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  • FAMILY NAME REQUIRED Please fill out this field. Please enter valid data.
  • Street Address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Registered at St. Catherine's Parish? REQUIRED (Select One) Yes No No, but send us the registration info Please fill out this field.
  • Parent/Guardian (#1) REQUIRED

    First Last name (and Religion on line below)

    Please fill out this field.
  • Phone Number #1 REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Preferred Email REQUIRED Please fill out this field. Please enter an email address.
  • Parent/Guardian (#2) REQUIRED

    First Last name (and Religion on line below)

    Please fill out this field.
  • Phone Number #2 REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Second Email Please enter an email address.
  • Emergency Contact REQUIRED

    (if guardian is unavailable) Name (first, last); Relationship; Address; Phone number

    Please fill out this field.
  • Current Homeschooling Family? REQUIRED (Select One) Yes No Please fill out this field.
  • Enrollment Option: Mondays Only Enrichment Full Academic (all 3 days)
  • • CHILDREN ENROLLING REQUIRED Please fill out this field.
    • Child 1
      • Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Upcoming Grade ('22-'23) REQUIRED (Select One) Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Please fill out this field.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments received:

        List all the sacraments your child has already received.

        Baptism Confession/Reconciliation First Holy Communion Confirmation
      • Learning Abilities/Challenges?

        Including issues that moght disrupt school time, ADHD, dyslexia, repeat a grade, skipped a grade, etc.
      • Health Concerns/Allergies? REQUIRED

        Including medical issues, ADHD, etc.

        Please fill out this field.
    • Child 2
      • Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Upcoming Grade ('22-'23) REQUIRED (Select One) Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Please fill out this field.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments received:

        List all the sacraments your child has already received.

        Baptism Confession/Reconciliation First Holy Communion Confirmation
      • Learning Abilities/Challenges?

        Including issues that moght disrupt school time, ADHD, dyslexia, repeat a grade, skipped a grade, etc.
      • Health Concerns/Allergies? REQUIRED

        Including medical issues, ADHD, etc.

        Please fill out this field.
    • Child 3
      • Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Upcoming Grade ('22-'23) REQUIRED (Select One) Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Please fill out this field.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments received:

        List all the sacraments your child has already received.

        Baptism Confession/Reconciliation First Holy Communion Confirmation
      • Learning Abilities/Challenges?

        Including issues that moght disrupt school time, ADHD, dyslexia, repeat a grade, skipped a grade, etc.
      • Health Concerns/Allergies? REQUIRED

        Including medical issues, ADHD, etc.

        Please fill out this field.
    • Child 4
      • Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Upcoming Grade ('22-'23) REQUIRED (Select One) Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Please fill out this field.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments received:

        List all the sacraments your child has already received.

        Baptism Confession/Reconciliation First Holy Communion Confirmation
      • Learning Abilities/Challenges?

        Including issues that moght disrupt school time, ADHD, dyslexia, repeat a grade, skipped a grade, etc.
      • Health Concerns/Allergies? REQUIRED

        Including medical issues, ADHD, etc.

        Please fill out this field.
    • Child 5
      • Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Upcoming Grade ('22-'23) REQUIRED (Select One) Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Please fill out this field.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments received:

        List all the sacraments your child has already received.

        Baptism Confession/Reconciliation First Holy Communion Confirmation
      • Learning Abilities/Challenges?

        Including issues that moght disrupt school time, ADHD, dyslexia, repeat a grade, skipped a grade, etc.
      • Health Concerns/Allergies? REQUIRED

        Including medical issues, ADHD, etc.

        Please fill out this field.
    • Child 6
      • Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Upcoming Grade ('22-'23) REQUIRED (Select One) Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Please fill out this field.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments received:

        List all the sacraments your child has already received.

        Baptism Confession/Reconciliation First Holy Communion Confirmation
      • Learning Abilities/Challenges?

        Including issues that moght disrupt school time, ADHD, dyslexia, repeat a grade, skipped a grade, etc.
      • Health Concerns/Allergies? REQUIRED

        Including medical issues, ADHD, etc.

        Please fill out this field.
    • Child 7
      • Name Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Upcoming Grade ('22-'23) REQUIRED (Select One) Pre-K K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Please fill out this field.
      • Religion REQUIRED Please fill out this field. Please enter valid data.
      • Sacraments received:

        List all the sacraments your child has already received.

        Baptism Confession/Reconciliation First Holy Communion Confirmation
      • Learning Abilities/Challenges?

        Including issues that moght disrupt school time, ADHD, dyslexia, repeat a grade, skipped a grade, etc.
      • Health Concerns/Allergies? REQUIRED

        Including medical issues, ADHD, etc.

        Please fill out this field.
  • • NURSERY CHILDREN REQUIRED Please fill out this field.
    • Child 1
      • Name REQUIRED Please fill out this field. Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Health Concerns/Allergies?

        Including medical issues, ADHD, etc.
    • Child 2
      • Name REQUIRED Please fill out this field. Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Health Concerns/Allergies?

        Including medical issues, ADHD, etc.
    • Child 3
      • Name REQUIRED Please fill out this field. Please enter valid data.
      • Date of Birth REQUIRED Please fill out this field. Please enter a date.
      • Gender REQUIRED (Select One) Male Female Please fill out this field.
      • Health Concerns/Allergies?

        Including medical issues, ADHD, etc.
  • VOLUNTEERING/HELP:
  • Other Information?

    Please type any other information you think is important.
  • Tuition Payment Preference REQUIRED

    Tuition begins to be due: Friday, August 5, 2022

    (Select One) Lump Sum Quarterly (4 equal payments of family's total) 10 monthly payments (due 1st Friday of the month, starting 8/5/22) Please fill out this field.
  • Auto Reply Email (if desired) Please enter an email address.
  • Today's Date REQUIRED Please fill out this field. Please enter a date.

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