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Registration

- Academics

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- Student's First Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Middle Name REQUIRED Please fill out this field. Please enter valid data.
- Student's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Student Social Security Number REQUIRED Please fill out this field. Please enter valid data.
- Grade Registering For REQUIRED Please fill out this field.
- Student's Age REQUIRED Please fill out this field. Please enter valid data.
- Student's Date of Birth REQUIRED Please fill out this field. Please enter valid data.
- Physical Address REQUIRED Please fill out this field. Please enter valid data.
- 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.
- Mailing Address if Different from Physical Address Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Religion REQUIRED Please fill out this field. Please enter valid data.
- Last School Attended REQUIRED Please fill out this field. Please enter valid data.
- Name and Grade of Other Children at St. Anthony Please enter valid data.
- Is this child the only or youngest child attending St. Anthony? REQUIRED Please fill out this field. Please enter valid data.
- If Catholic, which church parish do you belong to? Please enter valid data.
- If wanting St. Anthony Parishioner Discount, church envelop # required Please enter valid data.
- If you were to attend a public school, which school would you be zoned for? REQUIRED Please fill out this field. Please enter valid data.
- Mother/Guardian
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number (Home) Please enter a phone number.
  
  Phone Number (Cell) REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Employer REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number (Work) Please enter a phone number.
- Father/Guardian
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number (Home) Please enter a phone number.
  
  Phone Number (Cell) REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Employer REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number (Work) Please enter a phone number.
- If parents are separated/divorced, with whom does the child reside? Please enter valid data.
- Custody of Child Please enter valid data.
- Emergency Contact (Name) REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Local Physician's Name and Number: Please enter valid data.
- I am aware that all fees paid to register are non-refundable.
  I Agree Please select this field.
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