Our Lady of the Valley Regional School Application for Enrollment
PreK 3- Grade 8
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Child's Last Name *
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Child's First Name *
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Child's Middle Name *
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Street Address *
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Town *
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State *
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Zip Code *
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Parent/Guardian Primary Phone Number *
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Secondary Phone Number
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Emergency Contact Name and Number *
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Sex *
Place of Birth (Town and State) *
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Date of Birth *
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Ethnicity (Is this student Hispanic or Latino?)
What is the student's race (choose one or more)
School Last Attended (if applicable)
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City/State
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Grade Last Attended
Grade Entering at Time of Admission
Date of Baptism
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Church, City, State
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Date of First Communion
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Church, City, State
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Name of Parent 1 (include maiden name if applicable)
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Address
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Name of Parent 2 (include maiden name if applicable)
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Address
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Parent 1 Occupation
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Parent 2 Occupation
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Parent 1 Religion
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Parent 2 Religion
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Parish *
Parent 1 Email Address
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Parent 2 Email Address
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Is the student related to an OLV alumna or alumnus?
How did you hear about us?
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