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1A - Ms. Kaspar
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Miss Mitchell Dean of Students
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Holy Angels Regional School
Patchogue, NY
(631) 475-0422
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Home
About
Our Curriculum
Early Childhood Program
Kindergarten Program
Elementary School
Middle School 6-8
Our Extra-Curricular Activities
Parishes of Holy Angels Regional School & Board Members
Principal's Message
Student Life
Our Faith
Band
Clubs
National Junior Honor Society
Special Events
Middle School Sports (CMSAA)
Directory
Class Pages
Staff
Contact Us
Parents
Get Involved
Volunteer Sign Up
Parent Teacher Partnership
School Board
Resources
Before Care/After Care
School Handbook
Power School Parent Access Information
Transgenderism Policy - 2023
Nurse's Office
Welcome/Forms
Exams Done at School
Health Office Functions
Medication Policies
Sports Information from the Health Office
Admissions
Admissions
Visit
Registration Fee
Online Application for Nursery Program
Online Application for New Students (PK-8)
Necessary Documents to Register
FACTS Tuition Management
Tomorrow's Hope Foundation Scholarship Information
Tuition
Give
Donate Online
Resources
DRVC Education Dept
Book Club / Learning Resources
Virtual Backpack
Weekly Update
Calendar
Online Application for New Students
Admissions
Admissions
Visit
Registration Fee
Online Application for Nursery Program
Online Application for New Students (PK-8)
Necessary Documents to Register
FACTS Tuition Management
Tomorrow's Hope Foundation Scholarship Information
Tuition
The maximum number of form submissions has been reached. This form is currently not available.
Holy Angels Regional School
Application Form for New Admission (PK-8th) 2026/2027
Dear New Families,
Welcome to Holy Angels! It is our hope that your child’s enrollment here will be a wonderful, faith-filled experience. Submittance of this application indicates that you have read and will comply with these important policies.
1. All school and health records, included documentation of immunization must be sent to the school before September 1, 2026. No student will be able to attend classes on the first day of school without this documentation.
2. All students are on probation for the first 60 days of school. This is done to ensure placement at Holy Angels is mutually acceptable to all.
3. Tuition is to be paid according to schedule. If there is any unforeseen situation that may arise, it is the parent’s responsibility to contact the Business Office immediately.
Student Information
Grade Entering
REQUIRED
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Please enter valid data.
(For Pre-K Only) (PLEASE SEE NOTE ABOVE)
3 Day
5 Day
First Name
REQUIRED
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Middle Name (if no Middle Name, type "None")
REQUIRED
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Last Name
REQUIRED
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Address
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City
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State
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Zip
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Gender
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Female
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Date of Birth
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Birthplace City, State
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Country of Birth
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Home Phone Number
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Student Lives with
REQUIRED
(Select One)
Both Parents
Mother
Father
Other (please specify)
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Other (please specify)
Public School District in which the student resides
REQUIRED
(Select One)
Patchogue-Meford
South Country
Middle Country
Longwood
William Floyd
Sachem
Other (please specify)
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Other (please specify)
Home Parish (parish that you are registered with/attend)
REQUIRED
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Student's Religion
REQUIRED
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If the student is Catholic, please complete the following:
Baptism
- If not applicable, type "N/A"
Church (please include City, State)
REQUIRED
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Baptismal Date
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Reconciliation
- If not applicable, type "N/A"
Church (please include City, State)
REQUIRED
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Reconciliation Date
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First Eucharist
- If not applicable, type "N/A"
Church (please include City, State)
REQUIRED
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First Eucharist Date
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Confirmation
- If not applicable, type "N/A"
Church (please include City, State)
REQUIRED
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Confirmation Date
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Ethnic Background of Student: (this information is used to complete the New York State Educational Data Systems report that all public and nonpublic schools are required to submit).
REQUIRED
American Indian/Native Alaskan
Asian
Black/African American
Hispanic or Latino
Native Hawaiian/Pacific Islander
White
Mutli-Racial
All Others
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What is the Students Race?
REQUIRED
American Indian/Native Alaskan
Black/African American
White
Asian
Native Hawaiian/Pacific Islander
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Current School or Pre-School/Grade
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Reason For Leaving
Physician Name
REQUIRED
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Physician Phone Number
REQUIRED
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Dentist Name
REQUIRED
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Dentist Phone Number
REQUIRED
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Emergency Contacts (Please include three (3))
Emergency Contact 1
First Name
REQUIRED
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Last Name
REQUIRED
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Relationship
REQUIRED
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Home Phone
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Work Phone
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Cell Phone
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Emergency Contact 2
First Name
REQUIRED
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Last Name
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Relationship
REQUIRED
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Home Phone
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Work Phone
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Cell Phone
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Emergency Contact 3
First Name
REQUIRED
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Last Name
REQUIRED
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Relationship
REQUIRED
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Home Phone
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Work Phone
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Cell Phone
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Family Background
: Mother Information
First Name
REQUIRED
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Last Name
REQUIRED
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Maiden Name
REQUIRED
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Relationship
REQUIRED
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Home Address (if different)
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Religion
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Country of Birth
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Date of Entry into USA
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Education Completed
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Occupation
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Employer
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Employer Address, City
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Home Phone
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Work Phone
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Cell Phone
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Home Email
REQUIRED
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Work Email
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Family Background
: Father Information
First Name
REQUIRED
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Please enter valid data.
Last Name
REQUIRED
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Please enter valid data.
Relationship
REQUIRED
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Please enter valid data.
Home Address (if different)
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Religion
Please enter valid data.
Country of Birth
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Date of Entry into USA
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Education Completed
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Occupation
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Employer
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Employer Address, City
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Home Phone
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Work Phone
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Cell Phone
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Home Email
REQUIRED
Please fill out this field.
Please enter valid data.
Parent/s Marital Status
REQUIRED
(Select One)
Single
Married
Separated
Divorced
Father Deceased
Mother Deceased
Please fill out this field.
Work Email
Please enter valid data.
Parent/s Marital Status
REQUIRED
(Select One)
Single
Married
Separated
Divorced
Father Deceased
Mother Deceased
Please fill out this field.
Child/ren live with
REQUIRED
(Select One)
Both parents
Mother
Father
Other
Please fill out this field.
Other (please specify)
Please enter valid data.
Note: Both parents
have a right to school
information regarding the student unless one parent presents a
legal document
that does not permit this.
Custody:
This school assumes that
both parents
have full parental and residential custody. If this is not the case, it is the responsibility of the parents to provide the school with that portion of the divorce decree or separation agreement that articulates parental and residential custody. Should any changes occur during the year, please inform the school
Please check here if the school should expect a custody agreement
Custody agreement
In case of divorce or separation, please complete the following:
Applicant lives with:
Mother
Father
Other
Legal Custody:
Joint
Mother
Father
Other
Correspondence should be sent to:
Please enter valid data.
If remarried, name of stepfather
Please enter valid data.
If remarried, name of stepmother
Please enter valid data.
A copy of the Court Orders should be on file in the school office if custodial rights are restricted.
Academic Information
:
Unofficial copies of transcripts and reports have been requested or are attached for admission purposes. Acceptances are not final until records have been reviewed by the principal.
Does the student have a Behavioral Intervention Plan?
REQUIRED
Yes
No
Please fill out this field.
If yes, what are the terms of that plan? Please specify below:
Does the student require any particular accommodations to facilitate his or her participation in the educational program offered by the school other than what has been indicated in the question above?
REQUIRED
Yes
No
Please fill out this field.
If yes, what are those accommodations? Please specify below:
Has the student ever been tested for learning problems?
REQUIRED
Yes
No
Please fill out this field.
Has testing for learning problems ever been suggested?
REQUIRED
Yes
No
Please fill out this field.
Does the Student have an IEP or IESP?
REQUIRED
Yes
No
Please fill out this field.
Does the student have a 504 Accommodation Plan?
REQUIRED
Yes
No
Please fill out this field.
Please use the Authorization for Release of Information form for these documents to be sent to the school.
It is the parent's responsibility to provide any special needs files for the student prior to acceptance. Failure to do so may result in the student being denied acceptance. If it is discovered, after the student has been admitted, that records were withheld, the student may be asked to withdraw.
Health Information
:
Is the student currently taking medications?
Yes
No
If yes, please specify:
Will the school have to administer medication?
Yes
No
If yes, please specify:
Does the medication need to be administered during the school day?
Yes
No
If yes, when?
Provide explanation if your child has any serious health concerns or allergies
List any disabilities or special needs your child may have (physical, behavioral, emotional or academic)
Indicate any diagnostic evaluations (educational or psychological) that have been administered to your child
Explain the reasons if your child has been suspended, dismissed from, or not allowed to return to any school
To be considered for admission, the following documents, including a non-refundable application fee ($200.00), must accompany this application (Registration Fee: $150.00 Early Bird Discount through February 13, 2026
:
1. Completed Student Application
2. Copies of Birth Certificate and Baptismal Certificate
3. Immunization Record:
Must be completed and signed by physician before child is accepted.
4. Current report card including comments
and
two previous academic year's report cards before acceptance is considered.
5. Signed Authorization For Release of Information (Grades 1-8)
6. Registered Online with FACTS Management Co. ~ https://online.factsmgt.com/signin/3LZDZ
7. Bus Transportation: Bus Transportation is provided by district of residence. It is the paren'ts responsibility to contact the school district in order to complete necessary forms by April 1, 2026.
8. Textbooks: All families must be district verified in order to pick up textbooks.
9. Tuition Agreement: must be completed by each family as part of the registration process and returned to Holy Angels. These forms may be obtained through your rectory if you are a member of a regional parish, or through Holy Angels for non-regional and non-Catholic families.
Submit