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Re-enrollment Form

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  Current Family Re-Enrollment
  for the 2022-2023 School Year
  
  This is an enrollment request for current St. Susanna School families. Registration fee is $100 per student and is due at the time of registration.
  
  Class Offerings for 2022-2023
  Preschool, MWF, Half Day (P3H)
            (must be Age 3 by August 1 & independently toilet-trained)
  Preschool, MWF, Full Day (P3F)
            (must be Age 3 by August 1 & independently toilet-trained)
  Preschool, M-F, Full Day (P5F)
            (must be Age 3 by August 1 & independently toilet-trained)
  Pre-Kindergarten, M-F, Half Day (PKH)      (must be Age 4 by August 1)
  Pre-Kindergarten, M-F, Full Day (PKF)      (must be Age 4 by August 1)
  Kindergarten, M-F, Full Day    (must be Age 5 by August 1)
  Grade 1 through Grade 8
            * Class offerings may be adjusted based upon confirmed enrollment.
  
  Parent's/Guardian's Name REQUIRED Maximum 41 characters Please fill out this field. Please enter valid data.
  
  Best Contact Email Address REQUIRED Please fill out this field. Please enter an email address.
  
  Best Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Home School District REQUIRED Please fill out this field. Please enter valid data.
  
  Religion REQUIRED Catholic Non-Catholic Please fill out this field.
  
  Parish Membership/Attended REQUIRED Please fill out this field. Please enter valid data.
  
  Number of Students Enrolling REQUIRED
  Number of children enrolling at St. Susanna School next year (including siblings new to St. Susanna School.)
  Please fill out this field.
  
  Student 1
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 2
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 3
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 4
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 5
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 6
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 7
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 8
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 9
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Student 10
  
  Child First Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Child Last Name REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Enrolling in Grade Level REQUIRED Please fill out this field.
  
  Is your child currently attending St. Susanna School? REQUIRED Yes, child is attending St. Susanna School presently. No, child will be a new student next school year. Please also complete a New Student Application at www.SaintSusannaSchool.com/apply   after submitting this Re-Enrollment Form. Please fill out this field.
  
  Number of children currently enrolled who will NOT be returning next school year? REQUIRED Please fill out this field.
  
  Non-returning Students 1
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 2
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 3
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 4
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 5
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 6
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 7
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 8
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 9
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  Non-returning Students 10
  
  Child First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  New School REQUIRED Maximum 40 characters Please fill out this field. Please enter valid data.
  
  Reason for Leaving REQUIRED Please fill out this field.
  
  ___________________________________________________________________________
  INDIANA DEPARTMENT OF EDUCATION MIGRANT WORKER SURVEY
  
  The Migrant Education Program (MEP) provides supplemental education and support services to eligible children through national funding. The purpose of the program is to ensure that all migrant students reach the academic standards and graduate with a high school diploma (or complete GED/HSE). The Indiana Department of Education requires that we identify these students by asking the following two questions.
  
  Work Survey Question #1 REQUIRED Yes, my children have moved (for any reason) within the last 3 years. No, my children have NOT moved (for any reason) within the last 3 years. Please fill out this field.
  
  Work Survey Question #2 REQUIRED Yes, someone in my household has moved for one school district to another within the United States to look for seasonal or temporary work in agriculture. No, no one in my household has moved from one school district to another within the United States to look for seasonal or temporary work in agriculture. Please fill out this field.
  
  ___________________________________________________________________________
  SCHOOL POLICY ACCEPTANCE
  
  Each year our school policies and procedures are reviewed, amended, and approved by our principal and school commission. We ask all families to review and accept the Parent & Student Handbook which includes the School Uniform Policy, Acceptable Use Policy, Health & Wellness Policy, and the Attendance Policy. These policies are posted on the school website. Please indicate that you will review and abide by all of the policies of St. Susanna School.
  
  School Policy Acceptance REQUIRED Yes, I will review with my child the Parent & Student Handbook including the Attendance Policy, Acceptable Use Policy, Health & Wellness Policy, and Uniform Policy and we will abide by all policies set forth. No, I need to discuss a policy concern with the school principal. Please fill out this field.
  
  ___________________________________________________________________________
  PESTICIDE NOTIFICATION
  
  Indiana State Law requires St. Susanna School to invite parents, guardians, & staff to be added to the pesticide registry at the start of each school year or when a student enrolls or transfers in. If you wish to be contacted via email 48 hours in advance of planned pesticide applications (such as yard fertilization or pest applications) on the parish campus, please complete a Pesticide Notification Registry form at the reception desk.
  
  ___________________________________________________________________________
  MEDIA RELEASE STATEMENT
  
  We believe that our students, staff, and school benefit from positive recognition. There may be occasions for media coverage during the school year that involves our students. We ask permission to release pictures or other communication to the media, should the opportunity arise. This may include, but would not be limited to: newspapers, news station coverage of events, our newsletter, bulletin boards, videos made during the school year, and our school website. Please indicate whether you do or do not grant permission.
  
  Authorize Media Release REQUIRED Yes, I grant permission No, I DO NOT grant permission. Please fill out this field.
  
  ___________________________________________________________________________
  REGISTRATION FEE
  
  Registration Fee is $100 per student and must be paid to secure placement in a class. The fee is non-refundable and will not be applied to any fees. Online enrollment without accompanying registration fee payments will not be processed. Plans for space allocations, classroom placement, and faculty assignments will be decided once registration figures are finalized.
  
  Method of Payment REQUIRED Check--Please send with student in backpack mail or remit to the school receptionist. Cash (exact amount)--Please remit to receptionist. Pay Online with Mastercard/VISA/Checking/Savings--www.saintsusannaschool.com/pay (no added bank fees) Please contact me about payment arrangements. We are a CHOICE family. We have no children returning--no amount is due. Please fill out this field.
  
  Additional Information
  
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