REGISTRATION FORM

GENERAL INFORMATION

Dear Parents: 

            Please check the information below and make any necessary changes.  This information is needed for the school register and cumulative folders.  Since these are legal documents, they need to be kept updated.  Thank you for taking the time to make this form as complete as possible.

Pupil’s full name:                                                         Birthplace:  

Birth date:                                                         Last grade completed: 

Student’s Social Security Number: 

Indicate child’s position in family by a circle:    1   2   3   4   5   6   7   8

Place a check above total number of children in family.  Underline the number of boys.

Name of last school attended: 

Is student baptized?                                                    If yes, date baptized:                                              

Place baptized:                                                            Place of membership:      

Father’s Name:                                                            Mother’s Name:    

Student’s home address (include mailing and street):

                                                                                        Phone: 

PARENT INFORMATION

Father:                                                                            Phone:  

                        address if different from above                                   Work Phone: 

Occupation: 

Church Affiliation:                                                          Place of Birth:  

Citizenship:                                                                    Education: 

Language Spoken at Home:  

Mother:                                                                           Phone:  

                        address if different from above                                  Work Phone: 

Occupation: 

Church Affiliation:                                                         Place of Birth: 

Citizenship:                                                                   Education: 

Language Spoken at Home: 

EMERGENCY CONTACT INFORMATION

In case of emergency, we may call: 

Relationship:                                                                Home Phone: 

                                                                                      Work Phone:   

Family Doctor:                                                             Phone: