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St. Mary's Preschool

211 4th Street • Aurora, IN 47001
(812) 926-1558

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Preschool
- - Preschool Information
  - Preschool Registration
Photo Gallery
Lenten Fish Fry
- - Lenten Fish Fry
Parish

Parent / Student Information Sheet

Parent / Student Information
The maximum number of form submissions has been reached. This form is currently not available.
- Father / Male Guardian
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- St. Mary's Church Parishoner: REQUIRED Yes No Please fill out this field.
- Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Phone Carrier REQUIRED Please fill out this field. Please enter valid data.
- Place of Employment REQUIRED Please fill out this field. Please enter valid data.
- Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Family Email REQUIRED Please fill out this field. Please enter an email address.
- Mother / Legal Guardian
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Street Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- St. Mary's Church Parishoner: REQUIRED Yes No Please fill out this field.
- Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Phone Carrier REQUIRED Please fill out this field. Please enter valid data.
- Place of Employment REQUIRED Please fill out this field. Please enter valid data.
- Work Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Family Email REQUIRED Please fill out this field. Please enter an email address.
- Student lives with: Mother & Father Mother & Stepfather Father & Stepmother Mother Father Guardians
- Student(s) Enrolling
- Student #1 REQUIRED
  List your child's first, middle and last name and nickname if they go by one. Include grade they are enrolling into and date of birth.
  Please fill out this field.
- Student #2
  List your child's first, middle and last name and nickname if they go by one. Include grade they are enrolling into and date of birth.
- Student #3
  List your child's first, middle and last name and nickname if they go by one. Include grade they are enrolling into and date of birth.
- $100 per family100.0
Total:

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