Parent/student Information Sheet

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Parent/Student Information Sheet
Please Print ALL Information
Father/Legal Guardian
Last Name ______________________________ First Name __________________________
St. Mary’s Church Parishioner: Yes No
Street Address:
_______________________________________________________________
City, State, Zip
_______________________________________________________________
Township Name:
_____________________________________
Home Phone #:
_____________________________________
Cell Phone #:
_____________________________________
Place of Employment:
__________________________________________________
Work Phone #:
__________________________________________________
Family E-mail Address:
_____________________________________
(e-mail is required, it is our primary means of correspondence)
Mother/Legal Guardian
Last Name ______________________________ First Name __________________________
St. Mary’s Church Parishioner: Yes No
Street Address:
_______________________________________________________________
City, State, Zip
_______________________________________________________________
Township Name:
_____________________________________
Home Phone #:
_____________________________________
Cell Phone #:
_____________________________________
Place of Employment:
__________________________________________________
Work Phone #:
__________________________________________________
Family E-mail Address:
_____________________________________
(e-mail is required, it is our primary means of correspondence)
Name (as listed on birth certificate) and grades of students attending St. Mary’s School. Please
list oldest to youngest)
First
Middle
Last
Nickname
Grade
Date of Birth
Student Lives with: ( ) Father & Mother; ( ) Father;
( ) Mother; ( ) Guardian

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