Academy of St. Benedict the African School

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STUDENT REGISTRATION FOR THE 2022-23 SCHOOL YEAR

Email *

Student Information

Student Last name: *

Student First name: *

Middle Name

Gender *

Date of Birth *

(mm/dd/yyyy)

YYYY

Is this child Oldest or Only? *

Is this child Youngest or Only? *

Race *

African-American

Hispanic

Multi-racial

Caucasian

Other:

Ethnicity - *

Asian

African-American

Hispanic/Latinx

Native American

Pacific Islander

White

Mixed Race

Other:

Is this child a new or returning student? *

Grade Level (Next School Year) *

Religion *

Last School Attended

(if different from Academy of St. Benedict)

Do you have another student to register at Academy of St. Benedict the African *

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