NEW STUDENT REGISTRATION

St. Augustine and St. Mary’s Cathedral School

428 2^nd St. SE

St. Cloud, MN 56304

1-320-251-2376

Name of Child______________________________________ Male______ Female______

Last First Middle

Address___________________________________________________________________

Street City State Zip

Telephone_________________________ County_____________ School District_________

Grade_________ Age as of Sept. 1____________ Rank in Family ___________

Date of Birth________________ Place of Birth_______________________________

Date of Baptism_____________ Place of Baptism____________________________

Church City State

Date of First Communion__________ Place of First Communion_____________________

Ethnic Background____________________________

Parish Membership________________________________________

Father Mother

Name____________________________ Name_______________________________

Maiden Name_________________________

Stepfather Stepmother

Name____________________________ Name_______________________________

Place of Birth______________________ Place of Birth_________________________

Occupation_______________________ Occupation___________________________

Place of Business__________________ Place of Business______________________

Religion__________________________ Religion______________________________

Marital Status ______________________ Marital Status_________________________

Student lives with______________________________________________

Names of all children in order of birth:

First Middle Last Sex Birthdate

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

__________________________________________________________________________

Pre-Kindergarten Experience: Where_____________ When__________ How Long______

School Last Attended_________________________________________________________

Address______________________________________________________________

Street City State Zip

Child is left or right handed?________________

Does your child have any special needs? _________________________________________

PLEASE NOTE: Information will be used for the administration and management of this student’s educational program. You are encouraged but not legally required to complete all items on this form.

OFFICE USE ONLY:

BIRTH CERTIFICATE BAPTISMAL CERTIFICATE

Certificate # ______________________ Date of Baptism _________________

Date of Birth ______________________ Church ________________________

City, State ______________________

Verified by: _______________________ Date: __________________