WEST CATHOLIC HIGH SCHOOL
We Stand Together in Learning, Forever in Faith
1801 Bristol NW • Grand Rapids, MI 49504 • (616) 233-5920 • grwestcatholic.org
9th Grade Application
Class of 2020
Please send completed application to:
Todd Peters, Director of Admissions
West Catholic High School
1801 Bristol Ave NW
Grand Rapids, MI 49504
STUDENT INFORMATION
Please Print Clearly
Student’s Full Name
First
Middle
Prefers to be called ______________________
Gender
Last
□Male □Female
Home Address _________________________________________________________Phone ________________
Date of Birth _________________
Place of Birth _________________________________________________
Religion _________________Practicing:
□Yes □No
Registered Parish/Church ________________________
Current School ________________________________________ Grades Attended at this School _____________
Other School(s) Attended __________________________________Grades Attended at School(s) _____________
__________________________________Grades Attended at School(s) _____________
Ethnic Origin (Check all that apply) ~ optional
 Caucasian  African American  Hispanic/Latino
 Native American  Asian Indian
 Chinese
 Filipino
 Japanese
 Korean
 Pacific Islander
 Vietnamese  Other Asian American __________________
 Other _____________________
Primary language spoken at home: _______________________________
Siblings
Name
Age
Current/Alumni Relatives at West Catholic or Catholic Central High School
Name
Address
Grade & School
Relationship
PARENT/GUARDIAN INFORMATION
Please mark with an X the Legal/Custodial Parent/Guardian on the line provided before their name
___Father/Guardian Name (please circle)
Last
First
Middle
Home Address
Street
City
Zip
Cell Phone _________________ Work Phone
Home Phone
E-mail Address _______________________________Religion
US Citizen
State
□Yes □No
Place of Birth
□Married □Divorced □Single
Marital Status
___Mother/Guardian Name (please circle)
Last
First
Middle
Home Address
Street
City
Home Phone _________________ Cell Phone _________________
E-mail Address _______________________________Religion
US Citizen
□Yes □No
Marital Status
State
Zip
Work Phone
Place of Birth
□Married □Divorced □Single
___Step Parent Name(s) (if applicable)
Last
First
Middle
Please state why you want your child to attend West Catholic High School. (Please type or print clearly. It is
acceptable to attach a computer generated response.)
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Will this be your first child attending West Catholic?
□Yes □No
□Yes □No
Does your child require special accommodations? □Yes □No
Do you have daily access to the internet?
If yes, please provide professional evaluation to support request.
I hereby give permission for the Principal Evaluation Form to be forwarded to West Catholic High School.
Please check one:
_____ This evaluation is to be considered non-confidential. The evaluation may be shown to me upon request after the
completion of the admission decision.
_____ This evaluation is to be considered confidential. I hereby waive my right to review under the provisions of the Family
Educational Rights and Privacy Act of 1974, and I understand that the contents of this evaluation will not be available for my
inspection now or at any time in the future.
Parents/Guardian Signature_____________________________________Date______________________
STUDENT INFORMATION (To be completed by student applicant)
Activities (Please list up to five activities in which you have participated in the past three years. Include school,
church, community, music, arts and job. You may also include any honors, awards or positions held. It is
acceptable to attach a computer generated response.)
Activity
Dates Involved
______________________________________
______________________________________
______________________________________
______________________________________
Activity
Dates Involved
___________________________________________
___________________________________________
___________________________________________
___________________________________________
STUDENT ESSAY (to be completed independently by student).
Please use the space below to tell us something about yourself and why you want to attend West Catholic High
School. Some topics might include an important event in your life, a person who has influenced you, goals or
hopes for the future, what you value, or an activity that is important to you. (Please type or print clearly in the
space provided. It is acceptable to attach a computer generated response. Please limit to 200 words.)
Student Signature
Parent/Guardian Signature
Date____________________
Date
WEST CATHOLIC HIGH SCHOOL
We Stand Together in Learning, Forever in Faith
1801 Bristol NW • Grand Rapids, MI 49504 • (616) 233-5920 • grwestcatholic.org
Placement Test Registration Form
Saturday, January 9, 2016
I have a conflict on Saturday January 9, 2016 please have Mr. Peters contact me
This Form must be completed and submitted to West Catholic High School.
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The test measures cognitive skills in the following areas:
Reading, Mathematics, Science, Language, Verbal and Quantitative skills
The testing fee is $20.00. Please make checks payable to: West Catholic High School.
Families who qualify for the MI Free/Reduced Lunch program are not required to pay the testing fee.
You must pre-register by mailing this form and payment to:
West Catholic High School
Attn: Todd Peters, Admissions
1801 Bristol Ave
Grand Rapids, MI 49504
Testing Location:
West Catholic High School, 1801 Bristol Ave, Grand Rapids, MI 49504
Check in on testing date begins at 8:00 a.m. at the main entrance and testing runs from 8:30 a.m. to 12:00 p.m.
Student must bring two (2) sharpened #2 pencils. Calculators are NOT allowed.
Name of Student:
Name of Parent/Guardian(s):
Phone:
Home
Cell
Work
Email:
Current School:
*My family does qualify for free/reduced lunch______
Questions? Please contact Admissions Director Todd Peters at 616-233-5920 or toddpeters@grwestcatholic.org
Testing Accommodations: The test may be given with the extended time (1.5) if your child
currently receives testing accommodations at his/her current school. You must submit
proper documentation (IEP/504/accommodation plan) one week prior to test. Students
requesting this accommodation will be notified of approval by email or phone the week of
the test.