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Enrollment Application Form
- Saint Michael Roman Catholic School
  
  VERMONT’S FIRST CATHOLIC SCHOOL
  
  Excellence in Education since 1874
  48 Walnut Street, Brattleboro, VT 05301
  
  802-254-6320
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  Student Information
  
  Registration Cost Per Family
  Price: $175.00
  
  How many students are you registering? REQUIRED
  A maximum of 7 students per application.
  Please fill out this field.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Education Program REQUIRED Please fill out this field.
  
  Parish Please enter valid data.
  
  Note - To receive the Saint Michael Parish discount you must be a registered Parishioner and attend Mass regularly. All Parish attendance will be verified through local rectory offices.
  
  Contact Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Contact Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Contact Email Address REQUIRED Please fill out this field. Please enter valid data.
  
  Contact Address REQUIRED Please fill out this field. Please enter valid data.
  
  Please enter valid data.
  
  REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  REQUIRED Please fill out this field. Please enter valid data.
  
  Payment Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Payment Address
  
  Please enter valid data.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
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Saint Michael Roman Catholic School

VERMONT’S FIRST CATHOLIC SCHOOL