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Church School Registration Form
2017-2018
- The FIRST DAY of Church School is September 10, 2017
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* Indicates required question
Last Name
*
Your answer
First Name
*
Your answer
Date of Birth (PreK MUST be 3 Years Old by Sept. 1, 2017)
*
MM
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YYYY
Grade
*
Choose
Preschool
Kindergarten
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Student Cell
Your answer
Student Email
Your answer
Sibling Name (First and Last)
Your answer
Date of Birth (PreK MUST be 3 Years Old by Sept. 1, 2017)
MM
/
DD
/
YYYY
Grade
Choose
Preschool
Kindergarten
1
2
3
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5
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7
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9
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Student Cell
Your answer
Student Email
Your answer
Sibling Name (First and Last)
Your answer
Date of Birth (PreK MUST be 3 Years Old by Sept. 1, 2017)
MM
/
DD
/
YYYY
Grade
Choose
Preschool
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Student Cell
Your answer
Student Email
Your answer
Mother's Name (First and Last)
Your answer
Street Address
Your answer
City
Your answer
Zip Code
Your answer
Home Phone # (plus area code)
Your answer
Cell (include area code)
Your answer
Email
Your answer
Father's Name (First and Last)
Your answer
Address (If Different than above)
Your answer
City (If different than above)
Your answer
Zip Code (If different than above)
Your answer
Home Phone # (If different than above) - include Area Code
Your answer
Cell (include area code)
Your answer
Email
Your answer
Slava/Name Day
Your answer
Are you interested in offering your services?
(Check all that apply)
Substitute Teacher
Chaperone
Volunteer
Other:
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