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Forms |
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School Forms
Please click the links below to download school forms.
Dental Form
Health Forms
Home Language Survey
Memorandum of Catholic Understanding
Textbook Request
Uniform Order Form
Student Accident Insurance
For the 2017-2018 school year, the Diocesan Student Accident Insurance Program will be available through A-G Administrators, Inc., Valley Forge, PA. Their toll free number is 1-800-634-8628. This voluntary plan is purchased on individual basis by students.
The volunteer plan is $100 Primary Excess Coverage. This means that the insurance will pay the first $100 of a claim without regard of other insurance. Bills submitted in excess of this threshold must then be submitted to any other valid and collectible insurance. Any remaining balances must then be submitted to A-G for processing, along with the Explanation of Benefits (EOB's) from the other insurance carrier. These balances will then be processed according to the policy provisions. If the insured individual is not covered by any other insurance, this policy responds on a primary basis.
The premium is $28 for SCHOOL TIME ACCIDENT COVERAGE or $124 for 24 HOUR coverage.
If you would like to purchase this valuable coverage, please print the Individual Voluntary Enrollment Form and mail with a check for your premium payment directly to:
A-G Administrators, Inc.
PO Box 979
Valley Forge, PA 19482
Please do not return completed forms to school.
Coverage will be effect from date of received enrollment form and premium payment by A-G Administrators, Inc.
For additional information, please go to www.agadministrators.com.
To download the Individual Voluntary Enrollment Form, click here.
The volunteer plan is $100 Primary Excess Coverage. This means that the insurance will pay the first $100 of a claim without regard of other insurance. Bills submitted in excess of this threshold must then be submitted to any other valid and collectible insurance. Any remaining balances must then be submitted to A-G for processing, along with the Explanation of Benefits (EOB's) from the other insurance carrier. These balances will then be processed according to the policy provisions. If the insured individual is not covered by any other insurance, this policy responds on a primary basis.
The premium is $28 for SCHOOL TIME ACCIDENT COVERAGE or $124 for 24 HOUR coverage.
If you would like to purchase this valuable coverage, please print the Individual Voluntary Enrollment Form and mail with a check for your premium payment directly to:
A-G Administrators, Inc.
PO Box 979
Valley Forge, PA 19482
Please do not return completed forms to school.
Coverage will be effect from date of received enrollment form and premium payment by A-G Administrators, Inc.
For additional information, please go to www.agadministrators.com.
To download the Individual Voluntary Enrollment Form, click here.