The Trinity School Registration form
2022-2023 school year
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Email *
Student's Name *
Student's Birthdate *
MM
/
DD
/
YYYY
Boy/Girl *
What class will your child be in? (The class is decided by the child's age as of September 1st ) *
How often will your child attend school? *
Emergency Contact Information. Please include Name/Relation to your child and the contact number *
The next section will be questions about your child's Medical Information
Name of Students Physician/Physician's Group *
Physician's/Physician's Group Phone Number *
Does your child take any prescription medication on a daily basis? If yes, name of medication(s): *
Does your child need an inhaler? *
Required
Does your child have diagnosed allergies? *
Required
Does your child need an EpiPen *
Required
The next section will be questions about Family information
Student's mother and father are : *
If separated or divorced, who has legal custody?
Father/Guardian information. Name and Cell number *
Address *
Email *
Occupation, Business Name and Business Phone *
Mother/ Guardian information. Name and Cell number *
Address *
Email *
Occupation, Business Name and Business Phone *
Ethnic Origin *
Has this student ever been referred for evaluation for learning difficulties, behavioral disorder, Chapter 1, or school adjustment problems by a school official, psychologist, or other professional? *
Required
If yes, please give details
A copy of your responses will be emailed to the address you provided.
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