Details – Catholic Schools

Applicant Information

Student Name:	Solorzano Kaitlin	Date	April 20, 2020
Sex	Female	Place of Birth	WASHINGTON,DC, United States
Email Address:		Home Address	1421 Belmont st nw B1 WASHINGTON, DC 20009 United States
Siblings	None		[]
Name	None	Grade
Religion:	Catholic	Baptized:	YES
Local Public School System:		Local Public School Child Would Attend:
Race of the Student:		Ethnicity of Student:	Hispanic

Family Information

	Mother	Father
Full Name	Elsa Guerra
Maiden Name	De Jesus
Country of Birth	Guatemala
Home Address	1421 Belmont st nw	B1
Home Phone	(703) 835 5115
Mother Cell Phone	(202) 486 0811
Preferred Email	elsagalarcon@gmail.com
Mother Occupation	Education
Employer	Edward c mazique
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
Occupation		Employer
Work Phone		Religion	Catholic
Parish/Church	Sacred heath	Person responsible for Tuition/Fee Payments:	Mother Elsa Guerra
Address, City, State, ZIP:	Washington DC 20009	Phone & Email:	(202) 486 0811

Emergency Contact Information

Contact #1:	Guerra Consuelo	Relation to Student:
Email Address:		Home Address:	1505 DOWNING STREET NE WASHINGTON, DC 20018 United States
Home Phone	(202) 468 1399	Other Phone
Contact #2	Solorzano Edith	Relation to Student:	Aunt
Email Address		Home Address:
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?	NO
If yes, please list (other forms will be required):
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:
Learning Disorder:	No known learning disorder

Home Language Survey

Primary language(s) spoken in students household:
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:	Father 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: , :

PERSON RESPONSIBLE FOR TUITION/FEES PAYMENT

Name:		Address:
Phone Number:		NOTES: