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Please complete and submit the form below to begin your child’s educational journey.

Gender

Siblings in Catholic School?

The student is Hispanic or Latino

Ethnic Group

Have an educational plan (e.g., IEP, 504) or class modifications ever been recommended for this student?

Does the student suffer from any serious medical condition or allergy?

Does this student have asthma?

Does this student use an inhaler or epi-pen?

Does this student require any medication throughout the day?

Student resides with: (please check all that apply)

Student's parents are:

If never married, divorced or separated, who has legal custody or decision-making responsibility of the student?

If never married, divorced or separated, who has physical custody or residential responsibility of the student?

If never married, divorced or separated, who has primary financial responsibility of the student?

Correspondence should be sent to:

Name of Parent

Parent is:

Name of Parent

Parent is:

Name of Guardian (if applicable)

Guardian is:

Name of Guardian (if applicable)

Guardian is:

Person(s) responsible for tuition and other financial obligations if other than parents, please complete the following:

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