Student Questionnaire

	Student Admission Questionnaire

1.	Student Name

2.	Student's Current School

3.	Reason for Student Wanting to Leave Current School and Enter CHS

4.	Grade for which the student is applying
	Grade for which the student is applying 9 10 11 12

5.	Parent/Guardian Name

6.	Parent's E-mail Address

7.	How did you learn about Catholic High School (CHS)?

8.	Please write a short paragraph about why you want to transfer to CHS at this time:

9.	Please write a short paragraph about the activities, experiences, and qualities that make you unique:

10.	What do you like best about your current school?

11.	What do you like least about your current school?

12.	What subjects do you enjoy the most?

13.	What kind of extra help, specialized instruction or tutoring have you received from your classes in high school?

14.	Have you been placed on academic probation, failed any classes or grades, become ineligible for sports/activities due to academic problems?
	Have you been placed on academic probation, failed any classes or grades, become ineligible for sports/activities due to academic problems? Yes No

15.	If 'YES', please explain:

16.	Have you been in good attendance?
	Have you been in good attendance? Yes No

17.	If 'NO', please explain any problems with attendance or tardies:

18.	Please discuss any disciplinary incidents in which you have been involved:

19.	Are you eligible to return to your current school?
	Are you eligible to return to your current school? Yes No

20.	Have you been involved with the legal or juvenile court system?
	Have you been involved with the legal or juvenile court system? Yes No

21.	If 'YES', please explain:

22.	Who are some of your friends at CHS?

23.	Please list any concerns about your ability to be successful at CHS?

24.	Please feel free to add any additional information you feel is necessary to further explain repsonses to any of the questions above:

	I understand that, if accepted, I must follow all disciplinary, academic, and attendance guidelines as outlined in the parent/student handbook, including regulations that prohibit use of drugs and alcohol by all students at all times.

25.	I verify that the information I have provided on this form is accurate.
	Name of person making verification: