Little Flower School Re-enrollment

Welcome back for the 2020-2021 school year!

2020-2021 LFCS Re-Enrollment

Re-Enrollment

For the 2020-2021 year, we’re excited to introduce a simple, secure online re-enrollment process. A few things to note about the process.

The form should take between 10-15 minutes to complete online.
The form goes directly to the front office.
The office will contact you if they have any questions, or any additional information is required.

Begin Now

2020-2021 LFCS Re-Enrollment

Re-Enrollment

Thank you for your interest in completing the registration for the 2020-2021 school year at Little Flower. Please contact the school office at 850-455-4851.

Begin Now

School Registration

1. Student Information
2. Family Information
3. Student Sacramental Information
4. Emergency / Health Information & Consent
5. Statement of Cooperation
6. Scholarship & Financial Information
7. Grandparent Information
8. Finance Information
9. Authorized Contacts

Spam protection, skip this field

Student Information (optional)

Student Information

Student's Legal Last Name

Last Name

Legal First Name

First Name

Middle Name (optional)

Middle Name

Nickname (optional)

Name student goes by

Gender

Male

Female

Social Security Number (optional)

XXX - XX - XXXX

Place of Birth (City / State / Country)

City / State / Country

Birthdate

Month
January
February
March
April
May
June
July
August
September
October
November
December

Year
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020

Contact Information (optional)

Contact Information

Home Address

Street Address, City, State, Zip

Street Address, City, State, Zip

Is your mailing address different?

Yes

Mailing Address (If Different)

Street Address, City, State, Zip

Street Address, City, State, Zip

Guardian Phone #

🇺🇸 +1

Guardian Email Address

Student Phone # (optional)

🇺🇸 +1

Student Email Address (optional)

Are we permitted to publish your contact information in our directory?

Yes, I give my consent

No, I do not consent

Race and ethnicity (optional)

Race and Ethnicity

Please respond to both the race and ethnicity (Hispanic or not) question, so that we may accurately complete required reports.

Is the student Hispanic or Latino?

Yes

Race (select one)

Select One
Asian
Black
White
American Indian / Native Alaskan
Native Hawaiian / Pacific Islander
Two or more races

Primary Language Spoken at home

Select One
English only
Chinese
Spanish or Spanish Creole
Korean
French
Tagalog
Viatnamese
Other language

Student's Religion (optional)

Student's Religion

Place of Worship

Student's Parish (if Catholic) or place of worship (if not Catholic)

Prior Education (optional)

Prior Education

Public School (for your residence)

Prior School Attended

Select one
Bailey Middle School
Beulah Academy of Science
Beulah Elementary School
Bellview Elementary School
Bellview Middle School
Blue Angels Elementary
Hellen Caro Elementary
Little Flower
Myrtle Grove Elementary
Navy Point Elementary
Sacred Heart
Sherwood Elementary
St. Paul
St. John the Evangelist
Warrington Middle School
West Pensacola Elementary
Other

Do you have an IEP or 504 Plan?

Yes

Does your student have an existing Individualized Education Plan (IEP) or 504 plan?

Family Information (optional)

Family Information

Student primarily lives with

Choose
Mother and Father
Mother
Father
Grandparent or Guardian
Mother and Stepfather
Father and Stepmother
Other

Does the student have siblings?

Yes

Names and Ages of Siblings

Legal Female Guardian (optional)

Legal Female Guardian

Information below is for parents, adoptive parents or those with legal guardianship over a child. Please include step-parent information on Authorized Contacts Form.

Female Guardian's Name (optional)

Guardian's Name

Female Guardian's Relationship (optional)

Relationship to Student

Female Guardian Address (optional)

Address (if different from above)

Street Address, City, State, Zip Code

Female Guardian Email (optional)

Email Address

name@domain.com

Female Guardian Military Service (optional)

Have you served in the military?
I've never served in the military
Active Duty
Retired
Veteran

Military Service

Female Guardian Occupation (optional)

Occupation

Female Guardian Employer (optional)

Employer

Female Guardian Primary Phone # (optional)

🇺🇸 +1

Primary Phone #

Female Guardian Secondary Phone # (optional)

🇺🇸 +1

Secondary Phone #

Female Guardian Work Address (optional)

Work Address

Work Address

Female Guardian Work Phone # (optional)

🇺🇸 +1

Work Phone #

Female Guardian Marital Status (optional)

Marital Status

Female Guardian Religion (optional)

Religion

Do you have any special gifts or talents that you would like to share with our school? (optional)

Alumna (optional)

Yes

Legal Male Guardian (optional)

Legal Male Guardian

Information below is for parents, adoptive parents or those with legal guardianship over a child. Please include step-parent information on Authorized Contacts Form.

Male Guardian's Name (optional)

Guardian's Name

Male Guardian's Relationship=) (optional)

Relationship to Student

Male Guardian Address (optional)

Address (if different from above)

Street Address, City, State, Zip Code

Male Guardian Email (optional)

Email Address

name@domain.com

Male Guardian Military Service (optional)

Have you served in the military?
I've never served in the military
Active Duty
Retired
Veteran

Military Service

Male Guardian Occupation (optional)

Occupation

Male Guardian Employer (optional)

Employer

Male Guardian Primary Phone # (optional)

🇺🇸 +1

Primary Phone #

Male Guardian Secondary Phone # (optional)

🇺🇸 +1

Secondary Phone #

Male Guardian Work Address (optional)

Work Address

Work Address

Male Guardian Work Phone # (optional)

🇺🇸 +1

Work Phone #

Male Guardian Marital Status (optional)

Marital Status

Male Guardian Religion (optional)

Religion

Do you have any special gifts or talents that you would like to share with our school? (Copy) (optional)

Alumnus (optional)

Yes

How did you hear about our school? (optional)

Parent Referral

Newspaper Advertisement

Church Bulletin

Billboard

Phone Book

Radio / Television Advertisement

Internet Search

Feeder School

Social Media

Student Sacramental Information (optional)

Student Sacramental Information

If your child has not received any of the sacraments (Baptism, Reconciliation, Eucharist by grade 3, Confirmation in high school), please contact your parish.

Is the student Catholic?

Yes

Has the student received any of the following sacraments?

Select all

Baptism

Eucharist

Reconciliation

Confirmation

Emergency / Health Information and Consent (optional)

Emergency / Health Information and Consent

Preferred Doctor

Doctor's Phone #

🇺🇸 +1

Preferred Hospital

Preferred Dentist (optional)

Dentist's Phone # (optional)

🇺🇸 +1

I give my permission for my child to receive emergency medical treatment, including calling 911

Yes, I give my consent

No, I do not consent

Emergency / Health Information and Consent (Copy) (optional)

List any medical considerations of which the school should be aware, as well as any medication which the student must take at any time. If the student must take medication during school hours as prescribed by a doctor you must turn in a form called Authorization for Administration of Medication #9400-HES-005. This form must be signed by the doctor. (Forms are available from the doctor).

Medical Issues (optional)

Medical Issues

Daily Medication (optional)

Daily Medication

Allergies (food, medicine, environmental) (optional)

Allergies (food, medicine, environmental)

Statement of Cooperation (optional)

Statement of Cooperation

In making application for my child, it is my desire to have him/her complete the school year 2020-2021. It is also my understanding that the policy of the school is to make no refunds on fees. If a child is withdrawn prior to July 1st, there will be a full refund of tuition minus fees. As of July 1st, there will be no refund of two (2) months of tuition.

I understand the policy that my child’s attendance at your school may be terminated if tuition is two (2) months in arrears, unless a payment plan has been approved by the Administration. Prior to the beginning of the school year, if two or more month’s tuition is not paid the student’s registration is automatically terminated and the student’s position is relinquished to another student.

If a student withdraws from school once classes have begun, tuition up to and including the quarter in which the student withdraws is non-refundable. At any time during the school year, if a family is delinquent in tuition payments by more than one month, the student may not attend school until payments are made current. This includes taking semester exams.

All payments for the 2020-2021 school year must be completed for a student to take final exams. I understand I am responsible for all tuition and fees incurred by my child up to the date of withdrawal. I hereby agree that my child and guardian(s) shall abide by the policies, rules and regulations of your school at all times.

I give my permission for my child to take part in all school activities, including sports and school-sponsored trips away from the school premises, and I absolve the school from liability to me or my child because of loss of property or because of any injury to my child at school or during any school activity.

Today's Date

Month
January
February
March
April
May
June
July
August
September
October
November
December

Year
2020
2021

Parent Signature

I agree that my typed name below will be as valid as a handwritten signature to the extent allowed by local law

Scholarship Information (optional)

Scholarship Information

In the state of Florida, we are blessed with several school choice scholarship opportunities for families of students in K-12 programs, as well as pre-kindergarten (VPK). Families may qualify for FTC Scholarship based on income and family size; McKay and Gardiner scholarships are based on qualifying special needs.

All families seeking tuition assistance should speak with their school’s principal about applying for one of the following scholarships in addition to seeking local financial aid. Please visit https://ptdiocese.org/scholarships for more information.

Grandparent Information (optional)

Grandparent Information

Paternal Grandparents (optional)

Paternal Grandparents Address (optional)

Street Address, City, State, Zip

Street Address, City, State, Zip

Were they alumni? (optional)

Maternal Grandparents (optional)

Maternal Grandparents Address (optional)

Street Address, City, State, Zip

Street Address, City, State, Zip

Were they alumni? (optional)

Finance Information (optional)

Finance Information

Name and address of person responsible for tuition and other financial obligations (if different from parent or guardians listed above).

Name (optional)

Phone # (optional)

🇺🇸 +1

Address (optional)

Authorized Contacts (optional)

Authorized Contacts (Emergency Contacts & Authorized Pickups)

Please use this form to list authorized contacts for your child/children. Everyone listed on this form will be eligible to pick up your student(s). Please instruct emergency contacts and authorized pickups to bring identification (driver's license or other government issued identification) with them when picking up a child.

Please indicate whether the person should be an emergency contact. We will always attempt to contact parents first in case of an emergency.

If there are custody, visitation, or other legal agreements or orders concerning the student or access to the student's records, please present the paperwork at the time of registration so that a copy may be placed in the records. Unless appropriate custody paperwork is received, both parents will have equal rights to access student records, and to provide emergency contacts and authorized pickups.

If you want to apply this list of contacts to all students in the family, please indicate by listing your children's names and grades below.

Apply list of contacts to multiple students (optional)

Please include Student Name + Student Grade for everyone the list of contacts should apply towards.

Authorized Contact #1 (optional)

Authorized Contact #1

Two authorized contacts are required.

#1 - Authorized Contact Name

Relationship to Student

Select One
Stepmother
Stepfather
Aunt
Uncle
Friend
Sibling
Coach
Sitter
Grandparent
Other

Additional Information

Select all

Emergency Contact

Lives with student

Other

Primary Phone Number

🇺🇸 +1

Secondary Phone Number (optional)

🇺🇸 +1

Authorized Contact #2 (optional)

Authorized Contact #2

Two authorized contacts are required.

#2 - Authorized Contact Name

Relationship to Student

Select One
Stepmother
Stepfather
Aunt
Uncle
Friend
Sibling
Coach
Sitter
Grandparent
Other

Additional Information

Select all

Emergency Contact

Lives with student

Other

Primary Phone Number

🇺🇸 +1

Secondary Phone Number (optional)

🇺🇸 +1

Would you like to add more authorized contacts?

Choose
No, I am done adding contacts
Yes, add one more contact
Yes, add two more contacts
Yes, add three more contacts
Yes, add four more contacts

Authorized Contact #3 (optional)

Authorized Contact #3

#3 - Authorized Contact Name

Relationship to Student

Select One
Stepmother
Stepfather
Aunt
Uncle
Friend
Sibling
Coach
Sitter
Grandparent
Other

Additional Information

Select all

Emergency Contact

Lives with student

Other

Primary Phone Number

🇺🇸 +1

Secondary Phone Number (optional)

🇺🇸 +1

Authorized Contact #4 (optional)

Authorized Contact #4

#3 - Authorized Contact Name

Relationship to Student

Select One
Stepmother
Stepfather
Aunt
Uncle
Friend
Sibling
Coach
Sitter
Grandparent
Other

Additional Information

Select all

Emergency Contact

Lives with student

Other

Primary Phone Number

🇺🇸 +1

Secondary Phone Number (optional)

🇺🇸 +1

Authorized Contact #5 (optional)

Authorized Contact #5

#5 - Authorized Contact Name

Relationship to Student

Select One
Stepmother
Stepfather
Aunt
Uncle
Friend
Sibling
Coach
Sitter
Grandparent
Other

Additional Information

Select all

Emergency Contact

Lives with student

Other

Primary Phone Number

🇺🇸 +1

Secondary Phone Number (optional)

🇺🇸 +1

Authorized Contact #6 (optional)

Authorized Contact #6

#6 - Authorized Contact Name

Relationship to Student

Select One
Stepmother
Stepfather
Aunt
Uncle
Friend
Sibling
Coach
Sitter
Grandparent
Other

Additional Information

Select all

Emergency Contact

Lives with student

Other

Primary Phone Number

🇺🇸 +1

Secondary Phone Number (optional)

🇺🇸 +1

2020-2021 Re-Enrollment - To complete the form for returning students, click here.

Little Flower School Re-enrollment

Welcome back for the 2020-2021 school year!

2020-2021 LFCS Re-Enrollment

Re-Enrollment

2020-2021 LFCS Re-Enrollment

Re-Enrollment

School Registration

Student Information

Contact Information

Race and Ethnicity

Student's Religion

Prior Education

Family Information

Legal Female Guardian

Legal Male Guardian

Student Sacramental Information

Emergency / Health Information and Consent

Statement of Cooperation

Scholarship Information

Grandparent Information

Finance Information

Authorized Contacts (Emergency Contacts & Authorized Pickups)

Authorized Contact #1

Authorized Contact #2

Authorized Contact #3

Authorized Contact #4

Authorized Contact #5

Authorized Contact #6

I'm New

Parents

Students

Quicklinks

Coronavirus Update - For up to date news and information, click here.