Editing previous response:

Please fix the highlighted areas below before submitting.

New Student Registration Form 2024 - 2025

Student Information

Legal First Name*

Answer Required

Legal Middle Name

Answer Required

Legal Last Name*

Answer Required

Preferred Name

Answer Required

Date of Birth*

Answer Required

Grade Entering*

Answer Required

Does your child have an IEP, 504, or diagnostic testing? *

Answer Required

Name of transferring school*

Answer Required

Reason for transferring to St. Malachy*

Answer Required

Catholic Yes/No*

Answer Required

First language spoken by student*

Answer Required

Languages spoken at home*

Answer Required

Student lives with mother, father, both parents, or other (list full name & relationship to student)*

Answer Required

Address

Street Address*

Answer Required

City*

Answer Required

Any health related issues or concerns? (asthma, migraines, allergies, eczema, etc.)*

Answer Required

Zip/Postal*

Answer Required

Home Phone*

Number Required

Parent 1 Information

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Email*

Answer Required

Mobile Phone*

Number Required

Work Phone

Number Required

Parent 2 Information

First Name

Answer Required

Middle Name

Answer Required

Last Name

Answer Required

Question

Answer Required

Mobile Phone

Number Required

Work Phone

Number Required

Emergency Contact Information

First Name*

Answer Required

Middle Name

Answer Required

Last Name*

Answer Required

Relationship to Student*

Answer Required

Phone*

Number Required

Family Doctor Information

Name

Answer Required

Phone

Number Required

If applicable, please upload any health related documents (physical, immunizations, dental, & vision)

Answer Required

Choose a file or drag it here.

If applicable, please upload academic records (most recent report card, test scores, & attendance)

Answer Required

Choose a file or drag it here.

Confirmation Email

Email Required