Student Information

Applying For Grade Kindergarten First Second Third Fourth Fifth Sixth Seventh *

How did you hear about OLM? (500 chars left)

Have you toured campus? Yes No

Last Name *

First Name *

Middle Name

Nickname

Date of Birth ... *

Birth City/State/Country *

Gender Female Male *

Age as of Sept 1, 2011 *

Present Grade Pre-school Kindergarten First Second Third Fourth Fifth Seventh *

Residence Address *

City *

ZIP Code *

Information about Father/Guardian

Father/Guardian Last Name *

Father Middle Name

Father First Name *

Birth Place *

Religion *

Marital Status *

Occupation *

Place of Work *

Home Phone *

Work Phone *

Mobile Phone *

Address

Father e-Mail *

Information about Mother/Guardian

Mother/Guardian Last Name *

Mother Maiden Name

Mother First Name *

Birth Place *

Religion *

Marital Status *

Occupation *

Place of Work *

Home Phone *

Work Phone *

Mobile Phone *

Address

Mother e-Mail *

If divorced, who has legal custody of child applicant

Religious Affiliation

Parish / Church

Applicant Baptism Date

Church

City/State

First Communion Date

First Communion Church

First Communion City/State

Why are you considering Our Lady of Malibu School for your child? (900 chars left) *

What ways will you participate in the community life at the school? (900 chars left) *

What would you like us to know about your child (900 chars left) *