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Family Interest Form

Tell us a little about you:

What is your first name?*

Answer Required

What is your last name?*

Answer Required

Street Address*

Answer Required

City*

Answer Required

State*

Answer Required

Zip/Postal*

Answer Required

What is the best phone number to reach you?*

Answer Required

What is your email address?*

Answer Required

What is your child's first name?*

Answer Required

What is your child's last name?*

Answer Required

For what school year are you applying?*

ex. 2016-2017

Answer Required

What is your child's current age? *

Answer Required

When is your child's birthday?*

Answer Required

What is your child's gender?*

Answer Required

Male

Female

Do you have additional children applying to St. Richard? Please list them here:

Answer Required

Where does child attend school currently?*

Answer Required

Does your child have any special needs which St. Richard should be made aware?*

Answer Required

Yes

If yes, please specify below:

Answer Required

How did you hear about us? *

Answer Required

Friend/Family

Parish bulletin/newspaper/magazine

Received an open house / tour invitation

Google Search

Other

Confirmation Email

Enter your email address here if you'd like to receive a confirmation upon submitting the form.

Email Required