2005 Davis Drive, Blair, NE 68008
402-218-4020
office@sjp2ca.com

Registration

Please complete one form per student you are enrolling.

DOWNLOAD PDF

 

Please enable JavaScript in your browser to complete this form.

Student Information

Student's Name
Gender
Religion
Grade Entering
Date of Birth
Home Address
Place of Birth

Parent / Guardian Information

Parent / Guardian Name #1
Relationship
Parent / Guardian Name #2
Relationship

Family Information

Each student in family will need to have a separate registration form on file.

Are you looking for tuition assistance?
Do you need before and/or after school care?

Important Information

Student's Doctor's Name
Is anyone besides you allowed to pick up your child?
Emergency Contact #1
Emergency Contact #2