Please choose the Academic Year in which your child(ren) would be enrolling. *

2023-2024

2024-2025

First Child's Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Second Child's Name

(if necessary)

First Name

Last Name

Date of Birth

(if necessary)

MM

DD

YYYY

Third Child's Name

(if necessary)

First Name

Last Name

Date of Birth

(if necessary)

MM

DD

YYYY

Fourth Child's Name

(if necessary)

First Name

Last Name

Date of Birth

(if necessary)

MM

DD

YYYY

Mother's Name *

First Name

Last Name

Father's Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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How did you first hear about Regina Pacis Academy? *

Personal Recommendation

Internet Search

Social Media Post

Parish Bulletin

Other (please specify below)

What interests you most about Regina Pacis Academy? *

Please check the three (3) aspects of our school most important to you:

Classical Curriculum

Authentically Catholic Environment

Small Class Size

Affordable Tuition

Lack of Technology

Character/Virtue Development

Close-knit Community of Like-minded Families

Other (please specify below)