St. Catharine Academy Middle School Registration

Please complete the form below. Required fields marked with an asterisk *

Student Information:

Student First Name*

Answer Required

Student Last Name*

Answer Required

Date of Birth*

Answer Required

U.S. Citizen*

Answer Required

Yes

Student E-Mail Address

Answer Required

Preferred Phone Number*

Answer Required

Street Address*

Answer Required

Apt. #*

Answer Required

Borough/City*

Answer Required

State*

Answer Required

Zip Code*

Answer Required

School Year Entering:*

Answer Required

2023-2024

2024-2025

Elementary/Grammar School*

Where child is attending school currently

Answer Required

Student's IESP (if applicable)

Answer Required

Choose a file or drag it here.

Language Spoken at Home if other than English

Answer Required

Census Information:

Ethnic Survey: Check One*

Answer Required

American Indian or Alaskan Native

Asian/Pacific Islander

Black, not of Hispanic Origin

Hispanic

White, not of Hispanic Origin

Middle Eastern

Religious Affiliation: Check One*

Answer Required

Roman Catholic Christian (Catholic)

Protestant

Baptist

Lutheran

Jewish

Muslim

Hindu

Other:

Parent/Legal Guardian of Student:

(Who does the Student live with during the School Year?)

Mr. & Mrs.

Answer Required

- Or -

Mr.

Answer Required

Ms.

Answer Required

Relationship to student*

Answer Required

Parents

Grandparent

Mother only

Father only

Mother/Stepfather

Father/Stepmother

Other/Non Relative Guardian (Explain)

Answer Required

Marital Status*

Answer Required

Single

Married

Separated

Divorced

Remarried

Widow

Mother/Stepmother Cell Phone*

Answer Required

Mother/Stepmother Email*

Answer Required

Mother/Stepmother Work*

Number Required

Father/Stepfather Cell Phone*

Answer Required

Father/Stepfather Email*

Answer Required

Father/Stepfather Work Phone*

Number Required

Birth Mother's Full Name (include Maiden Name)*

Answer Required

Birth Father's Full Name*

Answer Required

I give permission for my daughter's picture to be used in school news releases, publications, etc.:*

Answer Required

Yes

Signature*

Signature Required

Do you have a relative who attends/graduated from St. Catharine Academy?*

Answer Required

Yes

If yes, please provide their names, relation, and graduation year

Answer Required

Student's Birth Certificate & Most Recent Report Card*

Answer Required

Choose a file or drag it here.

Quantity

$300.00 NON-REFUNDABLE Registration Fee*

Price: $300.00

Please fix the highlighted areas below before submitting.

St. Catharine Academy Middle School Registration