St. Elizabeth Seton School
Registration Renewal 2021 – 2022 Grades: Pre-K– Eighth Grade
Student Name
First Name
Last Name
Student Name
First Name
Last Name
Student Name
First Name
Last Name
Student Name
First Name
Last Name
Student(s) Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
US Citizen?
Yes
No
School District in which students reside?
Church at which family are parishioners? (Please include City/State)
Father's First and Last Name
First Name
Last Name
Father's Home Telephone Number
-
Area Code
Phone Number
Father's Cell Phone Number
-
Area Code
Phone Number
Father's Email
example@example.com
Father's Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's Employer
Father's Occupation
Father's Work Phone Number
-
Area Code
Phone Number
Father's Work Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother's First and Last Name
First Name
Last Name
Mother's Home Phone Number
-
Area Code
Phone Number
Mother's Cell Phone Number
-
Area Code
Phone Number
Mother's Email
example@example.com
Mother's Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother's Occupation
Mother's Employer
Mother's Work Phone Number
-
Area Code
Phone Number
Mother's Work Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student(s) lives with:
Two Parent Family/Both Natural Parents
Two Parent Family/One Natural Parent and One Step-Parent
One Parent Family/Mother
One Parent Family/Father
Custody is held by:
Mother
Father
Joint
Other (Please explain arrangement below)
Special Custody Arrangements, please explain here. (Note: Legal guardians must provide school with pertinent court documentation.)
Names of other children in the family and their birth dates:
Name of Person who will be solely responsible for tuition payments?
First Name
Last Name
Registration completed by and your relationship to student:
Signature
*
Date
*
-
Month
-
Day
Year
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Registration Fee: A non-refundable $50 Registration fee per family must accompany this form.
*
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USD
Registration Renewal Fee
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First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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