Instructions
Please indicate your child's grade for the 2020-2021 Academic School Year.
Head of Household
Title
None
Mr.
Mr.
Ms.
Ms.
Mrs.
Mrs.
Miss
Miss
Dr.
Dr.
Fr.
Fr.
Msgr.
Msgr.
Sr.
Sr.
Rev.
Rev.
Deacon
Deacon
Sr.
Sr.
Sra
Sra
Mr. & Mrs.
Mr. & Mrs.
Mr. & Mrs.
Mr. & Mrs.
D/M
D/M
D/M
D/M
M/D
M/D
M/D
M/D
D/D
D/D
D/D
D/D
S/S
S/S
S/S
S/S
Adm
Adm
Amn
Amn
A1C
A1C
BG
BG
BG
BG
BG
BG
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
CMSgt
CMSgt
Col
Col
Col
Col
Col
Col
CSM
CSM
Cmdr
Cmdr
Cdr
Cdr
Como
Como
CPL
CPL
Ens
Ens
1Lt
1Lt
1Lt
1Lt
1Lt
1Lt
1SG
1SG
1st Sgt
1st Sgt
Gen
Gen
Gen
Gen
Gen
Gen
GySgt
GySgt
LCpl
LCpl
Lt
Lt
Ltc
Ltc
Ltc
Ltc
Ltc
Ltc
LCdr
LCdr
Ltg
Ltg
Ltg
Ltg
Ltg
Ltg
LtJG
LtJG
Maj
Maj
Maj
Maj
Maj
Maj
MG
MG
MG
MG
MG
MG
MGySgt
MGySgt
MSG
MSG
MSgt
MSgt
MSgt
MSgt
PSG
PSG
PVT
PVT
PVT
PVT
PFC
PFC
PFC
PFC
RAdm
RAdm
RDML
RDML
2Lt
2Lt
2Lt
2Lt
2Lt
2Lt
SMSgt
SMSgt
SGT
SGT
SFC
SFC
SGM
SGM
SMA
SMA
SP4
SP4
SrA
SrA
SSgt
SSgt
SSgt
SSgt
SSG
SSG
TSgt
TSgt
WO
WO
WO
WO
WO
WO
CWO2
CWO2
CWO3
CWO3
CWO4
CWO4
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
* First Name
* Last Name
Middle Name
Nickname
Relationship
Adopted
Adult
Aunt
B
Brother
Brother-In-Law
Child
Cousin
Daughter
Daughter in law
Daughter-in-Law
Father
Fiancee
Foster
Friend
Grandaughter
Grandchild
Grandfather
Grandmother
Grandson
Head
Head 2
Head of Household
Head-Female
Head-Male
Husband
In-Law
In-Laws
Mother
Mother-In-Law
Nephew
Niece
Other
Sister
Sister in law
Sister-In-Law
Son
Spouse
Stepchild
Stepdaughter
Stepfather
Stepmother
Stepson
Uncle
Wife
Young Ad
Young Adult
Maiden Name
Ethnicity
Australian
Black
Caucasian
Chinese
Cuban
Filipino
German
German/Italian
German\
Hispanic/American
Irish, Italian
Irish/Scotch/Germ
Irish/Scottish/Ger,am
Korean
Mexican
Nicaraguan
Norwegian/Irish
Panamanian
Peruvian
Polish/Irish
Slovac
Spanish
Vietnamese
Birth Date
* Gender
Female Male
Grade/Degree
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Pre-Sch
Pre-K
Bachelor's
Master's
College
16
14
13
Rn
Masters
Junior College
Graduate School
Post Masters
5A
1A
3A
6A
8A
8B
4B
2A
7A
4A
7B
2B
3B
K W/L
5B
OCIC
6 W/L
5 W/L
1 W/L
Sun 1A
8 W/L
Sat W/L
6B
Pre-K/K
CYM 9-12
7 W/L
3 W/L
RCIA
Army
1B
Sun2 2B
SP1
SP Needs
SP2
7th HS
7 HS
Sun2 SP1B
8 HS
6 Special Needs Clas
High School
1st
1
2
3
4
5
6
7
8
4th
9-12
Language
Amer Sign/Spanish
Arabic,Russian,Spanish
Bisany
Canadian French
Czech/English
Czech/Russian
English
English/Arabic
English/Tagulog
Filipino
Filipino/Chinese
Filipino/French
Filipino/Spanish
French
French & Spanish
French-Creole
French/English
French/German/Spanish
German/English
Ghanaian
Greek
Haition Creol,French
Interperatur To Deaf
Interpreter To The Deaf
Italian
Japanese
Korean
Korean/English
Mandarin Chinese Cantonese
Nicarguenses
Okin/French/Portuguese
Polish
Portuguese
Russian
See File
Spanish
Spanish/English
Spanish/Italian
Spanish/Latin
Spanish/Portuguese
Tagalog & Bisaya
Tagalog & Bisaya
Tagalog,Visayan, English
Tagalog/English
Thai/Lao
Tigranya/Italian
Vietnamese
Marital Status
Anglican
Annulled
Church Marriage
Divorced
Lutheran
Married
Presbyterian
Separated
Single
Widowed
Widower
* Religion
Anglican
Asatru
Assembley Of God
Baptist
Bretheren
Buddhist
Byz. Catholic
Catholic
Christian
Christian Science
Church Of Christ
Church Of England
Church Of God
Congregational
Coptic
Disciples Of Christ
Eastern Orthodox
Episcopalian
Greek Catholic
Greek Orthodox
Hindu
Jewish
Latter Day Of Saints
Lutheran
Methodist
Moorish American
Mormon
Muslim
Nazarene
Non-Denominational
None
Orthodox
Pentacostal
Presbyterian
Protestant
Reformed
Russian Orthodox
Russion Orthodox
Seventh Day Adventist
Southern Baptist
Speech Pathologist
Ucc
Ukranian Catholic
Ukranian Orthodox
Unitarian
United Church of Christ
Uniting Church Australia
Unknown
World-Wide Church Of God
Handicap
Adhd
Allelrgies/Asthma
Allergic To Amoxicillin
Allergic To Gluten/Wheat
Allergic To Jellowjackts
Allergic To Yellowjacket
Allergic/Amoxic/Heart Mur
Allergies
Allergyies Nut;Peanut
Alzheimers
Arthritis
Asperger Syndrome
Asthma
Asthma/Cancer Survivor
Asthma/speech Impairment
Asthmatic,Bowel Disease
Attention Deficit Disord
Autistic
Back pain
Blind
Cancer, Lung,Heart
Cancer/Learning Disabil
Cerebral Palsy
Cf
Chronic Renal Disease
Currently going thru chemo
Cystic Fibrosis
Deaf
Dementia
Development Disorder
Diabetes
Diabetic
Disabled
Down Syndrome
Eplipetic
Handicapped
Has Asthma
Hearing Loss
Hearing/Vision Impaired
Heart Condition
Heart Murmur/Glasses
Ichthyosis(skin disorder
Invalid
Juvenile Rheumatoid Arthritis
Lactose Intolerant
Learning Disability
Legally Blind
Lung Cancer,Emphysema
Lupus
Medical
Mental Illness
Mentally Disabled
Mild Autism
Mobility Limited
Ms/Pacemaker Implant
Multiple
Multiple Sclerosis
Neurological Damage
Neuropathy/uses cane
Only Has Rt Kidney
Orthopedically Impaired
Parkinson's Disease
Physcially
Physically
Respiratory Problems
Rhuematism/Crohns/hearing los/
Scoiliosis
Scoliosis
Sickle Cell Disease
Siezures/Low Blook Sugar
Special Ed
Speech/Language Delayed
Stroke/speech Impairment
Wheelchair
* Phone 1
Alternate Address
Ans Serv
Bus Ph
Cellular
Cellular-Verizon
Daughter
Emerg.
Father
Fax
Finance
Grandmother
Her Cell
Her work
Her/Work
His Cell
His work
His/Work
Home Ph.
Husband Cell
Husband Work
Office
Other
Pager
Sch Ofc
Self
T4611
Tdd
Wife
Wife Cell
Wife Work
Work
Other
( )
-
Email 1
Family
Her
His
Husband
Husband Work
mother
self
self work
spouse
step mother
Wife
Wife Work
Spouse
Title
None
Mr.
Mr.
Ms.
Ms.
Mrs.
Mrs.
Miss
Miss
Dr.
Dr.
Fr.
Fr.
Msgr.
Msgr.
Sr.
Sr.
Rev.
Rev.
Deacon
Deacon
Sr.
Sr.
Sra
Sra
Mr. & Mrs.
Mr. & Mrs.
Mr. & Mrs.
Mr. & Mrs.
D/M
D/M
D/M
D/M
M/D
M/D
M/D
M/D
D/D
D/D
D/D
D/D
S/S
S/S
S/S
S/S
Adm
Adm
Amn
Amn
A1C
A1C
BG
BG
BG
BG
BG
BG
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
CMSgt
CMSgt
Col
Col
Col
Col
Col
Col
CSM
CSM
Cmdr
Cmdr
Cdr
Cdr
Como
Como
CPL
CPL
Ens
Ens
1Lt
1Lt
1Lt
1Lt
1Lt
1Lt
1SG
1SG
1st Sgt
1st Sgt
Gen
Gen
Gen
Gen
Gen
Gen
GySgt
GySgt
LCpl
LCpl
Lt
Lt
Ltc
Ltc
Ltc
Ltc
Ltc
Ltc
LCdr
LCdr
Ltg
Ltg
Ltg
Ltg
Ltg
Ltg
LtJG
LtJG
Maj
Maj
Maj
Maj
Maj
Maj
MG
MG
MG
MG
MG
MG
MGySgt
MGySgt
MSG
MSG
MSgt
MSgt
MSgt
MSgt
PSG
PSG
PVT
PVT
PVT
PVT
PFC
PFC
PFC
PFC
RAdm
RAdm
RDML
RDML
2Lt
2Lt
2Lt
2Lt
2Lt
2Lt
SMSgt
SMSgt
SGT
SGT
SFC
SFC
SGM
SGM
SMA
SMA
SP4
SP4
SrA
SrA
SSgt
SSgt
SSgt
SSgt
SSG
SSG
TSgt
TSgt
WO
WO
WO
WO
WO
WO
CWO2
CWO2
CWO3
CWO3
CWO4
CWO4
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
First Name
Last Name
Middle Name
Nickname
Relationship
Adopted
Adult
Aunt
B
Brother
Brother-In-Law
Child
Cousin
Daughter
Daughter in law
Daughter-in-Law
Father
Fiancee
Foster
Friend
Grandaughter
Grandchild
Grandfather
Grandmother
Grandson
Head
Head 2
Head of Household
Head-Female
Head-Male
Husband
In-Law
In-Laws
Mother
Mother-In-Law
Nephew
Niece
Other
Sister
Sister in law
Sister-In-Law
Son
Spouse
Stepchild
Stepdaughter
Stepfather
Stepmother
Stepson
Uncle
Wife
Young Ad
Young Adult
Maiden Name
Ethnicity
Australian
Black
Caucasian
Chinese
Cuban
Filipino
German
German/Italian
German\
Hispanic/American
Irish, Italian
Irish/Scotch/Germ
Irish/Scottish/Ger,am
Korean
Mexican
Nicaraguan
Norwegian/Irish
Panamanian
Peruvian
Polish/Irish
Slovac
Spanish
Vietnamese
Birth Date
Gender
Female Male
Grade/Degree
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Pre-Sch
Pre-K
Bachelor's
Master's
College
16
14
13
Rn
Masters
Junior College
Graduate School
Post Masters
5A
1A
3A
6A
8A
8B
4B
2A
7A
4A
7B
2B
3B
K W/L
5B
OCIC
6 W/L
5 W/L
1 W/L
Sun 1A
8 W/L
Sat W/L
6B
Pre-K/K
CYM 9-12
7 W/L
3 W/L
RCIA
Army
1B
Sun2 2B
SP1
SP Needs
SP2
7th HS
7 HS
Sun2 SP1B
8 HS
6 Special Needs Clas
High School
1st
1
2
3
4
5
6
7
8
4th
9-12
Language
Amer Sign/Spanish
Arabic,Russian,Spanish
Bisany
Canadian French
Czech/English
Czech/Russian
English
English/Arabic
English/Tagulog
Filipino
Filipino/Chinese
Filipino/French
Filipino/Spanish
French
French & Spanish
French-Creole
French/English
French/German/Spanish
German/English
Ghanaian
Greek
Haition Creol,French
Interperatur To Deaf
Interpreter To The Deaf
Italian
Japanese
Korean
Korean/English
Mandarin Chinese Cantonese
Nicarguenses
Okin/French/Portuguese
Polish
Portuguese
Russian
See File
Spanish
Spanish/English
Spanish/Italian
Spanish/Latin
Spanish/Portuguese
Tagalog & Bisaya
Tagalog & Bisaya
Tagalog,Visayan, English
Tagalog/English
Thai/Lao
Tigranya/Italian
Vietnamese
Marital Status
Anglican
Annulled
Church Marriage
Divorced
Lutheran
Married
Presbyterian
Separated
Single
Widowed
Widower
Religion
Anglican
Asatru
Assembley Of God
Baptist
Bretheren
Buddhist
Byz. Catholic
Catholic
Christian
Christian Science
Church Of Christ
Church Of England
Church Of God
Congregational
Coptic
Disciples Of Christ
Eastern Orthodox
Episcopalian
Greek Catholic
Greek Orthodox
Hindu
Jewish
Latter Day Of Saints
Lutheran
Methodist
Moorish American
Mormon
Muslim
Nazarene
Non-Denominational
None
Orthodox
Pentacostal
Presbyterian
Protestant
Reformed
Russian Orthodox
Russion Orthodox
Seventh Day Adventist
Southern Baptist
Speech Pathologist
Ucc
Ukranian Catholic
Ukranian Orthodox
Unitarian
United Church of Christ
Uniting Church Australia
Unknown
World-Wide Church Of God
Handicap
Adhd
Allelrgies/Asthma
Allergic To Amoxicillin
Allergic To Gluten/Wheat
Allergic To Jellowjackts
Allergic To Yellowjacket
Allergic/Amoxic/Heart Mur
Allergies
Allergyies Nut;Peanut
Alzheimers
Arthritis
Asperger Syndrome
Asthma
Asthma/Cancer Survivor
Asthma/speech Impairment
Asthmatic,Bowel Disease
Attention Deficit Disord
Autistic
Back pain
Blind
Cancer, Lung,Heart
Cancer/Learning Disabil
Cerebral Palsy
Cf
Chronic Renal Disease
Currently going thru chemo
Cystic Fibrosis
Deaf
Dementia
Development Disorder
Diabetes
Diabetic
Disabled
Down Syndrome
Eplipetic
Handicapped
Has Asthma
Hearing Loss
Hearing/Vision Impaired
Heart Condition
Heart Murmur/Glasses
Ichthyosis(skin disorder
Invalid
Juvenile Rheumatoid Arthritis
Lactose Intolerant
Learning Disability
Legally Blind
Lung Cancer,Emphysema
Lupus
Medical
Mental Illness
Mentally Disabled
Mild Autism
Mobility Limited
Ms/Pacemaker Implant
Multiple
Multiple Sclerosis
Neurological Damage
Neuropathy/uses cane
Only Has Rt Kidney
Orthopedically Impaired
Parkinson's Disease
Physcially
Physically
Respiratory Problems
Rhuematism/Crohns/hearing los/
Scoiliosis
Scoliosis
Sickle Cell Disease
Siezures/Low Blook Sugar
Special Ed
Speech/Language Delayed
Stroke/speech Impairment
Wheelchair
Phone 1
Alternate Address
Ans Serv
Bus Ph
Cellular
Cellular-Verizon
Daughter
Emerg.
Father
Fax
Finance
Grandmother
Her Cell
Her work
Her/Work
His Cell
His work
His/Work
Home Ph.
Husband Cell
Husband Work
Office
Other
Pager
Sch Ofc
Self
T4611
Tdd
Wife
Wife Cell
Wife Work
Work
Other
( )
-
Email 1
Family
Her
His
Husband
Husband Work
mother
self
self work
spouse
step mother
Wife
Wife Work
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
Family Phone Numbers
* Primary
Alternate Address
Ans Serv
Bus Ph
Cellular
Cellular-Verizon
Daughter
Emerg.
Father
Fax
Finance
Grandmother
Her Cell
Her work
Her/Work
His Cell
His work
His/Work
Home Ph.
Husband Cell
Husband Work
Office
Other
Pager
Sch Ofc
Self
T4611
Tdd
Wife
Wife Cell
Wife Work
Work
Other
( )
-
Other
Alternate Address
Ans Serv
Bus Ph
Cellular
Cellular-Verizon
Daughter
Emerg.
Father
Fax
Finance
Grandmother
Her Cell
Her work
Her/Work
His Cell
His work
His/Work
Home Ph.
Husband Cell
Husband Work
Office
Other
Pager
Sch Ofc
Self
T4611
Tdd
Wife
Wife Cell
Wife Work
Work
Other
( )
-
Family Email Address
* Email
Family
Her
His
Husband
Husband Work
mother
self
self work
spouse
step mother
Wife
Wife Work
Fee Total = $0.00
Student 1
Type
Head of Household
Spouse
Adult
Young Adult
Child
Other
Title
None
Mr.
Mr.
Ms.
Ms.
Mrs.
Mrs.
Miss
Miss
Dr.
Dr.
Fr.
Fr.
Msgr.
Msgr.
Sr.
Sr.
Rev.
Rev.
Deacon
Deacon
Sr.
Sr.
Sra
Sra
Mr. & Mrs.
Mr. & Mrs.
Mr. & Mrs.
Mr. & Mrs.
D/M
D/M
D/M
D/M
M/D
M/D
M/D
M/D
D/D
D/D
D/D
D/D
S/S
S/S
S/S
S/S
Adm
Adm
Amn
Amn
A1C
A1C
BG
BG
BG
BG
BG
BG
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
Cpt
CMSgt
CMSgt
Col
Col
Col
Col
Col
Col
CSM
CSM
Cmdr
Cmdr
Cdr
Cdr
Como
Como
CPL
CPL
Ens
Ens
1Lt
1Lt
1Lt
1Lt
1Lt
1Lt
1SG
1SG
1st Sgt
1st Sgt
Gen
Gen
Gen
Gen
Gen
Gen
GySgt
GySgt
LCpl
LCpl
Lt
Lt
Ltc
Ltc
Ltc
Ltc
Ltc
Ltc
LCdr
LCdr
Ltg
Ltg
Ltg
Ltg
Ltg
Ltg
LtJG
LtJG
Maj
Maj
Maj
Maj
Maj
Maj
MG
MG
MG
MG
MG
MG
MGySgt
MGySgt
MSG
MSG
MSgt
MSgt
MSgt
MSgt
PSG
PSG
PVT
PVT
PVT
PVT
PFC
PFC
PFC
PFC
RAdm
RAdm
RDML
RDML
2Lt
2Lt
2Lt
2Lt
2Lt
2Lt
SMSgt
SMSgt
SGT
SGT
SFC
SFC
SGM
SGM
SMA
SMA
SP4
SP4
SrA
SrA
SSgt
SSgt
SSgt
SSgt
SSG
SSG
TSgt
TSgt
WO
WO
WO
WO
WO
WO
CWO2
CWO2
CWO3
CWO3
CWO4
CWO4
Suffix
None
Sr.
Jr.
II
III
IV
V
VI
VII
VIII
XV
X
* First Name
* Last Name
Middle Name
Nickname
Relationship
Adopted
Adult
Aunt
B
Brother
Brother-In-Law
Child
Cousin
Daughter
Daughter in law
Daughter-in-Law
Father
Fiancee
Foster
Friend
Grandaughter
Grandchild
Grandfather
Grandmother
Grandson
Head
Head 2
Head of Household
Head-Female
Head-Male
Husband
In-Law
In-Laws
Mother
Mother-In-Law
Nephew
Niece
Other
Sister
Sister in law
Sister-In-Law
Son
Spouse
Stepchild
Stepdaughter
Stepfather
Stepmother
Stepson
Uncle
Wife
Young Ad
Young Adult
Maiden Name
Ethnicity
Australian
Black
Caucasian
Chinese
Cuban
Filipino
German
German/Italian
German\
Hispanic/American
Irish, Italian
Irish/Scotch/Germ
Irish/Scottish/Ger,am
Korean
Mexican
Nicaraguan
Norwegian/Irish
Panamanian
Peruvian
Polish/Irish
Slovac
Spanish
Vietnamese
* Birth Date
* Gender
Female Male
* Grade/Degree
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Pre-Sch
Pre-K
Bachelor's
Master's
College
16
14
13
Rn
Masters
Junior College
Graduate School
Post Masters
5A
1A
3A
6A
8A
8B
4B
2A
7A
4A
7B
2B
3B
K W/L
5B
OCIC
6 W/L
5 W/L
1 W/L
Sun 1A
8 W/L
Sat W/L
6B
Pre-K/K
CYM 9-12
7 W/L
3 W/L
RCIA
Army
1B
Sun2 2B
SP1
SP Needs
SP2
7th HS
7 HS
Sun2 SP1B
8 HS
6 Special Needs Clas
High School
1st
1
2
3
4
5
6
7
8
4th
9-12
Language
Amer Sign/Spanish
Arabic,Russian,Spanish
Bisany
Canadian French
Czech/English
Czech/Russian
English
English/Arabic
English/Tagulog
Filipino
Filipino/Chinese
Filipino/French
Filipino/Spanish
French
French & Spanish
French-Creole
French/English
French/German/Spanish
German/English
Ghanaian
Greek
Haition Creol,French
Interperatur To Deaf
Interpreter To The Deaf
Italian
Japanese
Korean
Korean/English
Mandarin Chinese Cantonese
Nicarguenses
Okin/French/Portuguese
Polish
Portuguese
Russian
See File
Spanish
Spanish/English
Spanish/Italian
Spanish/Latin
Spanish/Portuguese
Tagalog & Bisaya
Tagalog & Bisaya
Tagalog,Visayan, English
Tagalog/English
Thai/Lao
Tigranya/Italian
Vietnamese
Marital Status
Anglican
Annulled
Church Marriage
Divorced
Lutheran
Married
Presbyterian
Separated
Single
Widowed
Widower
* Religion
Anglican
Asatru
Assembley Of God
Baptist
Bretheren
Buddhist
Byz. Catholic
Catholic
Christian
Christian Science
Church Of Christ
Church Of England
Church Of God
Congregational
Coptic
Disciples Of Christ
Eastern Orthodox
Episcopalian
Greek Catholic
Greek Orthodox
Hindu
Jewish
Latter Day Of Saints
Lutheran
Methodist
Moorish American
Mormon
Muslim
Nazarene
Non-Denominational
None
Orthodox
Pentacostal
Presbyterian
Protestant
Reformed
Russian Orthodox
Russion Orthodox
Seventh Day Adventist
Southern Baptist
Speech Pathologist
Ucc
Ukranian Catholic
Ukranian Orthodox
Unitarian
United Church of Christ
Uniting Church Australia
Unknown
World-Wide Church Of God
Handicap
Adhd
Allelrgies/Asthma
Allergic To Amoxicillin
Allergic To Gluten/Wheat
Allergic To Jellowjackts
Allergic To Yellowjacket
Allergic/Amoxic/Heart Mur
Allergies
Allergyies Nut;Peanut
Alzheimers
Arthritis
Asperger Syndrome
Asthma
Asthma/Cancer Survivor
Asthma/speech Impairment
Asthmatic,Bowel Disease
Attention Deficit Disord
Autistic
Back pain
Blind
Cancer, Lung,Heart
Cancer/Learning Disabil
Cerebral Palsy
Cf
Chronic Renal Disease
Currently going thru chemo
Cystic Fibrosis
Deaf
Dementia
Development Disorder
Diabetes
Diabetic
Disabled
Down Syndrome
Eplipetic
Handicapped
Has Asthma
Hearing Loss
Hearing/Vision Impaired
Heart Condition
Heart Murmur/Glasses
Ichthyosis(skin disorder
Invalid
Juvenile Rheumatoid Arthritis
Lactose Intolerant
Learning Disability
Legally Blind
Lung Cancer,Emphysema
Lupus
Medical
Mental Illness
Mentally Disabled
Mild Autism
Mobility Limited
Ms/Pacemaker Implant
Multiple
Multiple Sclerosis
Neurological Damage
Neuropathy/uses cane
Only Has Rt Kidney
Orthopedically Impaired
Parkinson's Disease
Physcially
Physically
Respiratory Problems
Rhuematism/Crohns/hearing los/
Scoiliosis
Scoliosis
Sickle Cell Disease
Siezures/Low Blook Sugar
Special Ed
Speech/Language Delayed
Stroke/speech Impairment
Wheelchair
Phone 1
Alternate Address
Ans Serv
Bus Ph
Cellular
Cellular-Verizon
Daughter
Emerg.
Father
Fax
Finance
Grandmother
Her Cell
Her work
Her/Work
His Cell
His work
His/Work
Home Ph.
Husband Cell
Husband Work
Office
Other
Pager
Sch Ofc
Self
T4611
Tdd
Wife
Wife Cell
Wife Work
Work
Other
( )
-
Email 1
Family
Her
His
Husband
Husband Work
mother
self
self work
spouse
step mother
Wife
Wife Work
Sacraments
* Baptism
Yes
No
Date
* 1st Comm
Yes
No
Date
* Confirm
Yes
No
Date
Class Choices
* Class 1
Student Remarks
General Remarks
Health Problems
Other Conditions
Misc. Information