K-8 Registration
K-8 Registration

Saint Michael the Archangel Regional School

www.smrsonline.com 

51 West North Street Clayton, NJ 08312 (856) 881-0067

Registration Form 2016-2017

$125 Non-Refundable Registration Fee per Child

            

Family Name: 

Address:  

City:  

Zip: 

Phone Number:  

E-mail: 

Religion:  

Parish:  

*Please submit a letter from your Parish confirming you are a registered parishioner*     

         Mother/Guardian                    Father/Guardian

Name:      

Address:      

Home Phone:        

Work Phone:     

Cell Phone:     

Employer:     

Please Check Marital Status: M  S  D  W

Child Resides With: Both    Mother   Father   Other

Ethnicity:​White  N Amer  Asian   Black  Other

 Unknown

Child's Name         Grade    Gender        DOB

    MF     Hisp Not Hisp

    MF     Hisp Not Hisp

    MF     Hisp Non Hisp

    MF     Hisp Non Hisp

St Michael the Archangel Regional School admits all students of any race, color, national

or ethnic origin to all the rights, privileges, programs and activities generally accorded

or made available to students at the school. It does not discriminate on the basis of race,

color, national or ethnic origin in the administration of education policies, admission policies,

athletic or other school sponsored programs.

Please note: No student will be admitted in September unless immunizations are up to date.

Parent signature: __________________________  Date:  

__________________________________________________________________________

Office use only                                

 Registration fee paid

   cash   check

Birth Certificate:  yes  no

Bapt. Certificate: yes  no    

Interview Date: 

Immunization Record:    yes  no

Letter from Parish:      yes   no   

Acceptance Date: 



Security Measure