SS. Peter and Paul School

116 Beecher Avenue

Waterbury, Connecticut 06705

(203) 755-0881

Dear Parents,

The Office of Catholic Schools requires each to file a report on United States citizens.

Please fill out the form below, one for each child, and return it to school by Sept. 5^th

Thank You

CHILD’S NAME________________________________________________ GR______

DATE OF BIRTH___________________ PLACE OF BIRTH___________________________

BE SURE TO FILL IN ALL APPROPRIATE SPACES BELOW FOR EACH FAMILY MEMBER

CHILD IS ______U.S. CITIZEN

______NON U.S. CITIZEN ________________________________TYPE OF VISA________

Non U.S. citizens must indicate City & Country of Citizenship & Type of Visa

FATHER IS ______U.S. CITIZEN

______NON U.S. CITIZEN ________________________________TYPE OF VISA________

Non U.S. citizens must indicate City & Country of Citizenship & Type of Visa

MOTHER IS ______U.S. CITIZEN

______NON U.S. CITIZEN ________________________________TYPE OF VISA________

Non U.S. citizens must indicate City & Country of Citizenship & Type of Visa