Mother’s Advent Retreat - Our Lady of Mercy Academy

Student Name(Required)

First Last

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Deadline Dates

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Letters of Recommendations

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Teacher #2(Required)

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Major(Required)

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First Quarter Grade Request Form

Our Lady of Mercy Academy will send first quarter grades ONLY to schools that request them. Please provide documentation from the college to substantiate the need for quarter 1 grades. Please attach documentation below. Please allow 7 business days for processing.

Student Name(Required)

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College Name(Required)

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Comments

Scholarship Application Request Form

Please fill out a separate form for each scholarship, and indicate whether you will be submitting your application separately in the Comments section. Please allow 7 business days for processing.

Date(Required)

Student Name(Required)

First Last

Student OLMA Email(Required)

Name of Scholarship(Required)

Scholarship Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Scholarship Deadline(Required)

How is application being submitted?(Required)

Please be specific ie electronically, mail, etc

Scholarship Contact Name

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Please indicate what OLMA needs to submit

(please check all that apply)

Transcript

College Counselor Letter of Recommendation

Teacher Letter of Recommendation

Report Card

Scholarship Application

Any additional information

This award was established in 2018. The proceeds from the Mercy Through the Decades Reunion Luncheon (Class gifts and sponsorships) funds scholarships for incoming freshmen and is a four (4) year award. By making a tax deductible donation, you will be supporting future Mercy girls.

I would like to make a Class Gift to be applied to the Alumnae Association Award in the amount of(Required)

Name(Required)

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Total

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Card Details

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Name

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Name(Required)

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Maiden Name

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Home Phone

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Graduation Year

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Name(Required)

First Last

Class of(Required)

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Phone(Required)

News(Required)

If you wish to pay via check, please make checks payable to
Our Lady of Mercy Academy (MPTO in the memo)

Mail Membership Form and check to
Attn: MPTO (Membership) Our Lady of Mercy Academy 815 Convent Road Syosset, NY 11791

Parent's Information

Name(Required)

First Last

Name

First Last

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Phone

Email(Required)

Daughter's Information

Name(Required)

First Last

Grade(Required)

MPTO Annual Membership Fee

This fee is per family.

Price:

Billing Information

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Card Details

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Comments

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