Pre-Registration Form
Congratulation you've been accepted to Christ the King Prep. Please fill out the registration form to the best of your knowledge. This form, along with the Private School Aid Service Application and any other missing documents, must be completed before your schedule registration appointment.
Student's Last Name
Your answer
Student's First Name
Your answer
Student's Date of Birth
MM
/
DD
/
YYYY
Student's Gender
Required
Grade level in September 2016
What is the student's street address
Your answer
Do you have an Apartment Number?
Your answer
What City do you live in?
Your answer
What State do you live in?
Your answer
What is your zip code?
Your answer
What County do you live in?
Your answer
What is the student's home phone number?
Your answer
What is the student's cell/mobile phone number?
Your answer
What is the student's e-mail address
Your answer
What is the student's ethnicity?
Your answer
What is the student's Religious Background?
Your answer
Name of Place of Worship?
Your answer
Student resides with
Required
What School do you currently attend?
Your answer
Number of siblings living at home?
Your answer
What is the Mother's/Guardian's last name?
Your answer
What is the Mother's/Guardian's first name?
Your answer
What is the Mother's/Guardian's home phone number?
Your answer
What is the Mother's/Guardian's cell/mobile phone number?
Your answer
What is the Mother's/Guardian's work phone number & Ext.?
Your answer
What is the Mother's/Guardian's e-mail address?
Your answer
What is the Mother's/Guardian's Employer's Name?
Your answer
What is the Mother's/Guardian's position?
Your answer
Mother's/Guardian's education completed:
Your answer
Mother's/Guardian's Educational Institutions Name?
Your answer
Mother's/Guardian's Highest Degree?
Your answer
What is the Father's/Guardian's last name?
Your answer
What is the Father's/Guardian's first name?
Your answer
What is the Father's/Guardian's home phone number?
Your answer
What is the Father's/Guardian's cell/mobile phone number?
Your answer
What is the Father's/Guardian's work phone number & Ext.?
Your answer
What is the Father's/Guardian's e-mail address?
Your answer
What is the Father's/Guardian's Employer's Name?
Your answer
What is the Father's/Guardian's position?
Your answer
Father's/Guardian's education completed:
Your answer
Father's/Guardian's Educational Institutions Name?
Your answer
Father's/Guardian's Highest Degree?
Your answer
Last Name of First Emergency Contact:
Your answer
First Name of First Emergency Contact:
Your answer
Relationship of First Emergency Contact:
Your answer
Day time phone number of first emergency contact?
Your answer
Cell/mobile phone number of first emergency contact?
Your answer
Last Name of Second Emergency Contact?
Your answer
First Name of Second Emergency Contact?
Your answer
Relationship of Second Emergency Contact:
Your answer
Day time phone number of Second emergency contact?
Your answer
Cell/mobile phone number of second emergency contact?
Your answer
Last Name of Third Emergency Contact?
Your answer
First Name of Third Emergency Contact?
Your answer
Relationship of Third Emergency Contact:
Your answer
Day time phone number of third emergency contact?
Your answer
Cell/mobile phone number of third emergency contact?
Your answer
Does the student have a Medical Condition? (If yes, provide medical documentation)
Your answer
Does the student have allergies?
Your answer
Does the student take prescription medication?
Your answer
Student's Physicians Name:
Your answer
Student's Physician's Phone Number:
Your answer
Student's Dentist:
Your answer
Student's Dentist's Phone Number
Your answer
Student's Height:
Your answer
Student's Weight
Your answer
Has the student participated in a sport while in 6th, 7th & 8th grade? If yes, please list all sports and position.
Your answer
List Winter, Spring and Fall sports Student is interested in.
Your answer
List extracurricular activities student is interested in.
Your answer
Once again Congratulations on your acceptance to the Class of 2020. We look forward in seeing you at your scheduled registration appointment. Registration Fee is an nonrefundable fee of $150.00 and Student Fee of $125.00. Christ the King Prep payment methods are, cash, money order, cashiers check and or personal check. These payments are due at time of registration. Registration Requirements Reminder: Acceptance letter, Admissions Acceptance Form, Missing documents, Birth Certificate, Immunization Records Social Security Card, non-refundable registration fee of $150.00 (cash, money order or check), Student Fee of $125.00 (cash, money order or check) and Smart Tuition Enrollment Form. IMPORTANT NOTE TO PARENTS OR GUARDIANS: Please review carefully and sign below. I understand that Christ the King Preparatory School is an academically challenging, Catholic school with a code of mandatory attendance, dress, and conduct. The hallmark of the school is its Corporate Internship Program in which the students work one day a week and sign over their earnings to pay for part of their high school education. I further understand that full participation of parents and guardians is necessary in order to fulfill requirements of the program. Admission to Christ the King Preparatory School is contingent upon successful completion of the students current grade and payment of all financial obligations to the current school. I understand that all accepted and registered students must attend and successfully graduate from our mandatory Summer Training Institute (B.O.O.T Camp)(July 5 to July 29, 2016) in order to enroll at Christ the King Preparatory School. I certify that the information furnished in this registration form is complete and accurate. Furthermore, I understand that if I knowingly provide false information, this may jeopardize my child’s registration. * We ask that you plan vacation time accordingly.
Submit
Never submit passwords through Google Forms.
This form was created inside of Christ the King Preparatory School. Report Abuse - Terms of Service - Additional Terms