Pius XI Parent Registration

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Pius XI Parents: Complete and submit the following form to receive access to a designated Current Pius XI Parent sections.

Please designate a parent or guardian as the primary contact for your child or children by clicking the button to the left of Parent/Guardian.

Required fields are marked with *.

Parent/Guardian

* First Name: * Last Name: * Relationship: * Address: * Home Phone: Work Phone: Cell Phone: * E-mail Address: Occupation: Employer: Place of Worship:
Are you a graduate of Pius XI?
Class Of: Name in Yearbook:

Parent/Guardian

* First Name: * Last Name: * Relationship: * Address: * Home Phone: Work Phone: Cell Phone: * E-mail Address: Occupation: Employer: Place of Worship:
Are you a graduate of Pius XI?
Class Of: Name in Yearbook:

Number of students currently at Pius XI:

Student Information

* First Name: * Last Name: * Date of Birth: * Gender: * Address: * Home Phone: E-mail Address: * Grade School: * Grade School City: * Current Grade Level:
Student's Interests (check all that apply)
Art Basketball Cross Country Dance Debate Engineering English Fitness & Wellness Football Forensics Golf Math Music Pom pons School Newspaper Science Service Projects Soccer Social Sciences Softball Swimming Theater Theology Tennis Track Volleyball World Languages Wrestling

Does the student have brothers and sisters who have attended Pius XI?
Yes No

Does the student have any younger brothers and sisters? Name: Grade Level: Name: Grade Level:

Student Information

* First Name: * Last Name: * Date of Birth: * Gender: * Address: * Home Phone: E-mail Address: * Grade School: * Grade School City: * Current Grade Level:
Student's Interests (check all that apply)
Art Basketball Cross Country Dance Debate Engineering English Fitness & Wellness Football Forensics Golf Math Music Pom pons School Newspaper Science Service Projects Soccer Social Sciences Softball Swimming Theater Theology Tennis Track Volleyball World Languages Wrestling

Does the student have brothers and sisters who have attended Pius XI?
Yes No

Does the student have any younger brothers and sisters? Name: Grade Level: Name: Grade Level:

Student Information

* First Name: * Last Name: * Date of Birth: * Gender: * Address: * Home Phone: E-mail Address: * Grade School: * Grade School City: * Current Grade Level:
Student's Interests (check all that apply)
Art Basketball Cross Country Dance Debate Engineering English Fitness & Wellness Football Forensics Golf Math Music Pom pons School Newspaper Science Service Projects Soccer Social Sciences Softball Swimming Theater Theology Tennis Track Volleyball World Languages Wrestling

Does the student have brothers and sisters who have attended Pius XI?
Yes No

Does the student have any younger brothers and sisters? Name: Grade Level: Name: Grade Level:

Student Information

* First Name: * Last Name: * Date of Birth: * Gender: * Address: * Home Phone: E-mail Address: * Grade School: * Grade School City: * Current Grade Level:
Student's Interests (check all that apply)
Art Basketball Cross Country Dance Debate Engineering English Fitness & Wellness Football Forensics Golf Math Music Pom pons School Newspaper Science Service Projects Soccer Social Sciences Softball Swimming Theater Theology Tennis Track Volleyball World Languages Wrestling

Does the student have brothers and sisters who have attended Pius XI?
Yes No

Does the student have any younger brothers and sisters? Name: Grade Level: Name: Grade Level:

Keep me informed about events at Pius XI.
Please contact me about volunteer opportunities at Pius XI.
E-mail Address: