Student's Last Name Last Email Father/Guardian Name First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCompany Name of Parent/Guardian (Father’s) Employer Work PhoneMother/Guardian Name First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCompany Name of Parent/Guardian (Mother's) Employer Work PhoneStudent lives with Either Parent/Guardian Military? Yes No Please list name(s) of your child(ren) who attend St. Peter School:NameGrade If your child(ren) has(have) an illness or accident, please list below the names and telephone numbers of friends and/or relatives who may authorize emergency care when we are unable to contact you.Name First Last Relationship Phone NumberName First Last Relationship Phone NumberList the names of the people to whom we are NOT permitted to release your child[ren]: I Will Read The Parent-Student Handbook and Abide By All The RulesParent/Guardian (Father’s) SignatureParent/Guardian (Mother’s) Signature
