Saint Robert Bellarmine Elementary School Application
APPLICATION FOR ENROLLMENT
154 N. 5TH ST. BURBANK, CA 91501;
CONTACT US: info@srbburbankschool.com
GRADE ENTERING *
WHAT SCHOOL YEAR ARE YOU APPLYING FOR *
Required
STUDENT(S) FIRST AND LAST NAME *
Your answer
SEX *
BIRTHDAY *
MM
/
DD
/
YYYY
BIRTHPLACE *
Your answer
ETHNIC BACKGROUND *
Your answer
RELIGION *
Your answer
SOCIAL SECURITY # *
Your answer
LANGUAGES SPOKEN AT HOME *
Your answer
LAST SCHOOL ATTENDED *
Your answer
PLEASE PROVIDE PREVIOUS SCHOOL ADDRESS & PHONE NUMBER *
Your answer
REASON FOR LEAVING *
Your answer
FATHER-FIRST, MIDDLE & LAST NAME *
Your answer
MOTHER-FIRST, MIDDLE & LAST NAME *
Your answer
IF ANY; GUARDIAN/LEGAL STEPPARENT FIRST, MIDDLE & LAST NAME
Your answer
CURRENT ADDRESS *
Your answer
PHONE NUMBER *
Your answer
EMAIL *
Your answer
BAPTISM DATE OF YOUR CHILD
MM
/
DD
/
YYYY
CHURCH AND ADDRESS OF BAPTISM LOCATION
Your answer
WHY WOULD YOU LIKE YOUR CHILD/REN TO ATTEND ST. ROBERT BELLARMINE SCHOOL? *
Your answer
HOW DID YOU HEAR ABOUT ST. ROBERT BELLARMINE SCHOOL? *
Your answer
PLEASE LIST ANY RELATIVES ATTENDING OUR SCHOOL
Your answer
DESCRIBE ANY SPECIAL HEALTH NEEDS YOUR CHILD MAY HAVE
Your answer
IS THERE ANYTHING WE NEED TO KNOW THAT WOULD HELP US IN PROVIDING FOR YOUR CHILD'S EDUCATIONAL NEEDS?
Your answer
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