Family Last Name Home Phone #
Child’s Name Nickname
Birth date Age Social Security Number
Address Zip
Street City State
Parishioner Non-Parishioner
Date Registered in Parish
Religion Race
Baptism date and location____________________________________
Father’s First Name Occupation Work Phone
Mother’s First Name Occupation Work Phone
Stepfather’s Name Occupation Work Phone
Stepmother’s Name Occupation Work Phone
Mail should be addressed to: Mr. & Mrs. Mrs. only Mr. only
Home Status: Married Father only Mother only Stepfather Stepmother
Divorced Separated Please submit copy of custody papers to School Office
(For
office use Copy on File )
Please indicate School District in which your child resides, and which school they would attend.
Hamilton City Talawanda
Ross Other
Did your child attend Preschool? Yes No
If “Yes” which Preschool did your child attend?
All Kindergarten
students must provide a copy of an original birth certificate as well as a copy
of
baptismal certificate (if not baptized at Queen of Peace), and
the Registration Fee of $50.00 per
student for registration to be complete.
Received: Birth certificate (__), Baptismal certificate (__), Registration Fee (___), FACTS form (__)
FACTS fee (__)