Pre-Registration Form 22-23

St. Andrew Academy

Pre-Registration Form 2022-2023

A $125.00 non-refundable deposit, per family is due with this form.

(3% Credit Card charge)
Today's Date*

MonthDayYear
Date
Parent / Guardian Name 1*

First NameLast Name
Parent / Guardian Name 2 (if applicable)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Parents are (choose one): Separated / Divorced / Remarried / Deceased / Other *
Enrollment Type (choose one): St. Peter the Apostle, Catholic, Other*
If Catholic, please Identify Parish.
Student Information (Please list all students in your family that will attend SAA and the grade (s) they will enter).
Student Name 1*

First and Last NameIn-coming Grade
Student Information 1*

Date of BirthGender
Additional Student Name 2

First and Last NameIncoming Grade
Student Information 2

Date of BirthGender
Additional Student Name 3

First and Last NameIncoming Grade
Student Information 3

Date of BirthGender
Preschool Program: Full Time

PK2PK3PK4Part TimePK2PK3PK4
Should be Empty: