Application Renewal Form

Renewal Application Form

for

St. Joseph's Parish School

695 Stevens Avenue

Portland, ME 04103

Phone: (207) 797-7073

Please print out this form and bring or send it to our school office.

Present Date:__________________ Grade for which you are applying:______ School Year:_________________

NAME:______________________________________________________ _________________SEX:_______

(last)

(first)

(middle)

ADDRESS:____________________________________ CITY:________________ STATE:____ ZIP:_______

MAILING ADDRESS (if different):_____________________________________________________________

TELEPHONE (day):_________________ (eve.)________________ DATE OF BIRTH:____________________

FATHER

NAME:_______________________________ RELIGION:____________ Phone:_______________________

Occupation/Place of Work:___________________________________________ Work Phone/pager:_________

MOTHER

NAME:_______________________________ RELIGION:____________ Phone:_______________________

Occupation/Place of Work:___________________________________________ Work Phone/pager:_________

IMPORTANT: What Parish are you a member of?__________________________________________________

SCHOOL & ADDRESS LAST ATTENDED (if applicable):__________________________________________

____________________________________________________________________________________________

Whom may we contact in case of emergency, if parents aren't available?

Name & Relationship _________________________________telephone___________________cellphone/pager___

_____________________________________________________________________________________________

In case of accident and the school is unable to contact anyone, what is your hospital preference?__________________

Is your child covered by insurance?_______

Are you a graduate of St. Joseph's School?______ If yes, year of graduation:_______

Are there any other siblings at home? If yes, what are their ages?___________________________________________