Applicant Information
| Student Name: | Solorzano Sofia | Date | April 20, 2020 |
|---|---|---|---|
| Sex | Female | Place of Birth | Washington,Dc, United States |
| Email Address: | elsagalarcon@gmail.com | Home Address | 1421 Belmont st nw B1 WASHINGTON, DC 20009 United States |
| Siblings | None | [] | |
| Name | None | Grade | 0 |
| Religion: | Catholic | Baptized: | YES |
| Local Public School System: | Local Public School Child Would Attend: | Edward c mazique | |
| Race of the Student: | Ethnicity of Student: | Hispanic |
Family Information
| Mother | Father | |
|---|---|---|
| Full Name | Guerra | Elsa |
| Maiden Name | Jesus | |
| Country of Birth | Guatemala | |
| Home Address | 1421 Belmont st nw | Washington |
| Home Phone | (703) 835 5115 | |
| Mother Cell Phone | (202) 486 0811 | |
| Preferred Email | elsagalarcon@gmail.com | |
| Mother Occupation | Eduacation | |
| Employer | Edward cmazique | |
| Mother Work Phone | ||
| Religion | Catholic | |
| Parish/Church | Sacred hearth |
| Parents’ Marital Status: | Separated* | Student lives with: | Mother Only |
|---|---|---|---|
| Full Name | Marvin Solorzano | Country of Birth | United States |
| Home Address | 1505 DOWNING STREET NE | Preferred Email | |
| Home Phone | (703) 835 5115 | Cell Phone | (703) 835 5115 |
| Occupation | Employer | Self employed | |
| Work Phone | Religion | Catholic | |
| Parish/Church | Sacred hearth | Person responsible for Tuition/Fee Payments: |
Mother |
| Address, City, State, ZIP: | Washington DC 20009 | Phone & Email: | (202) 486 0811 |
Emergency Contact Information
| Contact #1: | Guerra Consuelo | Relation to Student: | Aunt |
|---|---|---|---|
| Email Address: | Home Address: | 1505 DOWNING STREET NE WASHINGTON, DC 20018 United States |
|
| Home Phone | (202) 468 1399 | Other Phone | |
| Contact #2 | Edith Solorzano | Relation to Student: | Aunt |
| Email Address | Home Address: | 1505 DOWNING STREET NE WASHINGTON, DC United States |
|
| Other Phone | (202) 553 9462 | Home Phone |
Student Background Information
| Does your child need any particular academic enrichment in order to be successful in school? | NO |
|---|---|
| If yes, please explain briefly (other forms will be required): | |
| Has your child received special services from a professional (e.g. counselor, speech therapist, special education teacher)? | NO |
| Briefly describe the type of service, length of service, and if it discontinued, a reason for discontinuation: | |
| Does your child need accommodations to be successful in school? | NO |
| Please list: | |
| Does your child have any diagnosed allergies? | YES |
| If yes, please list (other forms will be required): |
Exema |
| Will your child require medication to be administered during the school day? | NO |
| If yes, please explain briefly (other forms will be required): | |
| Medical Diagnosis: Please check ✓ all that apply: | No known medical conditions |
| Physical Disability: | No existing physical disability |
| Learning Disorder: | No known learning disorder |
Home Language Survey
| Primary language(s) spoken in students household: | Spanish |
|---|---|
| Does primary guardian speak English? | YES |
| Is the Student Bi-Lingual? | YES |
| Does the student spend significant time with a non-English speaking caregiver? | NO |
Transferring Students
| Is the student transferring from another school(s)? | NO |
|---|
| Dates Attended | School Name | City | Phone Number | Grade Avg |
|---|---|---|---|---|
For Catholic Applicants Only
| Current Parish: | Sacred hearth | Pastor: | Emilio |
|---|
| Date | Church | City | State | |
|---|---|---|---|---|
| Baptism | April 7, 2023 | |||
| Date Reconciliation: | ||||
| Date First Eucharist | ||||
| Date Confirmation | ||||
| Date Other | Date Other |
Parent/Guardian Acknowledgment
| ALL STUDENT APPLICANTS | |
|---|---|
| TRANSFER STUDENT APPLICANTS ONLY | |
| Mother Names of Parents/Guardians | Elsa Guerra |
| Father Names of Parents/Guardians | |
| Mother Signatures | Elsa Guerra |
For Office Use Only
| Check ✓and Date when each item is received and verified |
|---|
| Applicant Name: |
| Application Received: |
| Application Fee Paid: |
| Baptismal Certificate: |
| Immunization Documents: |
| Birth Certificate: |
| If Applicable |
| Allergy Agreement :, |
| Custody Decree: , |
| Transfer Students ONLY: |
| Report Cards: , |
| Test Scores: , |
| Admissions Interview Completed: , |
| RELIGION: , |
| Catholic |
| Non-Catholic: |
| Parish Registration Form: , |
| STATUS: |
| Accepted: , |
| Denied: , |
| Grade:, |
| Homeroom Teacher: , : |
| Name: | Address: | ||
|---|---|---|---|
| Phone Number: | NOTES: |