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  • Family Information
    • Family name REQUIRED Please fill out this field. Please enter valid data.
    • Father's name REQUIRED Please fill out this field. Please enter valid data.
    • Mother's name REQUIRED Please fill out this field. Please enter valid data.
    • Mother's maiden name REQUIRED Please fill out this field. Please enter valid data.
    • Guardian's name Please enter valid data.
  • Contact information
    • Email address REQUIRED Please fill out this field. Please enter an email address.
    • Home phone REQUIRED Please fill out this field. Please enter valid data.
    • Father's cell Please enter valid data.
    • Mother's cell Please enter valid data.
    • Street address REQUIRED Please fill out this field. Please enter valid data.
    • City (if not Pasadena) Please enter valid data.
    • Zip REQUIRED Please fill out this field. Please enter valid data.
  • Child 1
    • Child's name REQUIRED Please fill out this field. Please enter valid data.
    • Child's DOB REQUIRED Please fill out this field. Please enter valid data.
    • Child's school REQUIRED Please fill out this field. Please enter valid data.
    • Child's grade REQUIRED Please fill out this field. Please enter valid data.
    • Sacrament Registration REQUIRED (Select One) Eucharist 2nd Grade ($50 addtl fee applies) Reconciliation 4th Grade ($50 addtl fee applies) Confirmation 1st Year 9th Grade (No addtl fee applies) Confirmation 2nd Year 10th Grade ($50 addtl fee applies) None Please fill out this field.
    • Medical/School concerns

      (please provide detailed information concerning any allergies, medical conditions or special learning situations)
  • Child 2
    • Child's name Please enter valid data.
    • Child's DOB Please enter valid data.
    • Child's school Please enter valid data.
    • Child's grade Please enter valid data.
    • Sacrament Registration REQUIRED (Select One) None Eucharist 2nd Grade ($50 addtl fee applies) Reconciliation 4th Grade ($50 addtl fee applies) Confirmation 1st Year 9th Grade (No addtl fee applies) Confirmation 2nd Year 10th Grade ($50 addtl fee applies) Please fill out this field.
    • Medical/School concerns

      (please provide detailed information concerning any allergies, medical conditions or special learning situations)
  • Child 3
    • Child's name Please enter valid data.
    • Child's DOB Please enter valid data.
    • Child's school Please enter valid data.
    • Child's grade Please enter valid data.
    • Sacrament Registration REQUIRED (Select One) None Eucharist 2nd Grade ($50 addtl fee applies) Reconciliation 4th Grade ($50 addtl fee applies) Confirmation 1st Year 9th Grade (No addtl fee applies) Confirmation 2nd Year 10th Grade ($50 addtl fee applies) Please fill out this field.
    • Medical/School concerns

      (please provide detailed information concerning any allergies, medical conditions or special learning situations)
  • Child 4
    • Child's name Please enter valid data.
    • Child's DOB Please enter valid data.
    • Child's school Please enter valid data.
    • Child's grade Please enter valid data.
    • Sacrament Registration REQUIRED (Select One) None Eucharist 2nd Grade ($50 addtl fee applies) Reconciliation 4th Grade ($50 addtl fee applies) Confirmation 1st Year 9th Grade (No addtl fee applies) Confirmation 2nd Year 10th Grade ($50 addtl fee applies) Please fill out this field.
    • Medical/School concerns

      (please provide detailed information concerning any allergies, medical conditions or special learning situations)
  • Child 5
    • Child's name Please enter valid data.
    • Child's DOB Please enter valid data.
    • Child's school Please enter valid data.
    • Child's grade Please enter valid data.
    • Sacrament Registration REQUIRED (Select One) None Eucharist 2nd Grade ($50 addtl fee applies) Reconciliation 4th Grade ($50 addtl fee applies) Confirmation 1st Year 9th Grade (No addtl fee applies) Confirmation 2nd Year 10th Grade ($50 addtl fee applies) Please fill out this field.
    • Medical/School concerns

      (please provide detailed information concerning any allergies, medical conditions or special learning situations)
  • Other Information
    • If you are divorced or separated are there any custody arrangements that we should be aware of?
    • I want to home school my child(ren) REQUIRED Yes No Please fill out this field.
    • Tuition payment option REQUIRED (Select One) Active envelope user - Pay in full Active envelope user - Installments Non envelope user - Paid in full Non envelope user - Installments Home study -- Paid in full Home Study - Installment if multiple children OLC Program Teacher Partial Scholarship Requested -- A scholarship request form will be emailed to you. Full Scholarship requested -- A scholarship request form will be emailed to you. Please fill out this field.
    • Parish Envelope number REQUIRED Please fill out this field. Please enter valid data.

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