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You may contact our Main Office at any time to register your child or children to attend St. Michael School. Tours are available. Our Main Office phone number is 315-331-2297.
St. Michael School 320 South Main Street Newark, NY 14513-1721 (315) 331-2297 New Student Registration Form Registration for St. Michael School Date of Registration _____________ Date of entrance into new school _____________ Grade level entering _____________ PLEASE PRINT Student’s Name ________________________________________ Male _____ Female _____ Last Name First Name Middle Name Address ______________________________________________________________________ Street City/Town State Zip Birth date___/___/___ Birthplace____________________SS# ___ ___ ___ - ___ ___ - ___ ___ ___ ___ Phone ( ) Unlisted? – Yes_____ No_____ Public school district where student resides _______________________________________________ Please Check American Indian/ Black (non-Hispanic) _____ Hispanic _____ Alaskan Native _____ Asian/Pacific _____ White (non-Hispanic) _____ Last school attended ______________________________________________ Grade ___________ School’s address ____________________________________________________________________ Street City/Town State Zip Child lives with ________________________________ Relationship to student _______________ Parent/Guardian (as you wish your name to appear on official communication) Circle one: Mr./Mrs. Dr. Mr. Mrs. Ms. _________________________________________________ Last Name First Name Middle Initial Mailing Address ____________________________________________________________________ Street City/Town State Zip Home Phone ( ) . Work Phone ( ) .Cell Phone ( ) . Medical Insurance Company ____________________________________ Policy # _______________ Person to be contacted in case of emergency if parent/guardian cannot be reached: Name _____________________________________________ Relationship ____________________ Address _______________________________________________________ Phone ( ) . Street City/Town State Zip Student’s Religion ___________________ Family registered in ___________________Parish/Church Baptism: Date ________ Church _____________________ Location ______________ First Communion: Date ________ Church _____________________ Location ______________ First Penance Program: Date ________ Church _____________________ Location ______________ Confirmation: Date ________ Church _____________________ Location ______________
OVER ? FAMILY INFORMATION
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