Open House Registration

Student First Name REQUIRED Please fill out this field. Please enter valid data.

Student Last Name REQUIRED Please fill out this field. Please enter valid data.

Student Current Grade Level REQUIRED Please fill out this field. Please enter valid data.

Student Primary Street Address REQUIRED Please fill out this field. Please enter valid data.

Student City REQUIRED Please fill out this field. Please enter valid data.

Student State REQUIRED Please fill out this field. Please enter valid data.

Student Zip Code REQUIRED Please fill out this field. Please enter valid data.

Parent(s) First Name(s) REQUIRED Please fill out this field. Please enter valid data.

Parent(s) Last Name(s) REQUIRED Please fill out this field. Please enter valid data.

Parent Email Address (one required) REQUIRED Please fill out this field. Please enter valid data.

Primary Phone Number REQUIRED Please fill out this field. Please enter valid data.

Phone Type REQUIRED Cell Home Work Please fill out this field.

Tell us a little bit about your student's interests, hobbies, athletics, extracurriculars, etc. (If Applicable)

Tell us how you heard about Shrine Catholic Grade School & ECC REQUIRED Church Bulletin Yard Signs Social Media Billboard Live in the Area Current Family Referral Current Employee Please fill out this field.