Re Registration Admission Form 24-25

755 Central Avenue, Pawtucket, RI 02861

401-723-9463
Re-Registration Admission Form

2024 - 2025
Pupil's Name *

First NameLast Name
Pupils Date of Birth*

MonthDayYear
Date
Place of Birth*
Religion
Gender*
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Grade Entering *
St. John Paul II Budget Envelope Number
Dismissal *
Mother/Guardian Name*

First NameLast Name
Mother/Guardian Occupation
Mother/Guardian Email *
example@example.com
Mother/Guardian Phone Number*
Please enter a valid phone number.
Father/Guardian Name*

First NameLast Name
Father/Guardian Occupation
Father/Guardian Email *
example@example.com
Father/Guardian Phone Number*
Please enter a valid phone number.
Address same as children?*
Address / If not the same as child.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name (other than parents)*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Relation to student*
Custodial Arrangements
Restraining Order
Educational Needs
Known allergies*
Current Medications*
Outstanding Medical History (i.e. Diabetes, Asthma, etc.)*
Insurance Company*
Name of Subscriber*
Policy Number*
Child's Physician*
Physician Phone*
$200.00 Registration Fee for Kindergarten - 8th Grade

https://square.link/u/Udf0a7en

$100.00 Registration Fee for Pre-Kindergarten

https://square.link/u/W8Bex3Ib
The Administration of Saint Cecilia School utilizes the services provided by Facts Tuition Management Systems to facilitate tuition collection for the school year. Accordingly, FACTS, in conjunction with Saint Cecilia School, is pleased to offer the following options from which you will be asked to choose. There is a $50 FACTS service fee. Please make sure your FACTS tuition is up to date and your application is completed.

Signin (factsmgt.com)

Apply at our school’s website: https://online.factsmgt.com/signin/3HP8R
Photo Release *Your answer will serve as your electronic signature*
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755 Central Avenue, Pawtucket, RI 02861

Re-Registration Admission Form

Signin (factsmgt.com)