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8th Graduation and Kindergarten Tea - June 2010

Have a Safe and Happy Summer!!!

New Student Application
2010-2011

Student Name:

__________________________________________________________
First                    Middle                Last

____________________________________________________________
Address:        Number & Street        City          State            Zip

Home Phone:______________________

Boy:  _________       Girl: _________

Age:  _________       Date of Birth: _________      Place of Birth: _________

Where do you go to school now?  ____________________________________________

What grade are you in now? _______________________________

PARENT/GUARDIAN INFORMATION

MOTHER:  Name: _________                            Address:  _________                               

BEST PHONE NUMBER TO REACH YOU:  ________        _          

FATHER:  Name: _________                            Address:  _________                               

BEST PHONE NUMBER TO REACH YOU:  _________                  

Languages spoken at home:  _                            ________      

Number of children in family: _________            _  Ages: _________________

How did you hear about St. Patrick School?___________________________________

_______________________________________________________________________

Why do you wish to enroll your child in St. Patrick School?______________________

_______________________________________________________________________

Please return this application with:

• Copy of Birth Certificate

• Copy of Baptismal Certificate (if you have one)

• Copy of Immunizations

• Copy of latest school report/report card

All information must be provided in order to be considered for acceptance.

Print a copy of this form and mail it to: 

St. Patrick School and Educational Center
311 Adams Street
Lowell, MA 01854
978.458.4232