Parishioner Non-Parishioner Grade____________
Date Registered in Parish
Family Last Name Home Phone #
Address Zip
Street City State
Child’s Name Nickname
Birth date Age Social Security Number
Religion Race
Baptism date and location____________________________________
Current Grade and School Attending _____________________________ __________
Please indicate School District in which your child resides, and which school they would attend.
Hamilton
City Talawanda
Ross Other
List all schools and districts that your child has attended:
_____
Please submit a copy of the Birth Certificate, Baptism record, and Registration Fee of $50.00 per student to the
school office
with this paperwork.
1. Father’s Name Work Phone
__ Birth Father __ Stepfather __ Guardian
Occupation Religion Marital Status
2. Mother’s Name Work Phone
__ Birth Mother __ Stepmother __ Guardian
Occupation Religion Marital Status
3. Please list all stepparent information
Name Work Phone
4. Mail should be addressed to: