Saints Peter & Paul School Student Enrollment Form

School Year: _________________            New or Current Student          Grade in which to enroll: ______

First Name: ___________________________   Mid Init: ___   Last Name: __________________________________

Family Last Name: ________________

Birth Date______________

Male  Female

Race (Check all that apply): American Indian  Asian Black Hispanic Pacific Islander White   Other:_________________

Catholic Non-Catholic

City & State of Birth:__________________________

Previous School Attended: _________________________________________

Public School & District Area: ______________________________________________

If the student is Catholic, enter the following information if you have not previously submitted it.

Baptism

Date: ______________

Parish & Location:____________________________________________

First Communion

Date: ______________

Parish & Location:____________________________________________

EMERGENCY CONTACT (other than parents)

NAME______________________________________________RELATIONSHIP_______________________DAY PH __________________

ADDRESS_____________________________________________________________CELL PH__________________________________

NAME__________________________________________________RELATIONSHIP_________________________DAY PH_____________

ADDRESS___________________________________________________________CELL PH_____________________________________

NAME_____________________________________________RELATIONSHIP____________________________DAY PH_________________

ADDRESS_____________________________________________________________CELL PH__________________________________

NAME_____________________________________________RELATIONSHIP____________________________DAY PH_________________

ADDRESS_____________________________________________________________CELL PH__________________________________