
St Mark Church and School	l
4220 Ripa Ave St. Louis MO 63125

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Application for Student Enrollment

- St. Mark Catholic School

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- Please complete the information below to apply to St. Mark Catholic School.
- Child Information
  
  Application for School Year REQUIRED Please fill out this field. Please enter valid data.
  
  Grade REQUIRED Please fill out this field. Please enter valid data.
  
  Child's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's MIddle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Gender REQUIRED Male Female Please fill out this field.
  
  Child's Birth Place REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Birth Date REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Public School District REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Public School REQUIRED Please fill out this field. Please enter valid data.
  
  Home Phone Number REQUIRED Please fill out this field. Please enter valid data.
  
  Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip Code REQUIRED Please fill out this field. Please enter valid data.
- Father Information
  
  Father's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Birth Place REQUIRED Please fill out this field. Please enter valid data.
  
  Father U.S. Citizen? REQUIRED Please fill out this field.
  
  Father's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Business Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Business City REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Business State REQUIRED Please fill out this field.
  
  Father's Business Zip Code REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Business Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Home Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Mobile Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Father's E-Mail Address REQUIRED Please fill out this field. Please enter an email address.
- Mother Information
  
  Mother's First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Middle Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Birth Place REQUIRED Please fill out this field. Please enter valid data.
  
  Mother U.S. Citizen? REQUIRED Please fill out this field.
  
  Mother's Religion REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Occupation REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Business Street Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Business City REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Business State REQUIRED Please fill out this field.
  
  Mother's Business Zip Code REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Business Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Home Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Mobile Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's E-Mail Address REQUIRED Please fill out this field. Please enter an email address.
- Family Information
  
  With whom does the child live? REQUIRED Both Parents Mother Father Other Please fill out this field.
  
  If divorced or separated, who has custody?
  A copy of the custody section of the divorce or separation decree must be filed with the school office.
  Mother Father Other
  
  Roman Catholic Baptism Date REQUIRED Please fill out this field. Please enter valid data.
  
  Baptism Church Please enter valid data.
  
  Baptism City Please enter valid data.
  
  First Communion Date REQUIRED Please fill out this field. Please enter valid data.
  
  First Communion Church Please enter valid data.
  
  First Communion City Please enter valid data.
  
  Are you a registered parishioner of St. Mark Church? REQUIRED Please fill out this field.
  
  Are you registered in another Catholic Parish? REQUIRED Please fill out this field.
  
  If yes, name of parish Please enter valid data.
- Former School Information
  
  Has this child ever applied for admission or attended St. Mark Catholic School before? REQUIRED Please fill out this field.
  
  School name that child last attended or is not attending? Please enter valid data.
  
  Name of Principal at Former School Please enter valid data.
  
  Former School Street Address Please enter valid data.
  
  Former School City Please enter valid data.
  
  Former School State
  
  Former School Zip Code Please enter valid data.
  
  Former School Phone Number Please enter valid data.
- Information Certification
  
  Information Certification REQUIRED
  *To the best of my knowledge, I certify that the information provided in this application is true. This is an application and not a registration form. This application does not entail any obligation for the registration on the part of the school.
  I certify that the information provided above is true Please fill out this field.
  
  Confirmation E-Mail Address REQUIRED Please fill out this field. Please enter an email address.
- *
  
  The teaching of the Roman Catholic religion and participation in the church liturgies is an integral part of the curriculum of St. Mark School. It is understood that non-Catholic students as well as Catholic students attend both the religion classes and the school liturgies. St. Mark School, mindful of its mission to educate young people to become respectful, responsible Christians who go forth to serve, admits students of any race, color and national and/or ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students at this school. St. Mark School does not discriminate on the basis of race, color and national and/or origin in administration of education policies, admissions policies or other school-administered programs.
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St. Mark Catholic Church

St. Louis, MO

Application for Student Enrollment