Current School Year: August 15, 2021 – May 22, 2022 CAPTCHAStudent InformationStudent Name(Required) First M.I. Last Current Grade(Required)Choose OnePreKKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thCurrent School Name(Required)Birth Date(Required) Month Day Year Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent Home Phone NumberParent Cell Phone Number(Required)Parent Email(Required) Does the Student Have a Cell Phone and/or Email Address?(Required) Yes, Cell Phone Yes, Email Yes, Both Neither Student Cell Phone NumberStudent Email Father's Name(Required) First Last Father's Religion(Required)Mother's Name(Required) First Last Mother's Religion(Required)Sacraments Received(Required)Check All That Have Been Received for the Student Baptism First Communion First Reconciliation Confirmation None Emergency Contact InformationEmergency Contact Name(Required) First Last Emergency Contact Phone Number(Required)Additional InformationPlease Add Any Additional InformationPhoneThis field is for validation purposes and should be left unchanged.
