All Saints Elementary of Tipperary Hill
112 SOUTH WILBUR AVENUE
SYRACUSE, NEW YORK 13204
(315) 422-3140
www.allsaintselementary.net
Boy: ___ Birthdate*: ______
Girl: ___
For Grade: ______Year: 20______
Application Date: ______
*Applicants for Kindergarten must be 5 years old by December 1st
Child’s Name: ______
Last First Middle
Home Address: ______
Street City Zip Code
Home Phone: ______Email Address:______Parish: ______
Present School: ______Grade: ______
School Address: ______
Street City Zip Code
Former Schools Attended: ______
Place of Birth: ______
City State
Baptism: ______
Date Church City/Zip Code
First Communion: ______
Date Church City/Zip Code
First Penance: ______
Date Church City/Zip Code
Father's Name: ______
Last First Middle
Place of Birth: ______
Religion: ______Occupation:______
Business Address: ______Work phone: ______
Mother's Maiden Name: ______
Last First Middle
Place of Birth: ______
Religion: ______Occupation:______
Business Address: ______Work phone: ______
Student’s Primary Language: ______
Does your child have special learning needs? Yes _____ No_____
Has your child ever been tested for a learning disability? Yes _____ No _____
Does your child have an IEP? Yes _____ No _____
Does your child have a Section 504 Plan? Yes _____ No _____
If you child has an IEP please attach a copy for our review
Reasons for applying to All Saints- Please be specific
Mother’s: _____________
______
______
Father’s:______
______
______
***
Have you toured our school? ______Date of tour: ______
Please check any special circumstances:
Parents separated: ___
Father remarried: ___
Mother remarried: ___
Other children in your family:
______
Name Age Current Grade Also applying to ASE? For Which Grade?
______
Name Age Current Grade Also applying to ASE? For Which Grade?
Please note: This is an application only. After the faculty and principal have evaluated the applicant's records, you will be notified. Priority will be given to children who have other family members currently enrolled at ASE.