Pre-K 4 APPLICATION FOR ADMISSION 2022-2023

Saint Augustine of Canterbury School
Pre-K 4 Application for Admission
2022-2023
Student Information
CHILD MUST BE FOUR (4) YEARS OF AGE ON OR BEFORE
OCTOBER 31, 2022
Name *

First Name Middle Name Last Name
Gender *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Township of Residency *
Home Phone Number *

Area Code Phone Number
Cell Phone Number

Area Code Phone Number
Date of Birth *

Month Day Year
Date
Place of Birth *
Religion
Language Spoken at Home
Parish Affiliation
Church Envelope Number
SACRAMENTAL HISTORY (if the child is Catholic)
Baptism - Church
Baptism - City/State
Baptism - Date

Month Day Year
PLEASE INDICATE YOUR SESSION PREFERENCE
First Choice

Four Year Olds - 8:00 to 10:30 AM - Monday to Friday Four Year Olds - 8:00 AM to 2:00 PM - Monday to Friday with Enrichment
Second Choice

Four Year Olds - 8:00 to 10:30 AM - Monday to Friday Four Year Olds - 8:00 AM to 2:00 PM - Monday to Friday with Enrichment