Please list all relatives who attend(s)/attended Villa Maria Academy​. (Name, Relationship, Graduation Year)​​​
Please list all younger siblings of the prospective student. (Name, Relationship, Current Grade Level)​​

Student Interests: Check any Clubs or Activities that you would like to participate in at Villa Maria Academy.

Athletics: Check any P.I.A.A. sport that you would like to participate in at Villa Maria Academy.

Other Opportunities in Athletics

Why do you, the prospective student, want to attend Villa Maria Academy?​​
Please type your full name which will serve as your signature. ​
Why do you, the parents, want your daughter to attend Villa Maria Academy?​​​
By typing my full name,I give permission for Villa Maria Academy to request and receive all pertinent records from my daughter's current school of attendance.​​​

Non-Discrimation Policy Statement: Although Villa Maria Academy is adistinctly Catholic school, it welcomes young women of all backgrounds and does not discriminate against qualified student on the basis of race, color, religious creed, ancestry, national origin, disability, or age, as required by law, in the administration of its educational policies, admissions procedures, financial aid/scholarship rewards, and/or any other school administered programs.

Has your child ever been previously suspended or expelled from any public or private school of the Commonwealth of Pennsylvania or any other state for an act or offense involving weapons, alcohol or drugs, or for the willful infliction of injury to another person or for any act of violence committed on school property.​
I understand that this form shall be maintained as part of the student’s disciplinary record. I further understand in making this statement that I am subject to penalties under 24 P.S. 13-1304-A9b) and 18 Pa.C.S.A.4904 relating to falsification to authorities, and that any willful false statement made on this form shall be a misdemeanor of the third degree. I swear or affirm that the facts contained herein are true and correct to the best of my knowledge, information and belief.​

Please provide an email address where we can send a link to your current form.

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