St. Jude’s Registration
2017/2018 School Year

Parent/Custodian Name (required)

Apartment

Email Address

Phone (Home) xxx-xxx-xxxx

Phone (Cell) xxx-xxx-xxxx

Phone (Work) xxx-xxx-xxxx

Address

Postal Code (required)

Student's Name (required)

Entering Grade (September, 2017) (required)

Medical Condition

Full Fee: $2,695.00 Including HST
Payment Options (Please check one)

Installments:

*First installment of $300.00 must be paid upon Registration*

Method of Payment (Please check one)

*Please note all credit cards will be charged an additional 2%*
*Make cheques payable to Next Stop School Busing*