name ______________________________________________________________Last First
Date App received___________________
Initials______________________________
Please submit your completed application along with the following documents by February 5, 2021. Students accepted at other Catholic high schools will not be considered for admission. If you plan to transfer from another high school, please contact the Admissions office before filling out an application.
Final 7th grade report card
8th grade 1st and 2nd quarter grades (First quarter grades must be submitted with the applicaton and all other supporting documents. Second quarter grades may be submitted once they are available).
A copy of the applicant's most recent spring standardized test national percentile rankings in Reading and Math (Aspire or MAP are the most common, and we will accept spring of 6th grade through fall of 8th grade).
a) 7th or 8th grade English or Math teacherb) Any teacher, counselor, employer, volunteer supervisor, or pastor who knows the applicant well
A copy of the applicant’s birth certifi cate demonstrating he/she will be fourteen years old by September 1 of his/her freshman year
A non-refundable application fee of $25.00 should accompany each application. Please make check or money order payable to Cristo Rey Jesuit High School. Cash is not accepted.
A copy of parents’ 2019 or 2020 complete tax forms (including all forms, schedules and W2s)
The two most recent payroll check stubs for each household wage earner
Enclosed financial aid application is required
Cristo Rey Jesuit High School
1852W. 22nd Place | Chicago, IL 60608
Ph. 773.890.6838
Two enclosed Recommendation Forms completed by one from each of the following areas:
Student’s Personal Information
STUDENT INFORMATION
Home Address
City State Zip
Student Cell Phone
What school is the applicant currently attending?
Language spoken at home Ethnic Background
Does the applicant live more than 1.5 miles from Cristo Rey?
How will the applicant get to school?
CTA Car Walk Other
How did you hear about Cristo Rey?
Application for:
FreshmanYear SophomoreYear Junior Year
Last
Month
Full Name
Birth Date
Country of Birth
First
Day
MI
Year
Yes No
Ethnicity
Baptism
Reconciliation
First Communion
Confi rmation
In process of receiving, please include the date
Not interestedin receiving
Would like to receiveReceived
If Catholic, please check off the status of the applicant in regards to the following sacraments:
Religious Information
Religious Affiliation Parish
Emergency Contact (other than parents)
Full Name Phone Number Relationship
Full Name Phone Number Relationship
Student Email
Home Phone
Number of people who live in the household?
Total income of everyone working in the
house for the year
Relationship
Name
Country of Birth
Occupation Company Name
Home Phone Work Phone
Cell Phone
Highest level of education
Elementary High School Associates Bachelors Graduate School
Parents’ marital status
FAMILY INFORMATION
Divorced Separated Mom Deceased
Personal Data of Parent or Guardian I
Brothers or Sisters
Personal Data of Parent or Guardian II
Please list any siblings that have attended Cristo Rey
Name Age Name Age
Name Age Name Age
Name Age Name Age
Name Relationship
Name Relationship
Name Relationship
City State Zip
Home Address (if not the same as student’s)
City State Zip
Relationship
Name
Country of Birth
Home Address (if not the same as student’s)
Occupation Company Name
Home Phone Work Phone
Cell Phone
Highest level of education
Elementary High School Associates Bachelors Graduate School
Widowed Single
Graduation year
Graduation year
Graduation year
Number of people who live in the household?
Married or Two Parent Household
Does the applicant have any physical conditions of which the school should be aware (hearing, vision, diabetes, allergy, etc.)?
Is there medication involved? Please explain. If the student has a 504 Plan, please include a copy.
SIGNATURES
Parent or Guardian Signature Date
Student Signature Date
List any schools outside of Cristo Rey that the applicant is applying to.
List any sports and clubs that the applicant currently participates in.
Does the applicant have any previous job experience? If so, please describe.
STUDENT QUESTIONS
STUDENT’S EDUCATIONAL HISTORY
Is the applicant currently in an English as a second language (ESL) program? If yes, for how long?
Has the applicant ever had a psycho-educational evaluation, or been tested for a Learning Disability or Attention Defi cit Disorder?
If yes, when was the applicant tested? Evaluation and IEP must be forwarded.
Yes No
TO THE TEACHERThank you for filling out this recommendation. Your comments may be written in the space provided or
included on a separate sheet. Please seal this recommendation form in an envelope and return it to the
student. If this is not possible, please send the recommendation with this form to the address below.
Thank you for agreeing to comment on behalf of your student. Your insights are appreciated and will assist
us in determining whether Cristo Rey Jesuit High School is the appropriate school for this student.
TOTHE APPLICANT
Please fill out the following information and provide this form to your teacher. Be sure your teacher
completes this form and places it in a sealed envelope. Please include this form along with all other
materials requested in the application.
Students Name:
Student Home Address:
Name of teacher providing recommendation:
Number of years this teacher has known you:
STUDENT SIGNATURE: Date:
Office of AdmissionsCristo Rey Jesuit High School
1852W. 22nd Place
Chicago, IL 60608
TEACHER RECOMMENDATION
Student’s Name:
PROFILE
Founded in 1996, Cristo Rey Jesuit High School remains committed to serving Spanish speaking families with limited financial means, who seek out a Jesuit, Catholic and college preparatory education for their children. Cristo Rey's innovative Corporate Work Study Program enables all of our students to earn approximately 70% of their annual tuition by working one day a week at an entry-level position for a corporation or nonprofit agency across the Chicago area. Through its dual language curriculum, Cristo Rey nurtures students as they grow into fully bilingual and biliterate Latino leaders.
Teacher Email:
Please answer the following questions that address the academic and social capacity of this student.
Please rate this student in terms of the following:
Avg.AboveAverage Top 5%
No basis forjudgment
Motivation
Initiative
Responsible
Employable
Academically Competent
Written Work
Class Participation
Work Habits
Interpersonal Relations
Below Avg.
How well do you know the student?
What subjects/grades have you taught the student?
Please comment on the student’s work ethic and any other qualities that make the student unique.
To your knowledge, has the student ever engaged in special education courses? If so, to what level and/or amount
of hours is/was the student dedicated to special education classes?
Do you feel this student can handle the workload and demands of a college preparatory education?
Please provide any additional information you feel may be helpful.
Teacher Signature Date
TEACHER RECOMMENDATION
TO THE TEACHERThank you for filling out this recommendation. Your comments may be written in the space provided or
included on a separate sheet. Please seal this recommendation form in an envelope and return it to the
student. If this is not possible, please send the recommendation with this form to the address below.
Thank you for agreeing to comment on behalf of your student. Your insights are appreciated and will assist
us in determining whether Cristo Rey Jesuit High School is the appropriate school for this student.
TOTHE APPLICANT
Please fill out the following information and provide this form to your teacher. Be sure your teacher
completes this form and places it in a sealed envelope. Please include this form along with all other
materials requested in the application.
Student Home Address:
Name of teacher providing recommendation:
Number of years this teacher has known you:
STUDENT SIGNATURE: Date:
Office of AdmissionsCristo Rey Jesuit High School
1852W. 22nd Place
Chicago, IL 60608
Teacher Email:
Student's Name:
PROFILE
Founded in 1996, Cristo Rey Jesuit High School remains committed to serving Spanish speaking families with limited financial means, who seek out a Jesuit, Catholic and college preparatory education for their children. Cristo Rey's innovative Corporate Work Study Program enables all of our students to earn approximately 70% of their annual tuition by working one day a week at an entry-level position for a corporation or nonprofit agency across the Chicago area. Through its dual language curriculum, Cristo Rey nurtures students as they grow into fully bilingual and biliterate Latino leaders.
Please answer the following questions that address the academic and social capacity of this student.
Please rate this student in terms of the following:
Avg.AboveAverage Top 5%
No basis forjudgment
Motivation
Initiative
Responsible
Employable
Academically Competent
Written Work
Class Participation
Work Habits
Interpersonal Relations
Below Avg.
How well do you know the student?
What subjects/grades have you taught the student?
Please comment on the student’s work ethic and any other qualities that make the student unique.
To your knowledge, has the student ever engaged in special education courses? If so, to what level and/or amount
of hours is/was the student dedicated to special education classes?
Do you feel this student can handle the workload and demands of a college preparatory education?
Please provide any additional information you feel may be helpful.
Teacher Signature Date
SOLICITUD DE ADMISION
Nombre del estudiante ___________________________________________________________Apellido Nombre
Fecha recibida_____________________
Initiales___________________________
Favor de entregar la solicitud con los siguientes documentos a más tardar el 5 de febrero 2021. Los alumnos ya aceptados en otras secundarias católicas no seran considerados para admisión a Cristo Rey. Si desea transferirse de otra secundaria favor de comunicarse con la oficina de Admisiones antes de llenar la solicitud.
a) Maestro(a) de inglés o matemáticas del séptimo o del octavo gradob) Cualquier maestro, consejero, supervisor de trabajo,
o pá rroco que conozca bien al postulante
Copia del Acta de Nacimiento del postulante mostrando que el estudiante tiene catorce años de edad antes del primero de septiembre de su primer año de secundaria
Un pago sin reembolso de $25.00 debe acompañar la solicitud. Favor de hacer el cheque o giro a nombre de Cristo Rey Jesuit High School. No se acepta dinero en efectivo.
Copias completas de las formas de impuesto del 2019 o del 2020 de los padres (incluyendo todas las formas, W2, y anexos)
Dos talones de cheques más recientes de cada persona empleada en casa
Llenar la solicitud de ayuda financiera incluida (requisito)
Cristo Rey Jesuit High School
1852W. 22nd Place | Chicago, IL 60608
Ph. 773.890.6838
Boleta de califi caciones completa del séptimo grado
Calificaciones del primer y segundo periodo del octavo grado (califi caciones del primer periodo se deben entregar con la solicitud y los demás documentos. Las califi caciones del segundo periodo se pueden entregar cuando estén disponibles).
Una copia de los percentiles nacionales en lectura y matemáticas de los exámenes estandarizados más recientes (Aspire o MAP son los más comunes y podemos aceptar desde la primavera del sexto grado hasta el otoño del octavo grado).
Dos formas de recomendación llenadas por una de cada una de las siguientes áreas:
Esta solicitud es para:
Primer año Segundo año Tercer año
Nombre completo Nombre Segundo nombre
Sí No
Datos personales del postulante
INFORMACIÓN DEL ESTUDIANTE
Apellido
Fecha de nacimiento AñoMes
País de nacimiento
Domicilio actual
Ciudad Estado Zona postal
Celular del estudiante
Nombre de la escuela actual
Idioma utilizado en la casa Raza
¿El postulante vive a una distancia mayor de 1.5 millas de Cristo Rey?
¿Qué modo de transporte usará para venir a la escuela?
CTA Coche Caminando Otra
¿Cómo se enteró de la existencia de Cristo Rey?
Fecha de
NacimientoAño
Bautismo
Reconciliación
Primera Comunión
Confi rmación
En proceso de recibir, favor de indicar la fecha
No esta interesado
Le gustaríarecibirRecibido
Si el estudiante es católico, favor de indicar el estatus del postulante referente a los siguientes sacramentos:
Contacto en caso de emergencia (a parte de los padres)
Nombre y apellido Número de teléfono Parentesco al estudiante
Nombre y apellido Número de teléfono Parentesco al estudiante
Información religiosa
Religión Parroquia
Correo electrónico del estudiante
Día
Viudo (a)
Número de teléfono en casa
Parentesco
Nombre y apellido
País de nacimiento
Domicilio actual (si fuera diferente al del postulante)
Ocupación Lugar de trabajo
Teléfono en la casa Teléfono en el trabajo
Teléfono celular
Nivel educativo alcanzado
Primaria Secundaria Licenciatura Técnica Licenciatura Otro
Estado civil de los padres
INFORMACIÓN FAMILIAR
Datos Personales del Padre o Tutor I
Hermanos o Hermanas
Datos Personales del Padre o Tutor II
Favor de mencionar hermanos que han asistido a Cristo Rey
Nombre Edad Nombre Edad
Nombre Edad Nombre Edad
Nombre Edad Nombre Edad
Nombre Relación
Nombre Relación
Nombre Relación
Número total de personas que viven en la casa
Total del ingreso anual familiar
Parentesco
Nombre y apellido
País de nacimiento
Domicilio actual (si fuera diferente al del postulante)
Ocupación Lugar de trabajo
Teléfono en la casa Teléfono en el trabajo
Teléfono celular
Nivel educativo alcanzado
Primaria Secundaria Licenciatura Técnica Licenciatura Otro
Ciudad Estado Zona postal
Ciudad Estado Zona postal
Correo electrónico
Correo electrónico
Año de graduación
Año de graduación
Año de graduación
Número total de personas que viven en la casa
Soltero (a)Viudo (a)Casados/hogar con dos padres Divorciados Separados
FIRMAS
Firma del padre, madre, o tutor Fecha
Firma del postulante Fecha
¿Tiene el postulante algún problema médico o cualquier condición física de que la escuela deba saber (por ejemplo oído, vista, diabetes, alergias, etc)?
¿Toma alguna medicación? En caso de ser positiva la respuesta, favor de explicar. Si tiene un plan 504, favor de incluir una copia.
Enumere cualquier otra(s) escuela(s) además de Cristo Rey a la cual el postulante está aplicando.
Enumere cualquier actividad y/o deportes en las que el postulante participa actualmente.
¿Tiene el postulante alguna experiencia previa de trabajo? Si es así, favor de explicar.
CUESTIONARIO PARA EL ESTUDIANTE
HISTORIAL EDUCATIVO DEL ESTUDIANTE
¿Actualmente participa el postulante en un programa de inglés como segundo lenguaje (ESL)? ¿Si la respuesta es sí, desde hace cuanto tiempo?
¿Ha sido el postulante evaluado en los aspectos sicológico-educativos, problemas de aprendizaje y/o de atención?
Si la respuesta es sí, favor de indicar cuándo se realizaron dichos exámenes y le pedimos nos entreguen los resultados.
Sí No
Student Name / Nombre del Estudiante Grade / Grado 2021-2022
1.
2.
3.
Home Address / Domicilio:
City / Ciudad: __________________________ State / Estado: __________ Zip / Zona Postal:
Home Telephone # / Teléfono de Casa:
Parent / Guardian's Work # / No. del Trabajo del P(M) adre of Guardían :
Cristo Rey Jesuit High School FINANCIAL AID APPLICATION 2021-2022
INFORMATION ABOUT ALL FAMILY MEMBERS (INCLUDING PARENTS) INFORMACIÓN DE TODOS LOS MIEMBROS DE FAMILIA (INCLUYENDO PADRE Y MADRE)
Name of Members earning income
/ Nombres de Personas
Generando Ingreso Relationship to Student Occupation: Annual Income
Relación al Estudiante Ocupación Ingreso Anual
1. _
2. _
3. _
TOTAL ANNUAL HOUSEHOLD INCOME / TOTAL DEL INGRESO ANUAL FAMILIAR : $
INCLUDE CURRENT PAYSTUBS WITH APPLICATION. INCLUYA LOS TALONES DE CHEQUES MAS RECIENTES.
Names of all household members / Nombres de Personas viviendo en casa
Including student(s) / Incluyendo el estudiante Age / Edad Place of work or school name / Nombre del Empleo o Escuela
If in school, amt. of tuition / Si esta en la Escuela, monto annual de colegiatura:
1. ___
2. ___
3. ___
4. ___
5. ___
6. ___
7. ___
8. ___
RETURNING FAMILIES MUST COMPLETE/ PARA LAS FAMILIAS ACTUALES FAVOR DE CONTESTAR
CURRENT HOUSEHOLD FINANCIAL STATUS / ESTADO FINANCIERO ACTUAL FAMILIAR
If you are a returning family, what was your monthly tuition payment last school year?
Para las familias actuales cual fue su pago mensual de colegiatura el año pasado? $ __
STUDENT INFORMATION / INFORMACIÓN DEL ESTUDIANTE
Will your son/daughter receive another type of aid (Scholarship, Grant, or Private Assistance) outside of Cristo Rey to help him/her with tuition?
¿Va su hijo(a) a recibir otro tipo de asistencia financiera (Beca, Asistencia privada, u otra) fuera de Cristo Rey para ayudarle con su colegiatura?
No Yes Amount of Aid / Cantidad Otorgada: $
Please attach proof of income for each family member at home generating income. Include COPIES OF the following documents:
Favor de Incluir: Comprobantes de Ingresos para cada miembro en casa que genera ingreso. Incluya COPIAS DE los siguientes documentos:
1. Income Tax return for 2020 and all W-2 forms / Planilla de Contribución Sobre Ingresos del 2020 y todas las formas del W-2
2. If you are paying Tuition at any other School please include the statement. Si esta pagando colegiatura en otra escuela por
favor incluya una copia del estado de cuenta.
Please include other information or letter of explanation, which helps us understand your family financial income status. / Por Favor
incluye cualquier otra información o carta explicando su situación económica para mejor conocer su estado financiero familiar.
We, the undersigned, certify that all information presented is true and complete to the best of our knowledge and fully authorize CRJHS to verify the information here submitted. Nosotros, los abajo firmantes, aseguramos que toda la información presentada es verdadera y
completa y damos plena autorización a CRJHS para verificar la información aquí escrita.
Signature of Father, Stepfather or Male Guardian Signature of Mother, Stepmother or Guardian
Firma del Padre, Padrastro o Guardián Firma de la Madre, Madrastra o Guardián
Date / Fecha _________________________ Date / Fecha _________________________
Incomplete applications will not be accepted! / ¡Solicitudes incompletas no serán aceptadas!
CRISTO REY JESUIT HIGH SCHOOL does not discriminate on the basis of race, religion, color, gender, national or ethnic origin in its student admission process, faculty and staff hiring practices, educational policies, athletics and other school-
administered programs.
CRISTO REY JESUIT HIGH SCHOOL no discrimina a causa de raza, religión, color, género u origen nacional o étnico en el proce-so de admisión de estudiantes, en sus prácticas de contratación de personal, en sus normas educativas, de becas, programas de
atletismo u otros programas administrados por la escuela.
SIGNATURES / FIRMAS
OTHER TUITION PAYMENT SOURCES (MUST COMPLETE) / OTROS RECURSOS DE PAGO PARA LA COLEGIATURA
PROOF OF INCOME & ADDITIONAL INFO. / COMPROBANTES DE INGRESO E INFORMACIÓN ADICIONAL (REQUERIDA)