Primary-Class Enrollment Form 2024-2025

Student Information *

First Name

Last Name

Child's Gender *

Male

Female

Birth Date *

MM

DD

YYYY

Father's Information *

First Name

Last Name

Cell Phone *

(###)

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Work Phone *

(###)

###

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Home Phone *

(###)

###

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Mother's Information *

First Name

Last Name

Cell Phone *

(###)

###

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Work Phone *

(###)

###

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Home Phone *

(###)

###

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Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country