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Nazareth Academy

Grade School

New Student Registration Form

Nazareth Academy Grade School Admissions Application
Today's Date:
School Year Applying For:
Grade Entering in September:
Child's Full Name
Child's Home Address:
Home Phone:
Primary Contact Email:
Date of Birth:
Child's Religion
Special Needs (Hearing, Visual, Allergies, Diabetic, etc):
Present Kindergarten/Primary School
Father's Name:
Father's Occupation:
Father's Work Number:
Father's Cell Number:
Father's Place of Birth:
Father's Religion:
Father's Parish:
Marital Status Father:

Mother's Name (First, Maiden, Last)
Mother's Occupation:
Mother's Work Number:
Mother's Cell Number:
Mother's Place of Birth:
Mother's Religion:
Mother's Parish:
Marital Status Mother:

Guardian's Name (If applicable):
Guardian's Contact Information:
Names of family who are current students or alumni of Nazareth Academy Grade School. Please note graduation year (if known):
How did you hear about Nazareth Academy Grade School? Check all that apply:

Your Name:
Your Email:
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