ST BRIGID SCHOOL, 695 STEVENS AVE., PORTLAND, ME 04103

FOR PARISIONERS REGISTERED OUTSIDE OF CLUSTER 28
(St. Joseph, St. Patrick and St. Pius)

APPLICATION AND AGREEMENT FOR PARISH SUBSIDIES 

I/We, ____________________________, the undersigned hereby submit this request to receive Tuition Subsidy from ______________________________
                                                                                                                                                                                                          ^Parish
Parish for my child(ren)’s enrollment at St. Brigid School for the 2009-2010 year.

It is understood in the event full subsidy is not received from our parish, I/We will be responsible for the difference in tuition due for the total of $4300.

____________________________________     ______________________________
Signature of Parent/Guardian                               # Of Children Enrolling 

___________________________________      _______________________________
(Print) Parent/Guardian Name                             Child(ren)’s Name  

___________________________________      ________________________________
Parish                                                                   Offertory Envelope Number 

___________________________________      ________________________________
Pastor’s Signature                                                Date