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Name of Principal Mrs. Kimberly C. Hartlage - page 1 / 15

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U.S. Department of EducationSeptember 2003

2003-2004 No Child Left Behind—Blue Ribbon Schools Program

Cover Sheet

Name of Principal   Mrs. Kimberly C. Hartlage

(Specify: Ms., Miss, Mrs., Dr., Mr., Other)  (As it should appear in the official records)

Official School Name   Saint Mary’s Catholic School

(As it should appear in the official records)

School Mailing Address   420 East Eighth Street_________________________

(If address is P.O. Box, also include street address)

New Albany                Indiana                                    47150-3200

City State                      Zip Code+4 (9 digits total)

Tel. (    812      )944-0888Fax (      812    )945-4770

Website/URLwww.smcsonline.com                            E-mail    principal@smcsonline.com

I have reviewed the information in this application, including the eligibility requirements on page 2, and certify that to the best of my knowledge all information is accurate.

Date____________________________

(Principal’s Signature)

Name of Superintendent*   Mrs. Annette “Mickey” Lentz

(Specify: Ms., Miss, Mrs., Dr., Mr., Other)       

District NameArchdiocese of IndianapolisTel. ( 800  )  382-9836

I have reviewed the information in this application, including the eligibility requirements on page 2, and certify that to the best of my knowledge it is accurate.

Date____________________________  (Superintendent’s Signature)

Name of School Board   Ms. Dawn Brodfehrer

President/Chairperson

(Specify: Ms., Miss, Mrs., Dr., Mr., Other)       

I have reviewed the information in this package, including the eligibility requirements on page 2, and certify that to the best of my knowledge it is accurate.

                                          Date____________________________

(School Board President’s/Chairperson’s Signature)

*Private Schools: If the information requested is not applicable, write N/A in the space.

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