Registration Form Preschool - 6th | St. Francis de Sales Parish

Last Name REQUIRED Please fill out this field. Please enter valid data.

First Name REQUIRED Please fill out this field. Please enter valid data.

Full Middle Name REQUIRED

Please include the full middle name(s) of child

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Gender REQUIRED Please fill out this field.

Age REQUIRED

Current age of the child.

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Date of Birth REQUIRED Please fill out this field. Please enter a date.

Place of birth REQUIRED

The city and state where the child was born, or if outside the USA, the city and country.

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Home Address REQUIRED

Street Number and Name

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City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Grade REQUIRED

Grade of student for the upcoming school year.

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School District REQUIRED Please fill out this field.

School Name REQUIRED

Name of school child will attend in upcoming school year.

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Medical information, food allergies, dietary restrictions or other pertinent information we should know about the child.