Student Information::
(* required fields)

*Last Name:: *First:: Middle::

Home Street Address::
City:: State:: DC MD VA Zip::

Home Phone:: *Parent E-mail::

SSN:: Gender:: Female Male Date of Birth::
Birth City:: Birth State:: Birth Country::

Applying for Grade:: 9th Grade 10th Grade 11th Grade 12th Grade Present School::

Religion:: Parish::

Parent Information::

Father Info::
Last Name:: First Name::

Birth City:: Birth State:: Birth Country::
Religion::
Employer/Title:: Business Phone::

Mother Info::
Last Name:: First Name::

Birth City:: Birth State:: Birth Country::
Religion::
Employer/Title:: Business Phone::

Check if Appropriate::

Father Deceased Mother Deceased Parents Separated
Parents Divorced Father Remarried Mother Remarried

Applicant Resides With:: Father Mother Both

Other Full Name::
Other Street::
Other City:: State:: DC MD VA Zip::

# of Brothers:: Ages:: # of Sisters:: Ages::

Relatives who attended or who have attended St. John's or other Lasallian schools:

Preferred Mailing Address::
Title:: First Name:: Last Name::

Street Address::
City:: State:: DC MD VA Zip::

Other Schools to which you are applying::

Financial aid sources to which you are applying::

Language(s) spoken, other than English::

I would like to be considered for the De La Salle Scholars Program. (incoming 9th graders only)
(If Yes, provide explanation in your essay, and see application procedures for admissions requirements)

I will be requesting/requiring any accommodations?
If Yes, please List::

Clubs, organizations and activities in which you participate (include awards/honors received in tese activities)::

Extracurricular life is a vital part of a St. John's education.
Please check those activities in which you are interested::

Personal Statement: Please submit an essay describing yourself to the Admissions Committe. Indicate why you wish to attend St. John's College High School and what you plan to contribute to the school community. Either Attach or Mail the essay separate from the application with the $50.00 application fee (make check payable to St. John's College High School).