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Parent / Guardian Information

First Parent / Guardian

First Name

Middle Name

Last Name

Salutation

Gender

Work Phone

Cell Phone

Second Parent / Guardian (leave blank if not applicable)

First Name

Middle Name

Last Name

Salutation

Gender

Work Phone

Cell Phone

Home Address

Street Address

City

Country

State

Zip

Home Phone

How Did You Hear About Us?

Student 1

First Name

Middle Name

Last Name

Birth Date

Gender

Grade Level of Interest

School Year

Current School

Student 2

First Name

Middle Name

Last Name

Birth Date

Gender

Grade Level of Interest

School Year

Current School

Student 3

First Name

Middle Name

Last Name

Birth Date

Gender

Grade Level of Interest

School Year

Current School

Student 4

First Name

Middle Name

Last Name

Birth Date

Gender

Grade Level of Interest

School Year

Current School

Notes

Parent / Guardian Notes

10 + 1 =

St. Joseph Catholic School
119210 Larch St., P.O. Box 6
Stratford, WI 54484
Phone: 715-687-4145
Fax: 715-687-4343