Date of Last Upload:
Friday, May 25, 2018
Student Enrollment Form
New Student Information
Select the Submit Application tab after you have filled in all information including students, primary and secondary family, and emergency/contacts. Use the tab buttons to select the pages to fill in the information.
*
Required fields are bold.
Student's Information
Primary Family Information
Secondary Family Information
Contact Information
Submit Application
Student 1
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Place of Birth
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
School Previously Attended
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
Native American
Two or more races
Unknown
E-Mail
*
Grade Level
<None>
Preschool
K
1
2
3
4
5
6
7
8
Prekindergarten
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Student 2
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Place of Birth
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
School Previously Attended
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
Native American
Two or more races
Unknown
E-Mail
*
Grade Level
<None>
Preschool
K
1
2
3
4
5
6
7
8
Prekindergarten
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Student 3
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Place of Birth
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
School Previously Attended
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
Native American
Two or more races
Unknown
E-Mail
*
Grade Level
<None>
Preschool
K
1
2
3
4
5
6
7
8
Prekindergarten
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Student 4
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Place of Birth
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
School Previously Attended
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
Native American
Two or more races
Unknown
E-Mail
*
Grade Level
<None>
Preschool
K
1
2
3
4
5
6
7
8
Prekindergarten
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Student 5
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Place of Birth
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
School Previously Attended
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
Native American
Two or more races
Unknown
E-Mail
*
Grade Level
<None>
Preschool
K
1
2
3
4
5
6
7
8
Prekindergarten
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Primary Family Information
Address Line 1
Address Line 2
City
State
ZIP Code
Home Phone
Home Listed
Cell Phone
Cell Listed
Parent 1 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Maiden Name
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
Gender
<None>
Female
Male
Home E-Mail
Cell Phone
Cell Listed
Company Name
Business Phone
Extension
Job Title
Is Emergency Contact
Business E-Mail
Is Allowed to Pickup
Parent 2 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Maiden Name
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
Gender
<None>
Female
Male
Home E-Mail
Cell Phone
Cell Listed
Company Name
Business Phone
Extension
Job Title
Is Emergency Contact
Business E-Mail
Is Allowed to Pickup
Secondary Family Information
Address Line 1
Address Line 2
City
State
ZIP Code
Home Phone
Home Listed
Cell Phone
Cell Listed
Parent 3 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Maiden Name
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
Gender
<None>
Female
Male
Home E-Mail
Cell Phone
Cell Listed
Company Name
Business Phone
Extension
Job Title
Is Emergency Contact
Business E-Mail
Is Allowed to Pickup
Parent 4 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Maiden Name
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
III
Jr
IV
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
Mr
Mrs
Ms
Church Affiliation
<None>
Annunciation of the Lord
Catholic
Christ The King
E.Freetown Christian Con
Holy
Holy Family
Holy Name
Holy Redeemer
Immaculate Conception
Mt. Carmel
Non-Catholic
Our Lady of Fatima
Our Lady of Guadalupe
Our Lady of Purgatory
Our Lady of Victory
Sacred Heart of Holy Fami
St. Anthony
St. Francis of Assisi
St. Francis Xavier
St. George
St. John Attleboro
St. John Neumann
St. John the Baptist
St. Joseph
St. Joseph-St. Therese
St. Julie's
St. Lawrence
St. Margaret
St. Mary
St. Mary's (Fhvn.)
St. Patrick Somerset
St. Patrick Wareham
St. Rita Marion
Sts. Martha & Mary
Unknown
Gender
<None>
Female
Male
Home E-Mail
Cell Phone
Cell Listed
Company Name
Business Phone
Extension
Job Title
Is Emergency Contact
Business E-Mail
Is Allowed to Pickup
Contact Information (Other than parents)
Contact 1
*
Last Name
*
First Name
Relation
<None>
Aunt
Friend
Grandparent
Spouse
Brother
Father
Mother
Uncle
Sister
Husband
daughter
son
mother-in-law
sister-in-law
Step-Father
Step-Mother
Godparent
Neighbor
Cousin
baby sitter
great grandparent
Great aunt
(father/step-father)
Grandmother/guardian
Is Emergency Contact
Home Phone
Is Allowed to Pickup
Business Phone
Pickup License
Mobile Phone
Pickup Tag
Pickup Notes
Contact 2
*
Last Name
*
First Name
Relation
<None>
Aunt
Friend
Grandparent
Spouse
Brother
Father
Mother
Uncle
Sister
Husband
daughter
son
mother-in-law
sister-in-law
Step-Father
Step-Mother
Godparent
Neighbor
Cousin
baby sitter
great grandparent
Great aunt
(father/step-father)
Grandmother/guardian
Is Emergency Contact
Home Phone
Is Allowed to Pickup
Business Phone
Pickup License
Mobile Phone
Pickup Tag
Pickup Notes
Contact 3
*
Last Name
*
First Name
Relation
<None>
Aunt
Friend
Grandparent
Spouse
Brother
Father
Mother
Uncle
Sister
Husband
daughter
son
mother-in-law
sister-in-law
Step-Father
Step-Mother
Godparent
Neighbor
Cousin
baby sitter
great grandparent
Great aunt
(father/step-father)
Grandmother/guardian
Is Emergency Contact
Home Phone
Is Allowed to Pickup
Business Phone
Pickup License
Mobile Phone
Pickup Tag
Pickup Notes
Medical Contacts
Physician
Physician Phone Number
Dentist
Dentist Phone Number
Hospital
Hospital Phone Number
Insurance
Insurance Phone Number
Policy Number
Allergies and/or Medical concerns
Finished
Confirmation E-Mail address:
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