Your Name: Your Relation to Student: Mother Father Step-parent Uncle Aunt Grandparent Guardian Other Street: City: State: Zip: Day Phone: Evening Phone: Email Address: Mother's name: Father's Name: Child 1 Name: Child 1 DOB: Child 1 Grade: PreK K 1 2 3 4 5 6 7 8 Child 2 Name: Child 2 DOB: Child 2 Grade: PreK K 1 2 3 4 5 6 7 8 Child 3 Name: Child 3 DOB: Child 3 Grade: PreK K 1 2 3 4 5 6 7 8 Child 4 Name: Child 4 DOB: Child 4 Grade: PreK K 1 2 3 4 5 6 7 8 How did you hear about us? A Current Family Website Church Bulletin Archdioces of Cincinnati Alumni Flyer Newspaper Mailing Radio/TV Other Please Tell Me About: Pre-K Program (Children 4 years old before Sept 30 of the school year) Kindergarten Program (Children 5 years old before Sept 30 of the school year) Extended Day Kindergarten Before and After School Care What would you most like to know about Bishop Leibold? (Check all that apply) Religious Education Academic Program Discipline Standardized Test results Transportation Becoming a member of the Parish Financial assistance Facilities Extra Curricular Activiites Other Learn more about BLS Please send me BLS information via US mail. Please provide an Ambassador who is a good match for me, based on the information I furnished on this form. (Our Ambassadors are current parents who speak to prospective parents and answer your questions now, and down the road.) Are you interesed in learning more about becoming a member of: Our Lady of Good Hope Parish (Miamisburg) St. Henry's Parish (Miami Township) Questions or Comments?
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