Instructions
Complete the following form in full as accurately as possible. Please note the following:
When choosing your child(ren)'s grade, be sure to indicate the grade your child will enter in the Fall of 2024.
If your child(ren)'s school is not listed, please choose "Other" and indicate the school in the Remarks box.
When choosing Yes for Medical Consent, you are agreeing to the following statement:
In the event of injury or illness, I/we give permission to transport my child to a hospital for emergency medical treatment. I/we also grant permission to any and all health care providers designated by the Catholic Community of Waukesha Staff to provide my children any and all necessary medical care related to the injury/illness. I/we understand that I/we will be contacted as soon as practical as to the medical emergency and be provided with all necessary information related to the medical emergency.
When choosing Yes for Photo/Video Consent, you are agreeing to the following statement:
I hereby consent that any still or electronic image and/or recording, in which I or my child may appear may be used by the Catholic Community of Waukesha. I understand that these materials are being used for promotion of the Catholic Community of Waukesha in support of recruitment, fundraising, evangelization and other communication efforts. I release the staff and volunteers and I understand and agree that the use of my picture is not an invasion of privacy. Neither I, nor anyone claiming to be speaking on my behalf, will later object to the Catholic Community of Waukeshas use of these photographs or videos.
Head of Household
Title
None
Mr.
Ms.
Mrs.
* First Name
* Last Name
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
Relationship
Daughter
Father
Mother
Son
Middle Name
Nickname
Maiden Name
Ethnicity
American Indian/Alaska Native
Arabic
Bi-Racial
Black/African American
Hispanic/Latino
Southeast Asian
White/Caucasian
* Birth Date
* Gender
Male
Female
* Language
American Sign Lang
Bilingual
English
Spanish
* Marital Status
Divorced
Domestic Partner
Married - Catholic faith
Married - Civil or other faith
Separated
Single - Never Married
Single Parent
Widowed
Religion
Agnostic
Baptist
Buddhist
Catholic
Christian
Episcopalian
Evangelical
Hindu
Jewish
Lutheran
Methodist
Mormon
Muslim
Non Practicing
Non-Denominational
Not Baptized
Orthodox
Other
Presbyterian
Protestant
RCIA
United Church Of Christ
Unknown
* Parish
St. John Neumann Parish
St. Joseph Parish
St. Mary Parish
St. William Parish
* Phone 1
Cell Mr
Cell Mrs
Home
Work Mr
Work Mrs
( )
-
Unlisted
* Email 1
Email Child
Email Family
Email Mr
Email Mrs
Unlisted
Spouse
Title
None
Mr.
Ms.
Mrs.
First Name
Last Name
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
Relationship
Daughter
Father
Mother
Son
Middle Name
Nickname
Maiden Name
Ethnicity
American Indian/Alaska Native
Arabic
Bi-Racial
Black/African American
Hispanic/Latino
Southeast Asian
White/Caucasian
Birth Date
Gender
Male
Female
Language
American Sign Lang
Bilingual
English
Spanish
Marital Status
Divorced
Domestic Partner
Married - Catholic faith
Married - Civil or other faith
Separated
Single - Never Married
Single Parent
Widowed
Religion
Agnostic
Baptist
Buddhist
Catholic
Christian
Episcopalian
Evangelical
Hindu
Jewish
Lutheran
Methodist
Mormon
Muslim
Non Practicing
Non-Denominational
Not Baptized
Orthodox
Other
Presbyterian
Protestant
RCIA
United Church Of Christ
Unknown
Parish
St. John Neumann Parish
St. Joseph Parish
St. Mary Parish
St. William Parish
Phone 1
Cell Mr
Cell Mrs
Home
Work Mr
Work Mrs
( )
-
Unlisted
Email 1
Email Child
Email Family
Email Mr
Email Mrs
Unlisted
Family Street Address
* Line 1
Line 2
* City
* State
Alabama (AL)
Alaska (AK)
American Samoa (AS)
Arizona (AZ)
Arkansas (AR)
California (CA)
Colorado (CO)
Connecticut (CT)
Delaware (DE)
District of Columbia (DC)
Federated States of Micronesia (FM)
Florida (FL)
Georgia (GA)
Guam (GU)
Hawaii (HI)
Idaho (ID)
Illinois (IL)
Indiana (IN)
Iowa (IA)
Kansas (KS)
Kentucky (KY)
Louisiana (LA)
Maine (ME)
Marshall Islands (MH)
Maryland (MD)
Massachusetts (MA)
Michigan (MI)
Minnesota (MN)
Mississippi (MS)
Missouri (MO)
Montana (MT)
Nebraska (NE)
Nevada (NV)
New Hampshire (NH)
New Jersey (NJ)
New Mexico (NM)
New York (NY)
North Carolina (NC)
North Dakota (ND)
Northern Mariana Islands (NP)
Ohio (OH)
Oklahoma (OK)
Oregon (OR)
Palau (PW)
Pennsylvania (PA)
Puerto Rico (PR)
Rhode Island (RI)
South Carolina (SC)
South Dakota (SD)
Tennessee (TN)
Texas (TX)
Utah (UT)
Vermont (VT)
Virgin Islands (VI)
Virginia (VA)
Washington (WA)
West Virginia (WV)
Wisconsin (WI)
Wyoming (WY)
Alberta (AB)
British Columbia (BC)
Manitoba (MB)
New Brunswick (NB)
Newfoundland and Labrador (NL)
Northwest Territories (NT)
Nova Scotia (NS)
Nunavut (NU)
Prince Edward Island (PE)
Saskatchewan (SK)
Ontario (ON)
Quebec (QC)
Yukon (YT)
Other
* ZIP
* Parish
Other
Queen of Apostles Parish, Pewaukee
St. Anthony Parish, Pewaukee
St. John Neumann Parish, Waukesha
St. Joseph Parish, Big Bend
St. Joseph Parish, Waukesha
St. Mary Parish, Waukesha
St. William Parish, Waukesha
Family Phone Numbers
* Primary
Cell Mr
Cell Mrs
Home
Work Mr
Work Mrs
( )
-
Unlisted
Other
Cell Mr
Cell Mrs
Home
Work Mr
Work Mrs
( )
-
Unlisted
Family Email Address
* Email
Email Child
Email Family
Email Mr
Email Mrs
Unlisted
Fee Total = $0.00
Enroll Student 1 Do Not Enroll Student 1
Student 1
Head of Household
Spouse
Adult
Young Adult
Child
Other
* First Name
* Last Name
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
Middle Name
Nickname
Ethnicity
American Indian/Alaska Native
Arabic
Bi-Racial
Black/African American
Hispanic/Latino
Southeast Asian
White/Caucasian
* Birth Date
* Gender
Male
Female
* Grade/Degree
K3
K4
K5
1
2
3
4
5
6
7
8
9
10
11
12
* School
Arrowhead HS
ASA Clark MS
Banting Elem
Bay Lane Elem
Beautiful Lutheran Savior
Bethesda Elem
Blair Elem
Brookfield Academy
Brookfield Central HS
Brookfield East HS
Bruce Guadalupe
Butler MS
Carroll University
Casa de Esperanza
Catholic Memorial HS
Charter
Cushing Elem
Divine Savior HS
eAchieve Academy
Golda Meir - Milwaukee
Hadfield Elem
Hamilton HS
Harvey Philip Alternative Acad
Hawthorne Elem
Headstart
Heyer Elem
Hillcrest Elem
Holy Apostles
Home School
Horizon Elem
Horning MS
Kettle Moraine Explorer
Kettle Moraine HS
Kettle Moraine MS
La Casa Charter School
Les Paul Central MS
Lowell Elem
Madison Elem
Magee Elem
Maple Avenue Elem
Marquette HS
Meadowbrook Elem
Montessori School of Waukesha
Mukwonago HS
Nathenhale HS
New Berlin West HS
North HS
Oconomowoc HS
Other
Parklawn Elem
Parkview MS
Pewaukee HS
Pewaukee Lake Elem
Pius HS
Poplar Creek Elementary
Prairie Elem
Preschool
Queen of Apostles
Rose Glen Elem
Section Elem
Silver Lake Intermediate
South HS
Spanish Immersion, MKE
St Jerome
St John Military Academy
St John Vianney, Brookfield
St. Charles
STEM Academy
STEM Academy Randall
STEM Academy Saratoga
Summit View Elem
Templeton MS
Trinity Academy
University Lake School
Wales Elem
Waukesha Catholic
WCTC
West HS
Whittier Elem
* Language
American Sign Lang
Bilingual
English
Spanish
Med. Issue
ADHD
Allergy - Drug
Allergy - Environmental
Allergy - Food
Anxiety
Asthma
Autism Spectrum
Celiac Disease
Cerebral Palsy
Cognitive/Developmental Delay
Diabetes
Down Syndrome
Hearing Impaired
Heart Disease
Migraines
Mobility Impaired
Multiple Schlerosis
Other Chronic Med. Condition
See Notes
Seizure Disorder
Speech Disorder
Visually Impaired
* Med Consent
No
Yes
* PhotoConsent
No
Yes
* Religion
Agnostic
Baptist
Buddhist
Catholic
Christian
Episcopalian
Evangelical
Hindu
Jewish
Lutheran
Methodist
Mormon
Muslim
Non Practicing
Non-Denominational
Not Baptized
Orthodox
Other
Presbyterian
Protestant
RCIA
United Church Of Christ
Unknown
* Parish
St. John Neumann Parish
St. Joseph Parish
St. Mary Parish
St. William Parish
Sacraments
Name
Received
Date
Baptism
Yes
No
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03
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12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
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2011
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2015
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2019
2020
2021
2022
2023
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2028
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2098
2099
2100
2101
2102
2103
2104
2105
2106
2107
2108
2109
2110
2111
2112
2113
2114
2115
2116
2117
2118
2119
2120
2121
2122
2123
2124
2125
2126
2127
2128
2129
2130
2131
2132
2133
2134
2135
2136
2137
2138
2139
2140
2141
2142
2143
2144
First Eucharist
Yes
No
MM
01
02
03
04
05
06
07
08
09
10
11
12
DD
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
2052
2053
2054
2055
2056
2057
2058
2059
2060
2061
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2063
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2066
2067
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2069
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2071
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2074
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2077
2078
2079
2080
2081
2082
2083
2084
2085
2086
2087
2088
2089
2090
2091
2092
2093
2094
2095
2096
2097
2098
2099
2100
2101
2102
2103
2104
2105
2106
2107
2108
2109
2110
2111
2112
2113
2114
2115
2116
2117
2118
2119
2120
2121
2122
2123
2124
2125
2126
2127
2128
2129
2130
2131
2132
2133
2134
2135
2136
2137
2138
2139
2140
2141
2142
2143
2144
* Class Choices
* Class 1
Student Remarks
General Remarks
Health Concerns
Other Conditions