Application for Admission

St. Pius V Catholic School

7681 Orangethorpe Ave.; Buena Park, CA 90621

Tel: 714-522-5313 Fax: 714-522-1767

Date
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Siblings Presently at St. Pius (Grade) Click here to enter text. / Siblings Also Applying (grade) Click here to enter text.
OFFICE USE ONLY TESTING DATE/TIME______
STUDENT INFORMATION
LEGAL Last Name
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☐ / Female
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Street Address
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City/Zip
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Date of Birth
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Primary Language at Home
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SACRAMENTS
Baptism / Date
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Reconciliation / Date
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1st Eucharist / Date
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Family Information - Father
LEGAL Last Name
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Place of Birth
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Place of Work
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Family Information - Mother
LEGAL Last Name
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Place of Birth
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Place of Work
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Home Situation

Check the best situation

☐ / 1.  Living with both parents married to each other
☐ / 2.  Living with both parents not married to each other
☐ / 3.  Parents separated: ☐ Living with Mother ☐Living with Father
☐ / 4.  Father not living; ☐Living with Mother alone ☐Mother and Stepfather
☐ / 5.  Mother not living; ☐Living with Father alone ☐Father and Stepmother
☐ / 6.  Parents divorced: ☐Living with Mother alone ☐Mother and Stepfather
☐ / 7.  Parents divorced: ☐Living with Father alone ☐ Father and Stepmother
☐ / 8.  Living with guardians who are relatives
☐ / 9.  Living with: ☐ single Mother ☐ single Father
☐ / 10.  Living with: ☐ foster Mother ☐ Father (Check both if applicable)
☐ / 11.  Other, explain

*  If any number other than “1” is checked, who has custodial rights or is a guardian?

Family Information – Legal Guardian
Legal Last Name
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Work Place
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Place of Birth
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Legal Documentation must accompany this form
Previous Schooling – School last attended
Name
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Address
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City/State/Zip
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Mission Statement of St. Pius V Catholic School

We, the St. Pius V Catholic School clergy, administration, faculty, and staff, join with parents in building God’s Kingdom through the intellectual and spiritual education of our students, kindergarten through eighth grade, as we prepare them for today and for the future. As a school community, we are guided by our faith in Christ, sustained by our hope for the coming of His Kingdom, and empowered by our love for each other and God.

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