Our Lady Help of Christians Academy

Online Pre-Enrollment Application

Complete this form in order to inform the Academy of your intention to enroll your child or children for the 2012-2013 Academic year. 
A full registration packet will be provided to you at the parent orientation in August.
Full registration forms may also be completed online or downloaded.

Please provide the following information about the child or children you wish to enroll:
(Should you have more than 6 children to enroll, please complete this form a second time to include your additional children.)





1

Name (first, middle, last) Age Date of Birth (dd/mm/yy) Gender Intended Grade
Name (first, middle, last) Age Date of Birth (dd/mm/yy) Gender Intended Grade
Name (first, middle, last) Age Date of Birth (dd/mm/yy) Gender Intended Grade
Name (first, middle, last) Age Date of Birth (dd/mm/yy) Gender Intended Grade
Name (first, middle, last) Age Date of Birth (dd/mm/yy) Gender Intended Grade
Name (first, middle, last) Age Date of Birth (dd/mm/yy) Gender Intended Grade

Please provide the following parent information:

Father Name (first, middle, last) Mother Name (first, middle, last)    
   
Street Address City State Zip Code
Home Phone Cell Phone Other Phone Select one
E-mail Address Other E-mail Address    
   

Questions or comments?