ST. SYLVESTER SCHOOL
2011-2012 School Year Registration Form
PLEASE PRINT: Complete all information that applies to the child (ren) registering.
2011-2012
Oldest/Only Child’s Name
Grade
Birth Date
City/State of Birth
2011-2012
(2) Child’s Name
Grade
(2) Birth Date
City/State of Birth
2011-2012
(3) Child’s Name
Grade
(3) Birth Date
City/State of Birth
Address
Zip Code
Is /Are the child (ren) Catholic?
Yes
No
Does your child (ren) have any diagnosed physical or learning disabilities?
If “YES”, please explain:
Father’s Name (First and Last)
Address
Birthplace
Highest Level of School
Zip Code
Marital Status
Religion
Occupation
Place of Employment
Business Phone
Home Phone
ext.
Cell Phone
Email Address
(First and Last) ______(First and Last)
Mother’s
Name (First and Last)
________________________________________________________
Maiden Name
Address
Address
Birthplace
Birthplace
Highest
Level
of School
Highest
Level
of School
Zip Code
Religion
Religion
Marital Status
Marital Status
Occupation
Occupation
Place of Employment
Place ofPhone
Employment
Business
ext.
Cell Phone
Home Phone
Email Address
Business Phone _____________________ext. ______Cell Phone
(First and Last) ______(First and Last)
Are
both parents living together?
YES
NO- If “NO”, please complete information below
________________________________________________________
Home Phone
Email Address
Father:
Living with Child
Deceased
Separated
Address
__________________________________________________
Mother: Living with Child
Deceased
Separated
Address
Birthplace
Marital Status
Religion
Ethnic background of student (please check one of the following):
Black, not of Hispanic origin, African American- having origins in any of the black racial groups.
White, not of Hispanic origin, having origins in any of the original peoples of Europe, North Africa or
the Middle East.
Bi-Racial
American Indian or Alaskan Native, having origins in any of the original peoples of North America.
Asian or Pacific Islander, having origins in any of the original peoples of the Far East, Southeast
Asian, Indian Subcontinent or Pacific Islands (China, Japan, the Philippines and Samoa, for example).
Hispanic, of Mexican, Puerto Rican, Cuban, Central or South American or other Spanish cultures of
origin regardless of race.
Other: specify ______________________
Language spoken at home if other than English
Name of nearest public school location to your home
Does the student live 1.5 miles or more from St. Sylvester School?
Yes
No
Auto
Walk
Are parent(s) registered member(s) of St. Sylvester Parish?
Yes
No
If not, are parent(s) registered members of another Catholic parish?
Yes
No
Normal means of transportation to school?
CTA Bus
Name of Parish
(FOR NEW STUDENTS ONLY)
Copies of any applicable Sacramental records need to be furnished to the school for the child’s file.
School Last Attended
School Name
Date of Withdrawal
How did you find out about us:
School Sign
Internet
Parish Bulletin
Address
City/State/Zip Code
Reason
School Flyer/Brochure
Friend/Family Name:
School Website

No Registration is considered complete unless all of the above items have been completed and turned
into the school.

St. Sylvester School is non-discriminatory in its admissions policies and admits students of any race,
color, religion, and national and ethnic origin.
FOR OFFICE USE ONLY
Date of
Registration