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Application for Continued Enrollment
in Good Shepherd Catholic School 2019-2020

Applicant's Full Name:
Home Phone Number:
Mailing Address:
Zip Code:
Date of Birth:
Town of Residence:
Name of Father (or Male Guardian):
Work Place:
Work Number:
Cell Number:
E-mail Address:
Name of Mother
(or Female Guardian):
Work Place:
Work Number:
Cell Number:
E-mail Address:
  Check here if any of the information above has changed from last year
For what grade is your child applying?
Please include any additional new information that you would like us to know about the applicant at this time.
Are you a practicing Catholic?" YesNo
If yes, which church are you registered?
My child was baptized at:
If the applicant is again enrolled in Good Shepherd Catholic School, is there another name and address that correspondence should be sent?
Full Name:
Mailing Address:
Zip Code:

Student Emergency Information

Applicant's Full Name:
Grade Entering:
Birth date:
Child's Physician:
Date Last Seen:
Telephone Number:
Allergies and any action to be taken in case of a reaction:
Medical background (Symptoms or history that the teacher should be aware of to protect your child's health).
Child's Dentist:
Date Last Seen:
Telephone Number:
Child's Therapist/Counselor:
Date Last Seen:
Telephone Number:
Please list two (2) nearby relatives or neighbors who will assume temporary care of your child(ren) if you cannot be reached.
Telephone Number:
Telephone Number:
In case my child(ren) incur(s) an accident or illness or in any other situation that warrants an emergency response at school or during a school-related function, I expressly agree to give to Good Shepherd Catholic School personnel control to seek emergency medical care for my child(ren), including transportation to the emergency room if necessary. I understand that at school or during a school-related function it is Good Shepherd Catholic School personnel's sole discretion to make decisions about appropriate treatment necessary for my child(ren). I hereby authorize the health-care provider in charge to administer whatever emergency treatment is necessary at my expense.
(Electronic) Signature of Parent/Guardian:
(Please notify the school if any information changes.)

Immunization Records

I hereby give permission for   (Physician)
Physician Mailing Address:
to release medical immunization information to Good Shepherd Catholic School. I give Good Shepherd Catholic School permission to share any pertinent medical information regarding my child with the staff and faculty.
(Electronic) Signature of Parent/Guardian:

Permission To Photograph

I doI do not
give my permission for Good Shepherd Catholic School to photograph/videotape; during school related activities. These photos may be submitted to newspapers for publicity purposes and also may be posted on the GSCS website. Photos will be placed in the Good Shepherd yearbook.

Transportation Permission

I give permission for the following person(s) to transport my child(ren).
Telephone Number:
Telephone Number:
Telephone Number:
I give permission for my child(ren) to walk home from Good Shepherd Catholic School.
The days he/she will be
regularly walking are:

Field Trips

Good Shepherd Catholic School regards the town of St. Johnsbury as a valuable academic and cultural resource. Teachers occasionally walk their classes to area places such as St. John's Church, the Fr. Joseph Lively Parish Center and playground, the Fairbanks Museum, the Athenaeum, St. Johnsbury Academy, the Sunset Home, Catamount Arts, Canterbury Inn, the Fire Station, the St. Johnsbury House, or other nearby destinations. At times, a class may simply go for a short walk as an exercise break.
I request that my child be allowed to take walking field trips in the town of St. Johnsbury to places such as the St. John's Church, the Fr. Joseph Lively Parish Center and playground, the Fairbanks Museum, the Athenaeum, St. Johnsbury Academy, the Sunset Home, Catamount Arts, Canterbury Inn, the Fire Station, the St. Johnsbury House, or other nearby destinations my child's teacher may choose.
I do not want my child participating in walking field trips.

Good Shepherd Acceptable Use Guidelines
for Technology

Technological resources, including iPads, at Good Shepherd are used for supporting the educational experience and mission of the school while abiding by the school's Code of Conduct. Use of these technologies is not a right, it is a privilege that carries responsibilities and behavioral expectations consistent with all school rules and policies, including but not limited to, those stated in the Student Handbook. As information on the Internet appears, disappears and changes, it is not possible to predict or control what students may locate or use. They may encounter information that is inaccurate, controversial or inappropriate. To ensure that students will benefit from the school's computer/Internet resources, all users are expected to adhere to the following guidelines:

Acceptable Uses:
  • Members of the Good Shepherd community will use iPads, computers, and all other electronic communication and computing devices, in a responsible, ethical and legal manner at all times.
  • Computer labs and Good Shepherd-owned equipment must be used for school-related purposes only.
  • Common sense and good judgment is expected to be used at all times.
  • Students will not share their usernames, passwords, addresses or other personal information on the Internet without the authorization of a parent or Good Shepherd representative. Users must never post personal contact information about themselves or other people. Personal information includes reference to age, names, as well as individual/school/parent/parent workplace address and telephone number.
  • Any viewing, sharing or transmission of material containing inappropriate content, offensive language, derogatory comments, rumors/gossip or other content not in keeping with Good Shepherd's mission or philosophy is strictly prohibited. In addition, any iPad/computer use, which could pose a risk of property loss or physical or mental harm to anyone is prohibited.
  • Before using their iPads or other devices, Good Shepherd strongly encourages students to consider whether others may regard their electronic communications and other iPad/device uses as offensive, hurtful or otherwise inappropriate.
  • Respect for and proper care of computer equipment is expected to be shown at all times. Food and drink are not permitted near computers.
  • Users must not engage in deliberate attempts to damage or disconnect computer equipment or peripherals, alter hardware or software components, change computer setups, develop or activate viruses, install unauthorized software or change settings.
  • In order to maintain the safety and security of the Good Shepherd community, iPad/computer activity, including communications, Internet history and other uses may be subject to monitoring by Good Shepherd. With respect to students' privacy, such monitoring would only occur if reasonable suspicion of inappropriate activity or probable cause of policy violation is present.
  • All files created, sent, received and stored on Good Shepherd owned equipment are the property of Good Shepherd.
  • The administration or designee has the right to view and/or delete user files contained on the Good Shepherd network.
  • Users must never modify or destroy data to which they are not authorized.
  • Certain Internet materials may not be copied or reproduced without the permission of the author or other right-holder. It is the student's responsibility to respect and adhere to all copyright, trademark and other intellectual rights and trade secrets laws.
  • Only authorized, licensed Good Shepherd-installed software can be used on Good Shepherd owned technology. Users must not install software of any kind (legally licensed or otherwise) without the expressed permission of the Good Shepherd administration or designee.
  • Users shall obey all privacy laws at all times. Posting and/or distributing photographs or audio/video recordings taken of any persons is strictly prohibited without their expressed consent.
  • Good Shepherd cannot guarantee the privacy, security or potential harm or damage caused by any Internet activity. Users should conduct all Internet activity with the understanding that any data, documents and computer activities could become publicly available.
  • Users must never engage in Internet activity, which, if it became publicly available, would embarrass or cause negative publicity to Good Shepherd, its staff, faculty, students or other school-related parties.
  • We expect parents to take an active role in monitoring their child's use of social networking sites such as Facebook, My Space, Twitter, and others. Good Shepherd will also take appropriate measures to maintain a respectful and responsible climate with regard to these sites.
  • Good Shepherd is not responsible for any damage suffered by a user. This includes, but is not limited to, personal financial obligations, loss of data resulting from delays, non-deliveries, inadvertent exposure to inappropriate material, service interruptions or civil or criminal liability.
  • This agreement will extend for the period a student is in attendance at Good Shepherd. All student users require the consent of their parent, legal guardian or sponsor before they can be issued accounts and access to computers.
BYOD (Bring Your Own Device) Program
Good Shepherd recognizes the importance of technology and the educational benefits available through the use of technology. The use of portable electronic devices in the classroom can add educational value when such devices deliver content and extend, enhance or reinforce the student learning process. Classroom teachers determine the appropriateness of in-class use of electronic devices, consistent with our school's instructional objectives, and with approval of the principal. All personal electronic devices must be used in a responsible and legal manner. Students using their own devices are subject to the Good Shepherd Acceptable Use Guidelines, and all other Good Shepherd policies and procedures including, but not limited to, the student code of conduct. Failure to adhere to these guidelines may result in the revocation of the privilege to use personal electronic devices in the classroom and/or disciplinary action as appropriate. The following personal electronic devices are approved:
  1. Laptop computers
  2. Tablet PCs
  3. iPads/iPods/iPhones
  4. E-readers
  5. Chromebook

Students are permitted to use approved personal electronic devices for educational purposes under the direction of a classroom teacher.

BYOD activities are implemented at the discretion of classroom teachers and building administrators. When electronic devices are used to enhance learning in the classroom, students without a personal device will be provided access to an appropriate school-owned digital device.

Violations of any school policies, regulations, or rules involving a student's personal electronic device may result in the loss of use of the device in school and/or disciplinary action. The school reserves the right to inspect a student's personal electronic device if there is reason to believe that the student has violated diocesan policies, regulations, school rules or has engaged in other misconduct while using their personal electronic device. Any search will be conducted in compliance with school policies.

The use of an approved personal electronic device is not a right, it is a privilege, and students may be denied access at any time. Students wishing to participate in the Bring your Own Device program must comply with the following guidelines and procedures.

  1. must abide by the Good Shepherd Acceptable Use Policy and Regulations, and are subject to all student code of conduct restrictions and disciplinary consequences relating to use or misuse of technology.
  2. are responsible for ensuring the safety of their own personal devices. Good Shepherd is not responsible for the loss or theft of a device, nor are they responsible for any damage done to the device while at school.
  3. will use approved devices only for an educational purpose, and only when directed by a classroom teacher or administrator.
  4. must keep devices turned off when not directed to use them.
  5. may not use the camera feature to capture, record, or transmit audio, video or still photos of other students, faculty, or staff without explicit permission given by the subject of the photo or video.
  6. are not to use the device in a manner that is disruptive to the educational environment.
  7. exhibiting harassing, intimidating behavior or found bullying through the use of a personal electronic device are subject to discipline under the Good Shepherd Student handbook policy and procedures.
  8. are responsible for servicing their personal electronic devices. Good Shepherd will not service, repair or maintain any non-school owned technology brought to, and used at school by students.

Consequences for Misuse
The use of computer systems is a privilege. The iPad/Computer/Internet Acceptable Use Policy must be followed. Any user violating this policy is subject to loss of computer privileges, possible disciplinary action by the school, up to and including expulsion, and legal action (civil and criminal) including reimbursement for any financial losses. Technology use is also subject to regular discipline procedures as outlined in the Good Shepherd Student Handbook.

My child and I have read and agree to the above. My child has my permission to use the Internet at Good Shepherd Catholic School. I understand that my child must follow the above guidelines in order to enjoy the privilege of using the Internet at school.

Google Apps for Education - Student Account Information

Good Shepherd has implemented "Google Apps for Education" for students, teachers, and administrative staff. All students will have accounts allowing for their documents and files to be stored online and accessible from home, school, and anywhere there is an Internet connection. These accounts can send and receive mail only from addresses within our Good Shepherd domain.

Students will have access to Google Calendar, Google Docs, and Google Email. Students will also have training on how to use Google Apps for Education. In addition, Good Shepherd will be creating email accounts for students in grades 3-8 to allow for collaborative sharing using Google Apps for Education. These accounts will be used at school for school related projects. Additionally, students may utilize their email address for signing up for collaborative Internet tools that may be used in the classroom.

Responsible Use Guidelines

Teachers will make every reasonable effort to monitor student conduct related to class content in order to maintain a positive learning environment. All participants will respect the teachers' time and professionalism by supporting the same positive approach.

In addition to the Terms and Conditions noted in this parent permission letter, students must comply with the Good Shepherd Acceptable Use Policy. Access to and use of the student's Google account is considered a privilege. Good Shepherd maintains the right to terminate the access and use of their Google account when there is reason to believe that violations of law or school policies have occurred.

Good Shepherd cannot and does not guarantee the security of electronic files used in Google Apps for Education. Google does have a content filter, however, Good Shepherd cannot ensure that users will not be exposed to unsolicited information.

I have read the Google Apps for Education - Student Account Information. My child has permission to use Google Apps for Education.

Volunteer Request Form

Good Shepherd Catholic School relies on help from our school community. As a school that operates without federal funding, we also depend on tuition, local parish and Diocesan support, and benefactors who contribute to our Annual Fund as funding sources. In addition to these sources, we have parent involved "fun"draisers throughout the year, which are listed below. As you have seen this year, these events were a huge success due to your involvement.

We ask you at this time to commit to helping with at least one event. Along with funding fieldtrips, guest speakers and extra-curricular programs, these fundraisers have allowed us to purchase computers, instructional equipment, playground equipment, a new gym floor and scoreboard to enrich your child's educational experience at Good Shepherd. Thank you for all your support, we couldn't do it without you.

Please check form below to sign up for at least one event.
Child(ren)'s Name(s) & Grade(s):
Kingdom Challenge - October
Grandparents' Day - November
Christmas Bazaar - December
Christmas Tree Sales - December
Catholic Schools Week - January
Father/Daughter Dance - February
Mardi Gras - February or March
Scholastic Book Fair - March
Spring Gala - April
You will receive a telephone call or an e-mail with more specific information approximately one month in advance of the event(s) you have signed up for. Thank you again for your support.

Good Shepherd Catholic School Mission Statement

Good Shepherd Catholic School prepares students for a life of learning, service, compassion, personal excellence, and faith in God.
AGREEMENT: We agree to the following:
  1. Upon electronically signing this agreement below, the parent/guardian of the applicant acknowledges and accepts responsibility for payment of tuition. No tuition refund is given if a student is required to leave the school for misconduct.

  2. Student will adhere to Good Shepherd Catholic School's Code of Conduct and abide by all regulations of Good Shepherd Catholic School as stated in the Parent/Student Handbook.
Good Shepherd Catholic School's Code of Conduct
With Jesus as my model and the Holy Spirit as my guide...
I am kind,
I respect God's creation and all it contains,
I accept responsibility in all I do, and
I behave in ways which uphold this sanctuary for myself and others.
(Electronic) Signature of Parent/Guardian:

121 Maple Street  ·  St. Johnsbury, VT 05819-2269  ·  Tel: 802.751.8223  ·  Fax: 802.751.8111
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