Registration for the 2020-21 School Year2020-21 School Registration
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Family Name *
Address
Address1 * Address2 City * State * Zip *
Telephone *
Phone Type Area Code Number
Child #1
First Name * Last Name *
Preferred Name
Nick Name
Date of Birth *
- -
MM * DD * YYYY *
Grade for 2020-21 School Year *
Child #2
First Name Last Name
Preferred Name
Nick Name
Date of Birth
- -
MM DD YYYY
Grade for 2020-21 School Year
Child #3
First Name Last Name
Preferred Name
Nick Name
Date of Birth
- -
MM DD YYYY
Grade for 2020-21 School Year
Child #4
First Name Last Name
Preferred Name
Nick Name
Date of Birth
- -
MM DD YYYY
Grade for 2020-21 School Year
Child #5
First Name Last Name
Preferred Name
Nick Name
Date of Birth
- -
MM DD YYYY
Grade for 2020-21 School Year
Father's Name
First Name Last Name
Preferred Name
Nick Name
Religion
Occupation
Employer
Work Phone
Area Code Number Extension
Cell Phone
Area Code Number
Email
Mother's Name & Maiden Name
First Name Last Name
Preferred Name
Nick Name
Religion
Occupation
Employer
Work Phone
Area Code Number Extension
Cell Phone
Area Code Number
Email
Marital Status
If you are divorced or separated, who is the custodial parent?
If you are divorced or separated, are there any court orders in effect for the child(ren) named above?


 
Name of Daycare Provider
First Name Last Name
Telephone
Phone Type Area Code Number
Days of the week your child(ren) are at this day care?





In case of illness and you cannot be reached, should the day care provider be contacted?


 
Name of the parish where you are registered
Where were the child/ren baptized?
 
By signing, I agree all above information is accurate.
Do you agree? Name Date (MM/DD/YYYY)
    1       Review