St. Clement Academy Interest Form

Thank you for attending our Open House! Please take a moment to complete this form so we can better understand your family’s needs and interest in St. Clement Academy.

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1. Parent/Guardian Information

Parent/Guardian Name(s): *

First

Last

Name (copy)

First

Last

Phone Numbers *

Email Addresses *

Best Way to Contact You *

• Phone
• Email
• Both

2. Child(ren)'s Information

Name(s): Level(s) Number

Number of Children Interested in Enrolling *

Child's Name *

First

Last

Child #2's Name *

First

Last

Child #3's Name *

First

Last

Child's Date of Birth *

Child #2's Date of Birth *

Child #3's Date of Birth *

Grade Level(s) Applying for *KG1st2nd3rd

3. Enrollment Interest

How likely are you to enroll your children at St. Clement Academy? *

• Very Likely
• Somewhat Likely
• Unsure but Interested

State Reason:

Additional Information

Are there any additional questions or concerns we can address?

Submit