Reminder- Registration is due May 15th $300.00 per child.           Talent Show - Friday, May 16th at 10:00am.
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:
2nd 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