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2023-2024 Application

- Admissions

Mandatory application checklist
Your registration will not be considered complete until all applicable items are received.
1. Application Form (see below)
2. Commitment Fee paid via FACTS Account (The Commitment Fee can be paid shortly after the application is submitted.)
3. Application for Private School Transportation (K-8 Only)
4. Loan of Textbooks (K-8 Only)
5. Request for Records (K-8 Only)
Health Office Requirements

All health forms must be submitted before your child will be allowed to attend school.
1. Healthy History and Physical Exam Form
2. Immunization Record from your child's physician's office
3. Special Health Considerations (if your child has special health needs such as allergies, asthma, or other health conditions)
Note: Roman Catholic families must provide a recent copy of your child/ren's baptismal certificate. Please contact the church where your child was baptized for this documentation. We will also gladly accept baptismal certificates from students baptized in other faith traditions.

Thank you for choosing Immaculate Conception School!

Application Form

The maximum number of form submissions has been reached. This form is currently not available.

Please check all that apply. REQUIRED I am submitting an application for a new student(s). I am reregistering a current student. I am submitting an application for a sibling of a current student. Please fill out this field.
Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Number of Children to be Registered REQUIRED Please fill out this field.
- Student 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 4
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 5
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 6
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 7
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 8
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 9
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 10
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2023 REQUIRED Please fill out this field.
  - School and Location Transferring From (If Applicable) Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Number of Parents/Guardians REQUIRED Please fill out this field.
- Parent/Guardian 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street 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.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
- Parent/Guardian 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street 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.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
- Parent/Guardian 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street 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.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
- Parent/Guardian 4
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street 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.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
Parental Information
Marital Status REQUIRED Please fill out this field.
Student resides with REQUIRED Please fill out this field.
Custodial Parent/Guardian REQUIRED Please fill out this field.
Religious Preference REQUIRED Please fill out this field. Please enter valid data.
Registered Parish REQUIRED Please fill out this field.
If you answered Other, please include the name and city of your registered Parish. Please enter valid data.
Please note:
In order to receive the K-8 Catholic Subsidized tuition rate, the student must be a registered, practicing member of a Catholic parish within the Diocese of Metuchen. If you entered a Catholic parish within the Diocese of Metuchen, the school office will verify your eligibility for the K-8 Catholic Subsidized tuition rate.
Will your family pursue Tuition Assistance from the Diocese and/or Immaculate Conception School? REQUIRED Yes No Please fill out this field.
The following section reviews the Service Hour and SCRIP obligations for families with students enrolled in grades K-8. If you are a preschool ONLY family with no K-8 students, please indicate that in the selections below.
Service Hour Obligation Option (K-8th Grade Only)
Service Hour forms must be submitted for verification of hours completed NO later than May 31, 2024 (8th Grade families due April 30, 2024). Unfulfilled hours will be billed at a rate of $30/hour. For more details, please refer to the Service Hour Program.
Service Hour Obligation REQUIRED Please fill out this field.
Agreement for Service Hour Obligation (K-8 Only) REQUIRED Yes, I understand that if the buyout option is chosen, or if I have not fulfilled my obligation, the amounts agreed to will be included in my FACTS payments or Paid in Full by the assigned due date. I do not have any children enrolled in grades K-8 and therefore do not have a service hour obligation to fulfill. Please fill out this field.
Payments not received by the assigned due date will be assessed a 10% late fee. Outstanding payments not received within 45 days will be forwarded to a collection agency and may preclude re-admission for the next school year.
SCRIP Obligation Option (K-8th Grade Only)

Number of Children	Rebate Obligation	Buy-Out Amount
1	$350.00	$647.50
2	$370.00	$684.50
3+	$390.00	$721.50

Unfulfilled SCRIP rebates will be billed at a rate of 185% of the unfulfilled rebate amounts. SCRIP obligations must be fulfilled by May 31, 2024 (8th Grade families must be fulfilled by April 30, 2024). For more details, please refer to the SCRIP Program.
SCRIP Obligation Options REQUIRED Please fill out this field.
Agreement for SCRIP Obligation (K-8 Only) REQUIRED Yes, I understand that if the buyout option is chosen, or if I have not fulfilled my SCRIP obligation, the amounts agreed to will be included in my FACTS payments or Paid in Full by the assigned due date. I do not have any children enrolled in grades K-8 and therefore do not have a SCRIP obligation to fulfill. Please fill out this field.
Payments not received by the assigned due date will be assessed a 10% late fee. Outstanding payments not received within 45 days will be forwarded to a collection agency and may preclude re-admission for the next school year.

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