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South Hills Catholic Academy Pre-Registration Form
Student Information
Student's Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender
*
Please Select
Male
Female
Birth Date
*
-
Month
-
Day
Year
Date
Entering Grade in Fall of 2021
*
4 Year Old Preschool (Half Day)
4 Year Old Preschool (Full Day)
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
Sixth Grade
Seventh Grade
Eighth Grade
Religion
*
Public School District of Residence (Taxes Paid To)
*
Baldwin Whitehall
Bethel Park
Brentwood
Chartiers Valley
City of Pittsburgh
Keystone Oaks
Mt. Lebanon
Peters Township
South Park
Upper St. Clair
Other
Current School (If Applicable)
Parent / Guardian Information
Parent / Guardian #1 Name
*
First Name
Last Name
Relationship to Child
*
Parent / Guardian #1 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent / Guardian #1 Email Address
*
example@example.com
Parent / Guardian #1 Primary Phone Number
*
Parent / Guardian #2 Name
First Name
Last Name
Relationship to Child
Parent / Guardian #2 Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent / Guardian #2 Email Address
example@example.com
Parent / Guardian #2 Primary Phone Number
Please enter a valid phone number.
Additional Student Information
If You Would Like To Pre-Register Additional Students, Please List Their First And Last Names, Genders, And Grade Levels Beginning In Fall Of 2021
First Name
Last Name
Gender
Entering Grade
Child # 2
Child # 3
Child # 4
Sign Electronically for Pre-Registration to be Complete
Document Will Auto-Submit With Signature
Should be Empty: