St. Thomas Aquinas Academy

New Student Cumulative Information Form

2016-2017

Student Information
Date of Enrollment *
Date of Enrollment
Student Grade *
Student Date of Birth *
Student Date of Birth
Student Gender *
Ethnicity *
Date of Baptism:
Date of Baptism:
Date of First Eucharist:
Date of First Eucharist:
Date of Reconciliation:
Date of Reconciliation:
Will you participate in the Choice Program? *
Will you participate in the Free/Reduced Lunch Program? *
Parent Information
Mother Address
Mother Address
Mother Telephone Number
Mother Telephone Number
Mother Work Phone
Mother Work Phone
Father Address
Father Address
Father Telephone Number
Father Telephone Number
Father Work Phone
Father Work Phone
Parents are:
Student lives with:
Student main address:
Student main address:
PHOTO/VIDEO RELEASE
I consent to the use by St. Thomas Aquinas Academy of any video, photograph, slide, audio or other visual or audio reproduction in which I or my child may appear. I understand that these materials are being used for promotion of St. Thomas Aquinas Academy and such promotional activies extend to recruitment, fundraising, advocacy, etc. I release the staff, volunteers, etc. of St. Thomas Aquinas Academy from any liability connected with the use of my or my child's picture or voice recording as part of any of the above or similar activities. (Should you have any questions regarding the use of these images, please contact Dan Heding at dheding@staamke.org) *