Registration Form for New StudentsNew Family Registration
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Registration  
Today's Date
- -
MM DD YYYY
Name of Student
First Name Middle Name Last Name
What grade are you registering for?
 
Student Information  
Student Name
First Name Middle Name Last Name
Gender
Date of Birth
- -
MM DD YYYY
Place of Birth
 
Family Information   
Father's Information
Name
First Name Middle Name Last Name
Religion
Occupation
Marital Status
Deceased
Mother's Information
Name
First Name Middle Name Last Name
Religion
Occupation
Marital Status
Deceased
Guardian
Use only if student is not living with parents.
Guardian Name
First Name Middle Name Last Name
Religion
Occupation
Marital Status
Family Relationship
 
Residence Information   
Address
Address1 City State Zip Country
Home Telephone
Area Code Number
Father's Work Phone
Area Code Number
Father's Cell Phone
Area Code Number
Father's Email
Mother's Work Phone
Area Code Number
Mother's Cell Phone
Area Code Number
Mother's Email
 
Sacramental Information  
Baptismal Date
- -
MM DD YYYY
Church
City, State
First Communion Date
- -
MM DD YYYY
Church
City, State
 
Sacramental Life  
Do you have any children attending St. John Chrysostom School? If so, provide name(s) and grade(s).
Does mother attend Mass regularly?
Does father attend Mass regularly?
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530 E. Florence Ave, Inglewood, CA 90301
Phone: 310-677-5868
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