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  Student Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender
  
  Date of Birth REQUIRED Please fill out this field. Please enter valid data.
  
  Grade applying for REQUIRED Please fill out this field. Please enter valid data.
  
  Last school attended and grade REQUIRED Please fill out this field. Please enter valid data.
  
  School year applying for REQUIRED Please fill out this field.
  
  Are there other children you would like to apply for to ICOLPH at this time as well? If yes, please add their information here:
  
  Student #2
  
  Student name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter valid data.
  
  Grade applying for Please enter valid data.
  
  Last school attended and grade Please enter valid data.
  
  Student #3
  
  Student name Please enter valid data.
  
  Gender
  
  Date of Birth Please enter valid data.
  
  Grade applying for Please enter valid data.
  
  Last school attended and grade Please enter valid data.
  
  Parent/Guardian Name(s) REQUIRED Please fill out this field. Please enter valid data.
  
  Address REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Catholic
  
  Parish Please enter valid data.
  
  Why do you want your child(ren) to attend ICOLPH School? REQUIRED Please fill out this field.
  
  Please identify any special needs or concerns your child has including any emotional or physical needs, allergies, or learning differences. Please also indicate if your child has an IEP or 504 plan in place, and if so, what needs these plans address.
  
  How did you learn about ICOLPH School? REQUIRED Please fill out this field.
  
  Applications will be processed in the order in which they are received. Applicant families will be contacted within 1 week of application submission and advised as to availability in the desired grade.
  
  Submit