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Our Lady of Mercy Academy

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Our Lady of Mercy Academy

Educating young women with Faith, Compassion, and Promise.

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815 Convent Road Syosset, NY 11791

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P:(516) 921-1047 F:(516) 266-1782

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Student Name(Required)

First Last

Student OLMA Email(Required)

College Name(Required)

College Address(Required)

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

Type of Application Submitted

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Deadline Dates

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College Deadline Date(Required)

MM slash DD slash YYYY

Letters of Recommendations

Please list in priority order; your counselor's letter will automatically be sent

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Phone

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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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Student Email(Required)

College Name(Required)

Documentation(Required)

Please attach either an email or screenshot of your portal

Max. file size: 128 MB.

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College Representative (Long Island) Name(Required)

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Admissions Office Fax Number

Comments

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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.

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Student Name(Required)

First Last

Student OLMA Email(Required)

Name of Scholarship(Required)

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

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College Counselor Letter of Recommendation

Teacher Letter of Recommendation

Report Card

Scholarship Application

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Any additional information

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Name(Required)

First Last

Maiden Name

Email(Required)

Address(Required)

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Cell Phone(Required)

Home Phone

Affiliation(Required)

Graduation Year

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Name

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News(Required)

I give OLMA permission to use this submission on social media platforms in an effort to further the mission of Mercy.

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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

Address(Required)

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

Phone

Email(Required)

Daughter's Information

Name(Required)

First Last

Grade(Required)

MPTO Annual Membership Fee

This fee is per family.

Price:

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Card Details

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