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Student Information
Legal First Name *
Legal Middle Name
Legal Last Name *
Suffix
Preferred Name
Gender
Date of Birth *
Address
Address 1
Address 2

City

State

Zip
Name of Person Completing Inquiry *
Relationship to Student *
Email *
Home Phone
Wireless Phone
Business Phone
Household Information
Address Same as Student
Yes No
Address
Address 1
Address 2

City

State

Zip
Parent/Guardian Information

Please be sure to include both Parent 1 and Parent 2, even if Parent 1 is the person completing this form.
Relationship to Student *
First Name *
Last Name *
Email
Wireless Phone
Best Way to Contact
Entering Year/Grade
Estimated Entrance Date
School Level
Entering Grade
Entering Grade
Current School
Name
Current Grade
Address
Address 1
Address 2

City

State

Zip
Referral
How did you hear about St. Anthony Catholic School?
Other
Referred by Existing Family
Yes No
Name of Family
Additional Referral Notes
Applying for Financial Aid
Yes No
Enter Your Email Address: *