School Registration Form

St. Susanna Parish School

500 Reading Road, Mason, OH 45040
2025-2026 School Registration

Additional documents are required for registration to be complete. Please bring the following documents to the school office or you can upload at the bottom of this form. We are required to view the original birth certificate and copy for your student's permanent record.
- Original Birth Certificate
- Baptismal Certificate (if Catholic)
- Current Immunization Records
- Custody documents (if applicable)
- Release of records (when registering for grades 1-8 only or repeating kindergarten)
- Registration fee ($100/one child or $150/two+ children). Payment can be made via cash, check (made out to St. Susanna School) or Online Giving.
**Registration will not be considered complete until the registration form and fee has been completed at a minimum**
Date

MonthDayYear
Date
This form will be available on Monday November 4th for current families of St. Susanna Parish School and St. Susanna Preschool.

Registration opens to all others on Monday January 13th.

Thank you!
Student Information
Legal Name:*

First NameMiddle NameLast Name
Nickname:
Date of Birth: *

MonthDayYear
Gender:*

MaleFemale
Current Grade:*
Expected Grade for Enrollment:*
If registering for kindergarten, please select class preference:*

Full DayFlex dayN/A
Ethnicity:*
What language does your child speak most frequently?*
What language do you speak most frequently to your child?*
Religion:*
Which Parish are you currently registered?*

Family Information
Family Primary Phone Number:*
Please enter a valid phone number.
Family Primary Email Address:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Status of Parents:*
Are you the natural parents of the child?*
Are you the adoptive parents of the child?*
If mother and father are separated/divorced, who has legal custody of the child?
Parent/Guardian

Please add both mother and father (or guardian) information below unless not applicable.
Relationship to Student:*
Name:*

PrefixFirst NameLast Name
Address (if different than student):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Phone Number:*

Area CodePhone Number
Work Phone Number:

Area CodePhone Number
Home Email Address:*
example@example.com
Work Email Address:
example@example.com
Religion:*
Occupation:*
Employer:*
Parent/Guardian
Relationship to Student:
Name:

PrefixFirst NameLast Name
Address (if different than student):

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Phone Number:*

Area CodePhone Number
Work Phone Number:

Area CodePhone Number
Home Email Address:*
example@example.com
Work Email Address:
example@example.com
Religion:*
Occupation:*
Employer:*

Notes
Please list siblings and expected entry date (month/year):*
Please list the ministries at St. Susanna Parish in which you have been active during the past year or any other pertinent information regarding your registration. Thank you.*
Please list any other pertinent information regarding your registration:*
Baptism Certificate

Cancelof
Immunization Records

Cancelof
Custody Documents

Cancelof
Release of Records

Cancelof
I, the undersigned, do hereby state and declare under penalty of falsification that I am the parent or legal guardian of the above named student and that this registration information is true and correct.
Electronic Signature of Parent/Guardian completing form:
Full Name
St. Susanna Parish School admits students of any race, color, and national or ethnic origin. This school complies with The Decree on Child Protection which is promulgated by the Archbishop of Cincinnati. Our fingerprinting policy includes manual fingerprinting for employees and electronic background checks for all employees and volunteers.

Certain information requested is mandated under Senate ORC Bill 140 and Education Management Information System (Sections 3301-0714).
Should be Empty:

St. Susanna Parish School

Student Information

School Information

Family Information

Parent/Guardian

Parent/Guardian

Notes