Enrollment

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Father Last Name (if different) Please enter valid data.

Father First Name REQUIRED Please fill out this field. Please enter valid data.

Father Cell Phone REQUIRED Please fill out this field. Please enter a phone number.

Father's Employer REQUIRED Please fill out this field. Please enter valid data.

Father's Work Phone Please enter a phone number.

Mother's Last Name (if different) Please enter valid data.

Mother's First Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Cell Phone REQUIRED Please fill out this field. Please enter a phone number.

Mother's Employer REQUIRED Please fill out this field. Please enter valid data.

Mother's Work Phone Please enter a phone number.

Home Address REQUIRED Please fill out this field.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Mailing Address (if different)

Additional Home Address (if applicable)

Email REQUIRED Please fill out this field. Please enter an email address.

Additional Email Please enter an email address.

Home Phone Number Please enter a phone number.

Emergency Contacts (other than parents) REQUIRED Please fill out this field.
Emergency Contacts 1
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Emergency Contact Phone Number Please enter a phone number.
Emergency Contacts 2
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Emergency Contact Phone Number Please enter a phone number.
Emergency Contacts 3
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Emergency Contact Phone Number Please enter a phone number.
Emergency Contacts 4
- First Name Please enter valid data.
  
  Last Name Please enter valid data.
- Emergency Contact Phone Number Please enter a phone number.

Child(ren) REQUIRED Please fill out this field.
Child 1
- Child First Name REQUIRED Please fill out this field. Please enter valid data.
- Child Last Name (if different from family name) Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Country of Birth REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Female Male Please fill out this field.
- Grade in the Fall REQUIRED Pre K Full Time (5 Day) Pre K M,W,F (3 Day) Pre K T, Th (2 Day) Kindergarten Grade 1-6 (1 Child) Grades 1-6 (2 Children) Grades 1-6 (3 Children) Grades 1-6 (4 Children) Please fill out this field.
- District of Residence REQUIRED Please fill out this field.
- Does your child have an IEP REQUIRED Yes No Please fill out this field.
- Ethnicity REQUIRED Hispanic or Latino American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Please fill out this field.
- Has this student received the Sacrament of Baptism? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- If baptized, please list church, location and date
- Has this student had their First Reconciliation ? Yes, please list the details in the next box No No, but I would like to discuss this and learn more.
- First Reconciliation details
- Has this student received their First Holy Communion? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- First Communion details
- Home Parish and location
- Primary Care Physician Name REQUIRED Please fill out this field. Please enter valid data.
- Primary Care Physician Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Dentist Name Please enter valid data.
- Dentist Phone Number Please enter valid data.
- Allergies? Yes, please list in the next box No
- Allergies
- Please provide a copy of your child(ren) birth certificate, immunization record, and Baptismal certificate (if applicable). Copies can be brought in to the school office, mailed to the school or emailed to: kelly.sano@stambroselatham.com. Thank you.
Child 2
- Child First Name REQUIRED Please fill out this field. Please enter valid data.
- Child Last Name (if different from family name) Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Country of Birth REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Female Male Please fill out this field.
- Grade in the Fall REQUIRED Pre K Full Time (5 Day) Pre K M,W,F (3 Day) Pre K T, Th (2 Day) Kindergarten Grade 1-6 (1 Child) Grades 1-6 (2 Children) Grades 1-6 (3 Children) Grades 1-6 (4 Children) Please fill out this field.
- District of Residence REQUIRED Please fill out this field.
- Does your child have an IEP REQUIRED Yes No Please fill out this field.
- Ethnicity REQUIRED Hispanic or Latino American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Please fill out this field.
- Has this student received the Sacrament of Baptism? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- If baptized, please list church, location and date
- Has this student had their First Reconciliation ? Yes, please list the details in the next box No No, but I would like to discuss this and learn more.
- First Reconciliation details
- Has this student received their First Holy Communion? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- First Communion details
- Home Parish and location
- Primary Care Physician Name REQUIRED Please fill out this field. Please enter valid data.
- Primary Care Physician Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Dentist Name Please enter valid data.
- Dentist Phone Number Please enter valid data.
- Allergies? Yes, please list in the next box No
- Allergies
- Please provide a copy of your child(ren) birth certificate, immunization record, and Baptismal certificate (if applicable). Copies can be brought in to the school office, mailed to the school or emailed to: kelly.sano@stambroselatham.com. Thank you.
Child 3
- Child First Name REQUIRED Please fill out this field. Please enter valid data.
- Child Last Name (if different from family name) Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Country of Birth REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Female Male Please fill out this field.
- Grade in the Fall REQUIRED Pre K Full Time (5 Day) Pre K M,W,F (3 Day) Pre K T, Th (2 Day) Kindergarten Grade 1-6 (1 Child) Grades 1-6 (2 Children) Grades 1-6 (3 Children) Grades 1-6 (4 Children) Please fill out this field.
- District of Residence REQUIRED Please fill out this field.
- Does your child have an IEP REQUIRED Yes No Please fill out this field.
- Ethnicity REQUIRED Hispanic or Latino American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Please fill out this field.
- Has this student received the Sacrament of Baptism? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- If baptized, please list church, location and date
- Has this student had their First Reconciliation ? Yes, please list the details in the next box No No, but I would like to discuss this and learn more.
- First Reconciliation details
- Has this student received their First Holy Communion? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- First Communion details
- Home Parish and location
- Primary Care Physician Name REQUIRED Please fill out this field. Please enter valid data.
- Primary Care Physician Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Dentist Name Please enter valid data.
- Dentist Phone Number Please enter valid data.
- Allergies? Yes, please list in the next box No
- Allergies
- Please provide a copy of your child(ren) birth certificate, immunization record, and Baptismal certificate (if applicable). Copies can be brought in to the school office, mailed to the school or emailed to: kelly.sano@stambroselatham.com. Thank you.
Child 4
- Child First Name REQUIRED Please fill out this field. Please enter valid data.
- Child Last Name (if different from family name) Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Country of Birth REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Female Male Please fill out this field.
- Grade in the Fall REQUIRED Pre K Full Time (5 Day) Pre K M,W,F (3 Day) Pre K T, Th (2 Day) Kindergarten Grade 1-6 (1 Child) Grades 1-6 (2 Children) Grades 1-6 (3 Children) Grades 1-6 (4 Children) Please fill out this field.
- District of Residence REQUIRED Please fill out this field.
- Does your child have an IEP REQUIRED Yes No Please fill out this field.
- Ethnicity REQUIRED Hispanic or Latino American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Please fill out this field.
- Has this student received the Sacrament of Baptism? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- If baptized, please list church, location and date
- Has this student had their First Reconciliation ? Yes, please list the details in the next box No No, but I would like to discuss this and learn more.
- First Reconciliation details
- Has this student received their First Holy Communion? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- First Communion details
- Home Parish and location
- Primary Care Physician Name REQUIRED Please fill out this field. Please enter valid data.
- Primary Care Physician Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Dentist Name Please enter valid data.
- Dentist Phone Number Please enter valid data.
- Allergies? Yes, please list in the next box No
- Allergies
- Please provide a copy of your child(ren) birth certificate, immunization record, and Baptismal certificate (if applicable). Copies can be brought in to the school office, mailed to the school or emailed to: kelly.sano@stambroselatham.com. Thank you.
Child 5
- Child First Name REQUIRED Please fill out this field. Please enter valid data.
- Child Last Name (if different from family name) Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Country of Birth REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Female Male Please fill out this field.
- Grade in the Fall REQUIRED Pre K Full Time (5 Day) Pre K M,W,F (3 Day) Pre K T, Th (2 Day) Kindergarten Grade 1-6 (1 Child) Grades 1-6 (2 Children) Grades 1-6 (3 Children) Grades 1-6 (4 Children) Please fill out this field.
- District of Residence REQUIRED Please fill out this field.
- Does your child have an IEP REQUIRED Yes No Please fill out this field.
- Ethnicity REQUIRED Hispanic or Latino American Indian or Alaska Native Asian Black or African American Native Hawaiian or other Pacific Islander White Please fill out this field.
- Has this student received the Sacrament of Baptism? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- If baptized, please list church, location and date
- Has this student had their First Reconciliation ? Yes, please list the details in the next box No No, but I would like to discuss this and learn more.
- First Reconciliation details
- Has this student received their First Holy Communion? Yes, please list the details in the box below No No, but I would like to discuss this and learn more.
- First Communion details
- Home Parish and location
- Primary Care Physician Name REQUIRED Please fill out this field. Please enter valid data.
- Primary Care Physician Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Dentist Name Please enter valid data.
- Dentist Phone Number Please enter valid data.
- Allergies? Yes, please list in the next box No
- Allergies
- Please provide a copy of your child(ren) birth certificate, immunization record, and Baptismal certificate (if applicable). Copies can be brought in to the school office, mailed to the school or emailed to: kelly.sano@stambroselatham.com. Thank you.

Non-refundable Registration Fee 250 – Individual 500 – Registering 2 or more

Saint Ambrose School applies $175 per registration fee paid towards 1 month's tuition payment. Registration fees are NON-REFUNDABLE.

I am applying for financial aid in the amount listed below. I understand that I will be notified if I am eligible in June. Until notified, I understand that I am responsible for the full tuition amount. REQUIRED Yes, I am applying and I understand. No, I am not applying for financial assistance. Please fill out this field.

By checking below, I, the above named person, agree that I will remit tuition payments as follows (please choose one option). REQUIRED Payment will be made in full no later than August 1, 2020 through FACTS. Ten payments to be made through FACTS beginning August 2020. Please fill out this field.

It is the tuition policy of the Albany Diocesan School Board to prohibit a student from entering class on the opening day of school if tuition payments are not current in accordance with the enrollment contract.

By checking the box below, I am responsible for all payments of all tuition and any after school charges. This agreement is made between Saint Ambrose School and me, the parent/guardian or another party responsible for the payment of all tuition charges.

I Agree Please select this field.