Catholic Diocese Student Information
Complete this form for each student.
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Email *
EMAIL_ADDRESS *
Enter the Parent's or Guardian's email address.
PARENT/GUARDIAN_FULL_NAME *
Please enter the full name of one parent or guardian.
STUDENTS_FIRST_NAME *
Enter the student's first name only.
STUDENTS_MIDDLE_NAME *
Enter the student's middle name only.
LAST_NAME *
Enter the student's last name only.
ADDRESS *
In this field, enter the student's street number and street name only.
APT
Enter the apartment number associated with the student's address, if applicable.
CITY *
Enter the city associated with the student's address.
STATE *
Choose the state associated with the student's address.
ZIP *
Enter the 5-digit zip code associated with the student's address.
STUDENTS_DATE_OF_BIRTH *
Enter the student's date of birth in the format: MM/DD/YYYY
MM
/
DD
/
YYYY
STUDENTS_GENDER *
Select the student's gender. (F=Female, M=Male)
ETHNICITY *
Select the student's ethnicity. You may select as many as needed.
Required
SPECIAL_NEEDS *
Choose Y if the student has special needs. Choose N if the student does not have special needs.
GRADE_LEVEL *
Choose the student's grade level. (Prekindergarten = -1) (Kindergarten = 00)
STUDENT_ID_NUMBER
Enter the student's 10-digit SASID (State Assigned Student Identification)
SCHOOL_BUILDING_CODE *
Enter the school building number, not the school's name.
HOME_PHONE_NUMBER *
Enter the student's home telephone number with area code.  
EMERGENCY_PHONE_NUMBER *
Enter an emergency phone number with area code.
CELL_PHONE_NUMBER *
Enter a cell phone number with area code.
ANOTHER_CHILD_ENTER *
Are there more students at this same address? If YES, please complete this form for each student. Select Y for Yes. Select N for No.
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