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Application

- Admissions

Mandatory application checklist
(Your registration will not be considered complete until all items are received).
1. Application Form (see below)
2. Commitment Fee Paid via FACTS Account
  1. The Commitment Fee can be paid via FACTS shortly after the application is submitted.
Please click below, print, fill-out & send the forms below to the school office:
Thank you for choosing Immaculate Conception School!

Application Form

The maximum number of form submissions has been reached. This form is currently not available.

Please check here if you are enrolling a sibling of a current registered family. REQUIRED Yes, I am enrolling a sibling of a current registered family. I am a new family. Please fill out this field.
Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Number of children to be registered REQUIRED Please fill out this field.
- Student 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 4
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 5
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 6
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 7
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 8
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 9
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Student 10
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Gender REQUIRED Please fill out this field.
  - Birthdate REQUIRED Please fill out this field. Please enter a date.
  - Ethnicity REQUIRED Please fill out this field.
  - Grade September 2021 REQUIRED Please fill out this field.
  - School and location transferring from Please enter valid data.
  - My child has received the following Sacraments REQUIRED Baptism First Holy Communion Confirmation None Please fill out this field.
  - Has the applicant ever been diagnosed or evaluated as having any learning disabilities? REQUIRED Yes No Please fill out this field.
  - Does the applicant have an Individual Education Plan (IEP), Individual Service Plan (ISP), or 504 Support Plan? REQUIRED Yes No Please fill out this field.
  - Has the applicant ever received any supplemental education services, public or private? Yes No
  - Has the applicant ever received severe disciplinary action at school (resulting in suspension or expulsion)? REQUIRED Yes No Please fill out this field.
- Number of Parents/Guardians REQUIRED Please fill out this field.
- Parent/Guardian 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street Address REQUIRED Please fill out this field. Please enter valid data.
  - City REQUIRED Please fill out this field. Please enter valid data.
    
    State REQUIRED Please fill out this field.
    
    Zip REQUIRED Please fill out this field. Please enter a zip code.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
- Parent/Guardian 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street Address REQUIRED Please fill out this field. Please enter valid data.
  - City REQUIRED Please fill out this field. Please enter valid data.
    
    State REQUIRED Please fill out this field.
    
    Zip REQUIRED Please fill out this field. Please enter a zip code.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
- Parent/Guardian 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street Address REQUIRED Please fill out this field. Please enter valid data.
  - City REQUIRED Please fill out this field. Please enter valid data.
    
    State REQUIRED Please fill out this field.
    
    Zip REQUIRED Please fill out this field. Please enter a zip code.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
- Parent/Guardian 4
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Email REQUIRED Please fill out this field. Please enter an email address.
  - Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Work Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  - Occupation REQUIRED Please fill out this field. Please enter valid data.
  - Street Address REQUIRED Please fill out this field. Please enter valid data.
  - City REQUIRED Please fill out this field. Please enter valid data.
    
    State REQUIRED Please fill out this field.
    
    Zip REQUIRED Please fill out this field. Please enter a zip code.
  - Do you wish to be listed in the School Directory REQUIRED Yes No Please fill out this field.
Parental Information
Marital Status REQUIRED Please fill out this field.
Student resides with REQUIRED Please fill out this field.
Custodial Parent/Guardian REQUIRED Please fill out this field.
Religious Preference REQUIRED Please fill out this field. Please enter valid data.
Registered Parish REQUIRED Please fill out this field.
If you answered Other, please include the name and city of your registered Parish Please enter valid data.
Please note:
In order to receive the K-8 Catholic Subsidized tuition rate, the student must be a registered, practicing member of a Catholic parish within the Diocese of Metuchen. If you entered a Catholic parish within the Diocese of Metuchen, the school office will verify your eligibility for the K-8 Catholic Subsidized tuition rate.
Will your family pursue Tuition Assistance from the Diocese and/or Immaculate Conception School? REQUIRED Yes No Please fill out this field.
The following section only applies if you are
enrolling a child in grades K-8
Service Hour Obligation Option (K-8th Grade Only)
Service Hour forms must be submitted for verification of hours completed NO later than May 31, 2022 (8th Grade families due April 30, 2022). Unfulfilled hours will be billed at a rate of $25/hour. For more details, please go to the Service Hour Program tab under "Parents."
If you are registering a child in grades K-8 and you select "None" for the following question, your registration will be considered incomplete.
Service Hour Obligation Options (K-8 Only)
If you are registering a child in grades K-8 and you do not "check" the following checkbox, your registration will be considered incomplete.
Agreement for Service Hour Obligation (K-8 Only) Yes, I understand that if the buyout option is chosen, or if I have not fulfilled my obligation, the amounts agreed to will be included in my FACTS payments or Paid in Full by the assigned due date.
Payments not received by the assigned due date will be assessed a 10% late fee. Outstanding payments not received within 45 days will be forwarded to a collection agency and may preclude re-admission for the next school year.
SCRIP Obligation Option (K-8th Grade Only)
Beginning with the 2021-2022 school year, SCRIP obligations are based on SCRIP REBATE amounts, not SCRIP purchase amounts. For more details, please go to the SCRIP Program tab under "Parents."
If you are registering a child in grades K-8 and you select "None" for the following question, your registration will be considered incomplete.
SCRIP Obligation Options (K-8 Only)

Number of Children	Rebate Obligation	Buy-Out Amount
1	$333.00	$616.05
2	$353.00	$653.05
3+	$373.00	$690.05

Unfulfilled SCRIP rebates will be billed at a rate of 185% of the unfulfilled rebate amounts. SCRIP obligations must be fulfilled by May 31, 2022 (8th Grade families must be fulfilled by April 30, 2022).
If you are registering a child in grades K-8 and you do not "check" the following checkbox, your registration will be considered incomplete.
Agreement for SCRIP Obligation (K-8 Only) Yes, I understand that if the buyout option is chosen, or if I have not fulfilled my obligation, the amounts agreed to will be included in my FACTS payments or Paid in Full by the assigned due date.
Payments not received by the assigned due date will be assessed a 10% late fee. Outstanding payments not received within 45 days will be forwarded to a collection agency and may preclude re-admission for the next school year.

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