New Registration

New Student Registration Form

* Indicates required field

Name *

First

Last

Gender *

Family Name (if different than above) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Student's Date of birth *

Home Phone *

Parent's full name *

Religion *

Parent's Full Name *

Mother's Maiden Name *

Religion *

Child resides with: *

If the child does not live with both birth parents, also include birth parent information

Name *

Relationship *

Address *

City/Zip *

Send courtesy copies? *

Family Email *

Email 2 *

Parent 1 *

Cell Phone *

Work Phone *

Okay to text *

Cell provider *

Parent 2 *

Cell Phone *

Work Phone *

Okay to text *

cell provider *

Emergency Name/Relationship *

Phone Number *

Student's FULL baptismal name *

Grade & School in September 2022 *

Level in Faith Formation 2022-23 *

Does the student have any Special Needs (Physical, Learning,Food Allergy, etc.)?

Please list here *

Baptism

Year *

Church *

City/State *

Certificate *

First Penance

Year *

Church *

City/State *

Certificate *

First Communion

Year *

church *

city/state *

Certificate *

Submit

NEW REGISTRATION FORM

New Student Registration Form