Family Mass and Book Fair Sunday - students who attend the 9:30 am mass in uniform have free dress on Monday!
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Application for Admission 2007 - 2008
This Form Is To Be Completed By Parent
Child’s Last Name:
Present Grade:
Grade in September:
First Name:
Middle Name:
Sex:
Date of Birth:
Address:
City:
Zip code:
State:
Home Phone:
Child’s Place of Birth
City:
Country:
Child Resides with:
Both Parents
Mother Only:
Father Only:
Other:
Father’s Information
First Name:
Middle Name:
Last Name:
Religion:
Address:
City:
State:
Zip Code:
Home Phone:
Father’s Place of Birth
City:
State:
Country:
Father’s Employment Information
Occupation:
Employer:
Phone:
Employer’s Address:
City:
Father’s Marital Status:
Married
Single
Remarried
Separated
Divorced
Deceased
Mother’s Information
First Name:
Middle Name:
Last Name:
Religion:
Address:
City:
State:
Zip Code:
Home Phone:
Mother’s Place of Birth
City:
State:
County:
Mother’s Employment Information
Occupation:
Employer:
Phone:
Employer’s Address:
City:
Zip Code:
Mother’s Marital Status:
Married
Single
Remarried
Separated
Divorced
Deceased
If Applicable Complete the Following:
Step-Father
Step-Mother
Legal Guardian
First Name:
Middle Name:
Last Name:
City:
State:
County:
Occupation:
Employer:
Employer’s Address:
City:
Phone:
Status:
Married
Remarried
Single
Separated
Divorced
Deceased
Religion:
Relationship:
Complete the Following
Ethnic Origin:
Caucasian
Hispanic
Black
Filipino
Other Asian
Multi-Racial
Main or 1st Language spoken at home:
2
nd
Language:
School Child is Currently Attending:
City:
List all Children Currently Attending St. Genevieve Elementary School
Name:
Grade:
Name:
Grade:
Name:
Grade:
Name:
Grade:
Sacrament Information
Baptism:
Yes
No
First Communion:
Yes
No
Confirmation:
Yes
No
Baptism
Date:
Church:
City:
State:
Zip:
First Communion
Date:
Church:
City:
State:
Zip:
Confirmation
Date:
Church:
City:
State:
Zip:
Parish Information
1. Are you currently a registered member of St. Genevieve Parish?
Yes
No
If yes, Envelope #
2. Does you child attend C.C.D?
Yes
No
If yes, Parish:
3. Do you live within the geographical boundaries of St. Genevieve Parish?
Yes
No
If not, in what Parish do you reside? Name:
City:
© St. Genevieve Elementary School
14024 Community Street, Panorama City, CA 91402, Tel.: (818) 892-3802
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