OLQP SCHOOL REGISTRATION FORM 20130903
FAMILY INFORMATION (Office Use) ID #: .
Registration date: -- 2 0 1
Referred by:
Family Name: (Last Name) (First Name)
Title: ☐ Mr. ☐Mrs. ☐M/M ☐Ms.
Status: ☐ Church Marriage ☐ Civil Marriage ☐ Co-resident
☐ Single ☐ Married ☐ Engaged ☐ Divorced ☐ Separated
Street Address:
2ND Address line (if needed):
City: State: Zip:
Parish:
Email:
Phone Number: - - Ext:
☐Home ☐Work ☐ Cell ☐ Unlisted
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PARENT/GUARDIAN INFORMATION
Parent/Guardian 1:______ (Last Name) (First Name)
Type: ☐ Father ☐ Mother ☐ Grandparent ☐ Ex-spouse ☐ Fiance(e)
Position: ☐ Head-of-House ☐ Spouse ☐ Other
Grade/Degree: Gender: ☐ Male ☐ Female
Date of Birth: - -
Languages: ☐English ☐Spanish ☐English & Spanish Other:______
Ethnicity: ☐Caucasian ☐Hispanic ☐Afro-American ☐Indian ☐Bi-racial ☐ Other ______
Occupation: ______
Phone Number: - - Ext:
☐Home ☐Work ☐ Cell ☐ Unlisted
Parent/Guardian 2: ______ (Last Name) (First Name)
Type: ☐ Father ☐ Mother ☐ Grandparent ☐ Ex-spouse ☐ Fiance(e)
Position: ☐ Head-of-House ☐ Spouse ☐ Other
Grade/Degree: Gender: ☐ Male ☐ Female
Date of Birth: - -
Languages: ☐English ☐Spanish ☐English & Spanish Other: ______
Ethnicity: ☐Caucasian ☐Hispanic ☐Afro-American ☐Indian ☐Bi-racial ☐ Other ______
Occupation: ______
Phone Number: - - Ext:
☐Home ☐Work ☐ Cell ☐ Unlisted
OLDEST STUDENT APPLICATION (For Office Use: Student ID: . )
Student Name: ______ (Last Name) (First Name)
Relationship: ☐ Son ☐ Daughter ☐ Grandchild ☐ Stepchild ☐Other
Previous school: ______
Enrolling to Grade: _____ ☐Male ☐Female Date of Birth: - -
(Month) (Day) (Year)
Languages: ☐English ☐Spanish ☐English & Spanish Other:
Ethnicity: ☐Caucasian ☐Hispanic ☐Afro-American ☐Polish ☐ German ☐ Indian ☐ Italian ☐ Puerto Rican ☐Bi-racial ☐ Irish
☐ Other: ______
Religion: ☐ Catholic ☐ Lutheran ☐ Baptist ☐ Pentecostal ☐ Methodist
☐Episcopal ☐ Non-Denominational ☐Jewish ☐ Moslem ☐ Buddhist
Place of Birth: __
(City) (State) (Country)
Father: ______Mother: ______
Sacraments: Baptized: ☐ NO ☐ YES If Yes:
Date Place:
(Month) (Day) (Year) (Name of Church)
(City) (State) (Country)
Reconciliation: ☐ YES ☐ NO
1st Communion: ☐ NO
If Yes: Date Place:
(Month) (Day) (Year) (Name of Church)
(City) (State) (Country)
2nd STUDENT APPLICATION (For Office Use: Student ID: . )
Student Name: (Last Name) (First Name)
Relationship: ☐ Son ☐ Daughter ☐ Grandchild ☐ Stepchild ☐Other
Previous school: ______
Enrolling to Grade: _____ ☐Male ☐Female Date of Birth: - -
(Month) (Day) (Year)
Languages: ☐English ☐Spanish ☐English & Spanish Other:
Ethnicity: ☐Caucasian ☐Hispanic ☐Afro-American ☐Polish ☐ German ☐ Indian ☐ Italian ☐ Puerto Rican ☐Bi-racial ☐ Irish
☐ Other: ______
Religion: ☐ Catholic ☐ Lutheran ☐ Baptist ☐ Pentecostal ☐ Methodist
☐Episcopal ☐ Non-Denominational ☐Jewish ☐ Moslem ☐ Buddhist
Place of Birth: __
(City) (State) (Country)
Father: ______Mother: ______
Sacraments: Baptized: ☐ NO ☐ YES If Yes:
Date Place:
(Month) (Day) (Year) (Name of Church)
(City) (State) (Country)
Reconciliation: ☐ YES ☐ NO
1st Communion: ☐ NO
If Yes: Date Place:
(Month) (Day) (Year) (Name of Church)
(City) (State) (Country)
3rd Student (For Office Use: Student ID: . )
Student Name: (Last Name) (First Name)
Relationship: ☐ Son ☐ Daughter ☐ Grandchild ☐ Stepchild ☐Other
Previous school: ______
Enrolling to Grade: _____ ☐Male ☐Female Date of Birth: - -
(Month) (Day) (Year)
Languages: ☐English ☐Spanish ☐English & Spanish Other:
Ethnicity: ☐Caucasian ☐Hispanic ☐Afro-American ☐Polish ☐ German ☐ Indian ☐ Italian ☐ Puerto Rican ☐Bi-racial ☐ Irish
☐ Other: ______
Religion: ☐ Catholic ☐ Lutheran ☐ Baptist ☐ Pentecostal ☐ Methodist
☐Episcopal ☐ Non-Denominational ☐Jewish ☐ Moslem ☐ Buddhist
Place of Birth: __
(City) (State) (Country)
Father: ______Mother: ______
Sacraments: Baptized: ☐ NO ☐ YES If Yes:
Date Place:
(Month) (Day) (Year) (Name of Church)
(City) (State) (Country)
Reconciliation: ☐ YES ☐ NO
1st Communion: ☐ NO
If Yes: Date Place:
(Month) (Day) (Year) (Name of Church)
(City) (State) (Country)
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