St. Edward School

REGISTRATION FORM

2008-2009

Child’s Name: __________________________ Date of Birth ____________

Sex: ___ Grade in September ______ Current School: ___________________________

Address _____________________________ Phone __________________________

Town _______________________________ Parish __________________________

Father’s Name ______________________ Phone ______________ Cell _____________

Address (If different) ______________________________Work Phone _____________

Town _______________________________ E-mail _________________________

Mother’s Name ______________________ Phone ______________ Cell ____________

Address (If different) _______________________________Work Phone ____________

Town _______________________________ E-mail __________________________

School last attended: ______________________Address _________________________

Dates of attendance _______________________Phone ___________________________

Religious Affiliation

Sacraments received: Baptism Date _________ Church _________________________

Address ______________________________________________

First Communion Date ______ Church _____________________

Address ______________________________________________

A child being enrolled for the first time ever in a school must supply a copy of his/her birth certificate. If the child is new to St. Edward School or has been enrolled in a public school, then a copy of his/her baptismal certificate is required.

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Registration Form

Page 2

Family Information

Mother’s occupation __________________________________________

Father’s occupation __________________________________________

Brothers __________________________ Age ___________

__________________________ Age ___________

Sisters __________________________ Age __________

__________________________ Age __________

If a member of St. Edward The Confessor Parish:

St. Edward Parish envelope No. ___________

PAYMENT PLAN

Choose One: ____ 10 months from July 1, 2008 to April 1, 2009

____ 12 months from July 1, 2008 to June 1. 2009

_____ Invoice Monthly _____ Automatically Charge Credit Card

_____ Visa ____ Master Card _____Discover ____ American Express

Acct. No. __________________________________ Expiration: ___________

Print Name: ________________________________________________

Signature: ________________________________________________

Date