Person Making Contact Today...

(Required Fields noted with *)

First and Last Name *

Mailing Address *

City * State * Zip *

Phone Number *

Email Address *

Name(s) of child(ren):

1. First Last
   Date of Birth Year of School looking to enter <select grade level> Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12
2. First Last
   Date of Birth Year of School looking to enter <select grade level> Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12
3. First Last
   Date of Birth Year of School looking to enter <select grade level> Pre-K K 1 2 3 4 5 6 7 8 9 10 11 12

School currently attending

Your relationship to prospective student(s) <select one> Father Mother Uncle Aunt Grandparent Guardian Other

How did you hear about our school? <select one> Current student/family Church bulletin Visit or call from school representative Newspaper Internet website Alumni Flyer Mailing Radio Referral Other

What are you most interested in knowing about our school? <select one> Academic program Discipline Results of standardized tests Transportation Religious education/spiritual opportunities Financial assistance Extra curricular opportunities Becoming a member of our parish Other

Would you like to schedule a school visit ? Yes No

Would you like to attend an open house? Yes No

Would you like to talk to the principal? Yes No

What is the best day/time to reach you? <select one> Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Questions or comments that you have at this time: