Apply | East Shoreline Catholic Academy (ESCA)

You can apply to the East Shoreline Catholic Academy online here, or you can print out and mail our application. Please review our admission process before applying, and keep in mind that applications will not be considered until ESCA receives the application fee.

Student Information

Last Name*

First Name*

Middle

Nickname

Student Home Address

Street*

City*

State*

Zip*

Home Phone*

Family Email Address*

Date of Birth*

Birthplace (City, State, Country)*

Grade Applying to*

Male/Female*:

Male

Female

Is student a U.S. citizen?*

Yes

Child lives with*:

Both parents

Mother

Father

Other

If "other individual," please indicate Name

Relationship to child

Father/Guardian Information

Prefix: (Mr./Dr.)

First Name*

Last Name*

Address (if different)

City

State

Zip

Home Tel. # (if different)

Work #

Cell #

Occupation*

Employer

Email Address

Custodial Parent

Yes

If no, please name custodial parent:

Mother/Guardian Information

Prefix: (Ms./Dr.)

First Name*

Last Name*

Address (if different)

City

State

Zip

Home Tel. # (if different)

Work #

Cell #

Occupation*

Employer

Email Address

Custodial Parent

Yes

If no, please name custodial parent:

Other Children in Family

Name	Age	Grade	School Attending

Please specify a language other than English spoken at home:
How did you hear about this school?*

Website

Family/Friends

Other

If "other," please specify:

Federal guidelines require us to record the Race/Ethnicity of every child. You must answer the following question and then indicate your race. Hispanic is considered an ethnicity and not a racist group.

Hispanic/Latino

American Indian

Alaska Native

Black/African American

Hawaiian Native/Pacific Islander

White

Religious Information

Religion of: Student*

Father

Mother

Guardian

If Catholic, please list the parish(es) or church your family is registered with or regularly attends:

Parish/Church

Town

Does your family contribute to your parish via the envelope system?

Yes

Please provide the following information concerning the applicant:

Baptismal Date

Name of Church

Town

State

First Communion Date

Name of Church

Town

State

Confirmation Date

Name of Church

Town

State

If not Catholic, please note denomination:

Academic Background

Please list all schools the applicant has previously attended:

School Attended	Grade Completed	Years Attended	Reason for Leaving

Has your child ever been expelled or refused admission or readmission by any school?*

Yes

If yes, state the name of the school, and the reason for the action:
Has your child ever received or been evaluated for Special Education Services in a private or public setting?*

Yes

If yes, please identify below who did the evaluation, and provide a brief description of the services required and the services provided:
Has your child ever undergone psycho-educational testing?*

Yes

If yes, please provide a brief description of the testing done: Name and Address of the tester:

Busing Information

Will your child require busing?*

Yes

If yes:

A.M.

P.M.

Both

I hereby give East Shoreline Catholic Academy the right to contact any previously attended school in regards to the recent enrollment of my child. I hereby authorize said school to supply any and all information requested. I release all persons, companies and corporations supplying and receiving such information to East Shoreline Catholic Academy, the Archdiocese of Hartford, and anyone acting on its/their behalf from and against any and all liability which might result from furnishing or receiving such information. I hereby certify that the information submitted in the application process, including this registration form is true. I understand that if it is determined that any information I have provided is false, the admission of my child may be revoked, or if my child is already in attendance, he or she may be subject to immediate expulsion.

Check to agree*:

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East Shoreline Catholic Academy is a Catholic school that accepts students from different religious, racial, and ethnic backgrounds.

Apply to ESCA

Application Information

Requirements

Online Application

Student Information

Student Home Address

Father/Guardian Information

Mother/Guardian Information

Other Children in Family

Federal guidelines require us to record the Race/Ethnicity of every child. You must answer the following question and then indicate your race. Hispanic is considered an ethnicity and not a racist group.

Religious Information

If Catholic, please list the parish(es) or church your family is registered with or regularly attends:

Academic Background

Busing Information