2023-24 Registration Form "*" indicates required fields Step 1 of 14 7% Are you a new All Saints Catholic School Family?*You are considered a new family if you did not have a child enrolled in Saints in Training or K4-8th grade at All Saints Catholic School for the 2022-23 school year. Yes No How were you referred to All Saints Catholic School?*Friends / FamilyInternet SearchParish / Parish BulletinKenosha NewsFacebookOtherName of referring friend or family If other, please specify Number of Students Enrolling*123456Parishioner Status*Please indicate if you are an active parishioner at one of our 10 supporting parishes by selecting your parish below, and therefore eligible for the active parishioner discount. Parishioner status will be verified for tuition discount purposes through your submission of the parish verification form by April 17th. Note: By listing your parish, we reserve the right to share your contact info with them. The parishioner verification form can be found under the forms section of the ASCS website.St. AnneSt. AnthonySt. ElizabethSt. JamesSt. MarySt. Mark the EvangelistSt. PeterOur Lady of the Holy RosaryOur Lady of Mount CarmelSt. Therese of LisieuxOtherI do not belong to any parishOther Parish*Please enter the parish you attend. Do you intend to submit the parishioner verification form by April 17, signed by your parish priest in order to receive the parish discount?* Yes No Primary Language*What is the primary language spoken at home? English Spanish Other First Student InformationIs this a new All Saints Catholic School student?* Yes No Has your child ever attended All Saints Catholic School in previous years?* Yes No Does your child have an IEP or require any additional services?* Yes No If yes, please explain.*Has your child ever been expelled?* Yes No Please submit your child's original birth certificate and updated immunization record to your campus office. Student's Legal First Name* Student's Legal Middle Name Student's Legal Last Name* Student's Sex* Male Female Student's Birthdate* MM slash DD slash YYYY If your child is a new student at ASCS, please submit your child's original birth certificate and updated immunization record to your campus officeIs the Student Hispanic?* Yes No Student's Ethnic Background*American Indian / Native AlaskanAsianBlackMulti-racialNative Hawaiian / Other Pacific IslanderWhiteStudent's Grade Level*Entering 2023-24 school year.If you are enrolling a new student at ASCS in grade 1 through 8 please provide a copy of your child’s most recent report card and any test results to the Administrative office.3-year-old preschool program (Saints in Training)K4 (Full Day)K4 (Half Day)Kindergarten12345678Choir / Band / Orchestra Selection*Students in grades 4-8 can choose between choir, orchestra, or band as their fine arts curriculum. All students in grades 4-8 will be assessed a $100 fine arts fee to cover the cost of additional programming for theatre, band, orchestra, and choir.ChoirBandOrchestraSaints in Training Program Half-Day Full-Day Is the student fully potty trained?Please note: Children attending Saints in Training are required to be fully potty trained by the first day of school. Yes No Child's First Day of Attendance (if different from the first day of school) MM slash DD slash YYYY Current School Current School Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Student's Religion* Catholic Other Please specify Religion Has this student been baptized?* Yes No If yes, where was student baptized? Has this student made their First Holy Communion?*At the start of the 2023-24 school year, will your child have made his/her First Holy Communion? Yes No Please list the parish where this student made their First Holy Communion.* Illness/Disability/AllergiesPlease list any illness/disability. Ex: ADD, ADHD, depression and/or anxiety, heart trouble, epilepsy, diabetes, asthma, etc., or any food or drug allergies.Medication (School or Home)Please list any medications that your child takes at school or home.Primary Residence*If divorced or separated, please indicate primary residence. If there are any legal restrictions regarding child custody, please provide documentation with paperwork at supply drop-off.Both Parents/Guardians (same address)Both Parents/Guardians (different addresses)Only Parent 1/Guardian 1Only Parent 2/Guardian 2OtherParent/Guardian NotesPlease provide any other information regarding placement of child custody that would be pertinent to All Saints Catholic School.Parent/Guardian 1's Information for First StudentRelation to First Student* Father Mother Guardian Other Parent/Guardian 1's Full Name* First Last Parent/Guardian 1's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1's Home Phone*Parent/Guardian 1's Cell PhoneWould you like to receive text messages to this phone number?* Yes No Parent/Guardian 1's Work PhoneParent/Guardian 1's Place of Employment* Parent/Guardian 1's Email*Majority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address?* Yes No Parent/Guardian 1's Religion* Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Parent/Guardian 2's Information for First StudentRelation to First Student Father Mother Guardian Other Parent/Guardian 2's Full Name First Last Same as Parent/Guardian 1's Address? Yes Parent/Guardian 2's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Same as Parent/Guardians 1's Home Phone? Yes Parent/Guardian 2's Home PhoneParent/Guardian 2's Cell PhoneWould you like to receive text messages to this phone number? Yes No Parent/Guardian 2's Work PhoneParent/Guardian 2's Place of Employment Parent/Guardian 2's EmailMajority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address? Yes No Parent/Guardian 2's Religion Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Second Student InformationIs the second student a new All Saints Catholic School student? Yes No Has your child ever attended All Saints Catholic School in previous years?* Yes No Does the second student have an IEP or require any additional services?* Yes No If yes, please explain.*Has the second student ever been expelled?* Yes No Please submit your child's original birth certificate and updated immunization record to your campus office. Second Student's Legal First Name* Second Student's Legal Middle Name Second Student's Legal Last Name* Second Student's Sex* Male Female Second Student's Birthdate* MM slash DD slash YYYY If your child is a new student at ASCS, please submit your child's original birth certificate and updated immunization record to your campus officeIs the Second Student Hispanic?* Yes No Second Student's Ethnic Background*American Indian / Native AlaskanAsianBlackMulti-racialNative Hawaiian / Other Pacific IslanderWhiteSecond Student's Grade Level*Entering 2023-24 school year.If you are enrolling a new student at ASCS in grade 1 through 8 please provide a copy of your child’s most recent report card and any test results to the Administrative office.3-year-old preschool program (Saints in Training)K4 (Full Day)K4 (Half Day)Kindergarten12345678Second Student's Choir / Band / Orchestra Selection*Students in grades 4-8 can choose between choir, orchestra, or band as their fine arts curriculum. All students in grades 4-8 will be assessed a $100 fine arts fee to cover the cost of additional programming for theatre, band, orchestra, and choir.ChoirBandOrchestraSaints in Training Program Half-Day Full-Day Is the second student fully potty trained?Please note: Children attending Saints in Training are required to be fully potty trained by the first day of school. Yes No Child's First Day of Attendance (if different from the first day of school) MM slash DD slash YYYY Second Student's Current School Second Student's Current School Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Second Student's Religion* Catholic Other Please specify Religion Has the second student been baptized?* Yes No If yes, where was student baptized? Has the second student made their First Holy Communion?*At the start of the 2023-24 school year, will your child have made his/her First Holy Communion? Yes No Please list the parish where the second student made their First Holy Communion.* Second Student Illness/Disability/AllergyPlease list any illness/disability. Ex: ADD, ADHD, depression and/or anxiety, heart trouble, epilepsy, diabetes, asthma, etc., or any food or drug allergies.Second Student Medication (School or Home)Please list any medications that your child takes at school or home.Second Student Primary Residence*If divorced or separated, please indicate primary residence. If there are any legal restrictions regarding child custody, please provide documentation with paperwork at supply drop-off.Both Parents/Guardians (same address)Both Parents/Guardians (different addresses)Only Parent 1/Guardian 1Only Parent 2/Guardian 2OtherParent/Guardian NotesPlease provide any other information regarding placement of child custody that would be pertinent to All Saints Catholic School.Are the Parents/Guardians the same as First Student?* Yes No Parent/Guardian 1's Information for Second StudentRelation to First Student* Father Mother Guardian Other Parent/Guardian 1's Full Name* First Last Parent/Guardian 1's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1's Home Phone*Parent/Guardian 1's Cell Phone*Would you like to receive text messages to this phone number?* Yes No Parent/Guardian 1's Work Phone*Parent/Guardian 1's Place of Employment* Parent/Guardian 1's Email* Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address?* Yes No Parent/Guardian 1's Religion* Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Parent/Guardian 2's Information for Second StudentRelation to Second Student Father Mother Guardian Other Parent/Guardian 2's Full Name First Last Same as Parent/Guardian 1's Address? Yes Parent/Guardian 2's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Same as Parent/Guardians 1's Home Phone? Yes Parent/Guardian 2's Home PhoneParent/Guardian 2's Cell PhoneWould you like to receive text messages to this phone number? Yes No Parent/Guardian 2's Work PhoneParent/Guardian 2's Place of Employment Parent/Guardian 2's EmailMajority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address? Yes No Parent/Guardian 2's Religion Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Third Student InformationIs the third student a new All Saints Catholic School student? Yes No Has your child ever attended All Saints Catholic School in previous years?* Yes No Does the third student have an IEP or require any additional services?* Yes No If yes, please explain.*Has your child ever been expelled?* Yes No Please submit your child's original birth certificate and updated immunization record to your campus office. Third Student's Legal First Name* Third Student's Legal Middle Name Third Student's Legal Last Name* Third Student's Sex* Male Female Third Student's Birthdate* MM slash DD slash YYYY If your child is a new student at ASCS, please submit your child's original birth certificate and updated immunization record to your campus officeIs the Third Student Hispanic?* Yes No Third Student's Ethnic Background*American Indian / Native AlaskanAsianBlackMulti-racialNative Hawaiian / Other Pacific IslanderWhiteThird Student's Grade Level*Entering 2023-24 school year.If you are enrolling a new student at ASCS in grade 1 through 8 please provide a copy of your child’s most recent report card and any test results to the Administrative office.3-year-old preschool program (Saints in Training)K4 (Full Day)K4 (Half Day)Kindergarten12345678Third Student's Choir / Band / Orchestra Selection*Students in grades 4-8 can choose between choir, orchestra, or band as their fine arts curriculum. All students in grades 4-8 will be assessed a $100 fine arts fee to cover the cost of additional programming for theatre, band, orchestra, and choir.ChoirBandOrchestraSaints in Training Program Half-Day Full-Day Is the third student fully potty trained?Please note: Children attending Saints in Training are required to be fully potty trained by the first day of school. Yes No Child's First Day of Attendance (if different from the first day of school) MM slash DD slash YYYY Third Student's Current School Third Student's Current School Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Third Student's Religion* Catholic Other Please specify Religion Has the third student been baptized?* Yes No If yes, where was student baptized? Has the third student made their First Holy Communion?*At the start of the 2023-24 school year, will your child have made his/her First Holy Communion? Yes No Please list the parish where the third student made their First Holy Communion.* Third Student Illness/Disability/AllergyPlease list any illness/disability. Ex: ADD, ADHD, depression and/or anxiety, heart trouble, epilepsy, diabetes, asthma, etc., or any food or drug allergies.Third Student Medication (School or Home)Please list any medications that your child takes at school or home.Third Student Primary Residence*If divorced or separated, please indicate primary residence. If there are any legal restrictions regarding child custody, please provide documentation with paperwork at supply drop-off.Both Parents/Guardians (same address)Both Parents/Guardians (different addresses)Only Parent 1/Guardian 1Only Parent 2/Guardian 2OtherParent/Guardian NotesPlease provide any other information regarding placement of child custody that would be pertinent to All Saints Catholic School.Are the Parents/Guardians the same as First Student?* Yes No Parent/Guardian 1's Information for Third StudentRelation to Third Student* Father Mother Guardian Other Parent/Guardian 1's Full Name* First Last Parent/Guardian 1's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1's Home Phone*Parent/Guardian 1's Cell PhoneWould you like to receive text messages to this phone number?* Yes No Parent/Guardian 1's Work PhoneParent/Guardian 1's Place of Employment* Parent/Guardian 1's Email* Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address?* Yes No Parent/Guardian 1's Religion* Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Parent/Guardian 2's Information for Third StudentRelation to Third Student Father Mother Guardian Other Parent/Guardian 2's Full Name First Last Same as Parent/Guardian 1's Address? Yes Parent/Guardian 2's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Same as Parent/Guardians 1's Home Phone? Yes Parent/Guardian 2's Home PhoneParent/Guardian 2's Cell PhoneWould you like to receive text messages to this phone number? Yes No Parent/Guardian 2's Work PhoneParent/Guardian 2's Place of Employment Parent/Guardian 2's EmailMajority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address? Yes No Parent/Guardian 2's Religion Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Fourth Student InformationIs the fourth student a new All Saints Catholic School student? Yes No Has your child ever attended All Saints Catholic School in previous years?* Yes No Does the fourth student have an IEP or require any additional services?* Yes No If yes, please explain.*Has your child ever been expelled?* Yes No Please submit your child's original birth certificate and updated immunization record to your campus office. Fourth Student's Legal First Name* Fourth Student's Legal Middle Name Fourth Student's Legal Last Name* Fourth Student's Sex* Male Female Fourth Student's Birthdate* MM slash DD slash YYYY If your child is a new student at ASCS, please submit your child's original birth certificate and updated immunization record to your campus officeIs the Fourth Student Hispanic?* Yes No Fourth Student's Ethnic Background*American Indian / Native AlaskanAsianBlackMulti-racialNative Hawaiian / Other Pacific IslanderWhiteFourth Student's Grade Level*Entering 2023-24 school year.If you are enrolling a new student at ASCS in grade 1 through 8 please provide a copy of your child’s most recent report card and any test results to the Administrative office.3-year-old preschool program (Saints in Training)K4 (Full Day)K4 (Half Day)Kindergarten12345678Fourth Student's Choir / Band / Orchestra Selection*Students in grades 4-8 can choose between choir, orchestra, or band as their fine arts curriculum. All students in grades 4-8 will be assessed a $100 fine arts fee to cover the cost of additional programming for theatre, band, orchestra, and choir.ChoirBandOrchestraSaints in Training Program Half-Day Full-Day Is the fourth student fully potty trained?Please note: Children attending Saints in Training are required to be fully potty trained by the first day of school. Yes No Child's First Day of Attendance (if different from the first day of school) MM slash DD slash YYYY Fourth Student's Current School Fourth Student's Current School Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Fourth Student's Religion* Catholic Other Please specify Religion Has the fourth student been baptized?* Yes No If yes, where was student baptized? Has this fourth student made their First Holy Communion?*At the start of the 2023-24 school year, will your child have made his/her First Holy Communion? Yes No Please list the parish where the fourth student made their First Holy Communion.* Fourth Student Illness/Disability/AllergyPlease list any illness/disability. Ex: ADD, ADHD, depression and/or anxiety, heart trouble, epilepsy, diabetes, asthma, etc., or any food or drug allergies.Fourth Student Medication (School or Home)Please list any medications that your child takes at school or home.Fourth Primary Residence*If divorced or separated, please indicate primary residence. If there are any legal restrictions regarding child custody, please provide documentation with paperwork at supply drop-off.Both Parents/Guardians (same address)Both Parents/Guardians (different addresses)Only Parent 1/Guardian 1Only Parent 2/Guardian 2OtherParent/Guardian NotesPlease provide any other information regarding placement of child custody that would be pertinent to All Saints Catholic School.Are the Parents/Guardians the same as First Student?* Yes No Parent/Guardian 1's Information for Fourth StudentRelation to Fourth Student* Father Mother Guardian Other Parent/Guardian 1's Full Name* First Last Parent/Guardian 1's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1's Home Phone*Parent/Guardian 1's Cell PhoneWould you like to receive text messages to this phone number?* Yes No Parent/Guardian 1's Work PhoneParent/Guardian 1's Place of Employment* Parent/Guardian 1's Email*Majority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address?* Yes No Parent/Guardian 1's Religion* Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Parent/Guardian 2's Information for Fourth StudentRelation to Fourth Student Father Mother Guardian Other Parent/Guardian 2's Full Name First Last Same as Parent/Guardian 1's Address? Yes Parent/Guardian 2's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Same as Parent/Guardians 1's Home Phone? Yes Parent/Guardian 2's Home PhoneParent/Guardian 2's Cell PhoneWould you like to receive text messages to this phone number? Yes No Parent/Guardian 2's Work PhoneParent/Guardian 2's Place of Employment Parent/Guardian 2's EmailMajority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address? Yes No Parent/Guardian 2's Religion Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Fifth Student InformationIs the fifth student a new All Saints Catholic School student? Yes No Has your child ever attended All Saints Catholic School in previous years?* Yes No Does the fifth student have an IEP or require any additional services?* Yes No If yes, please explain.*Has your child ever been expelled?* Yes No Please submit your child's original birth certificate and updated immunization record to your campus office. Fifth Student's Legal First Name* Fifth Student's Legal Middle Name Fifth Student's Legal Last Name* Fifth Student's Sex* Male Female Fifth Student's Birthdate* MM slash DD slash YYYY If your child is a new student at ASCS, please submit your child's original birth certificate and updated immunization record to your campus officeIs the Fifth Student Hispanic?* Yes No Fifth Student's Ethnic Background*American Indian / Native AlaskanAsianBlackMulti-racialNative Hawaiian / Pacific IslanderWhiteFifth Student's Grade Level*Entering 2023-24 school year.If you are enrolling a new student at ASCS in grade 1 through 8 please provide a copy of your child’s most recent report card and any test results to the Administrative office.3-year-old preschool program (Saints in Training)K4 (Full Day)K4 (Half Day)Kindergarten12345678Fifth Student's Choir / Band / Orchestra Selection*Students in grades 4-8 can choose between choir, orchestra, or band as their fine arts curriculum. All students in grades 4-8 will be assessed a $100 fine arts fee to cover the cost of additional programming for theatre, band, orchestra, and choir.ChoirBandOrchestraSaints in Training Program Half-Day Full-Day Is the fifth student fully potty trained?Please note: Children attending Saints in Training are required to be fully potty trained by the first day of school. Yes No Child's First Day of Attendance (if different from the first day of school) MM slash DD slash YYYY Fifth Student's Current School Fifth Student's Current School Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Fifth Student's Religion* Catholic Other Please specify Religion If yes, where was student baptized? Has the fifth student been baptized?* Yes No Has this fifth student made their First Holy Communion?*At the start of the 2023-24 school year, will your child have made his/her First Holy Communion? Yes No Please list the parish where the fifth student made their First Holy Communion.* Fifth Student Illness/Disability/AllergyPlease list any illness/disability. Ex: ADD, ADHD, depression and/or anxiety, heart trouble, epilepsy, diabetes, asthma, etc., or any food or drug allergies.Fifth Student Medication (School or Home)Please list any medications that your child takes at school or home.Fifth Primary Residence*If divorced or separated, please indicate primary residence. If there are any legal restrictions regarding child custody, please provide documentation with paperwork at supply drop-off.Both Parents/Guardians (same address)Both Parents/Guardians (different addresses)Only Parent 1/Guardian 1Only Parent 2/Guardian 2OtherParent/Guardian NotesPlease provide any other information regarding placement of child custody that would be pertinent to All Saints Catholic School.Are the Parents/Guardians the same as First Student?* Yes No Parent/Guardian 1's Information for Second StudentRelation to First Student* Father Mother Guardian Other Parent/Guardian 1's Full Name* First Last Parent/Guardian 1's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1's Home Phone*Parent/Guardian 1's Cell PhoneWould you like to receive text messages to this phone number?* Yes No Parent/Guardian 1's Work PhoneParent/Guardian 1's Place of Employment* Parent/Guardian 1's Email*Majority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address?* Yes No Parent/Guardian 1's Religion* Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Parent/Guardian 2's Information for Fifth StudentRelation to First Student Father Mother Guardian Other Parent/Guardian 2's Full Name First Last Same as Parent/Guardian 1's Address? Yes Parent/Guardian 2's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Same as Parent/Guardians 1's Home Phone? Yes Parent/Guardian 2's Home PhoneParent/Guardian 2's Cell PhoneWould you like to receive text messages to this phone number? Yes No Parent/Guardian 2's Work PhoneParent/Guardian 2's Place of Employment Parent/Guardian 2's EmailMajority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address? Yes No Parent/Guardian 2's Religion Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Sixth Student InformationIs the sixth student a new All Saints Catholic School student? Yes No Has your child ever attended All Saints Catholic School in previous years?* Yes No Does the sixth student have an IEP or require any additional services?* Yes No If yes, please explain.*Has your child ever been expelled?* Yes No Please submit your child's original birth certificate and updated immunization record to your campus office. Sixth Student's Legal First Name* Sixth Student's Legal Middle Name Sixth Student's Legal Last Name* Sixth Student's Sex* Male Female Sixth Student's Birthdate* MM slash DD slash YYYY If your child is a new student at ASCS, please submit your child's original birth certificate and updated immunization record to your campus officeIs the Fifth Student Hispanic?* Yes No Sixth Student's Ethnic Background*American Indian / Native AlaskanAsianBlackMulti-racialNative Hawaiian / Pacific IslanderWhiteSixth Student's Grade Level*Entering 2023-24 school year.If you are enrolling a new student at ASCS in grade 1 through 8 please provide a copy of your child’s most recent report card and any test results to the Administrative office.3-year-old preschool program (Saints in Training)K4 (Full Day)K4 (Half Day)Kindergarten12345678Sixth Student's Choir / Band / Orchestra Selection*Students in grades 4-8 can choose between choir, orchestra, or band as their fine arts curriculum. All students in grades 4-8 will be assessed a $100 fine arts fee to cover the cost of additional programming for theatre, band, orchestra, and choir.ChoirBandOrchestraSaints in Training Program Half-Day Full-Day Is the sixth student fully potty trained?Please note: Children attending Saints in Training are required to be fully potty trained by the first day of school. Yes No Child's First Day of Attendance (if different from the first day of school) MM slash DD slash YYYY Sixth Student's Current School Sixth Student's Current School Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Sixth Student's Religion* Catholic Other Please specify Religion Has the sixth student been baptized?* Yes No If yes, where was student baptized? Has this sixth student made their First Holy Communion?*At the start of the 2023-24 school year, will your child have made his/her First Holy Communion? Yes No Please list the parish where the sixth student made their First Holy Communion.* Sixth Student Illness/Disability/AllergyPlease list any illness/disability. Ex: ADD, ADHD, depression and/or anxiety, heart trouble, epilepsy, diabetes, asthma, etc., or any food or drug allergies.Sixth Student Medication (School or Home)Please list any medications that your child takes at school or home.Sixth Primary Residence*If divorced or separated, please indicate primary residence. If there are any legal restrictions regarding child custody, please provide documentation with paperwork at supply drop-off.Both Parents/Guardians (same address)Both Parents/Guardians (different addresses)Only Parent 1/Guardian 1Only Parent 2/Guardian 2OtherParent/Guardian NotesPlease provide any other information regarding placement of child custody that would be pertinent to All Saints Catholic School.Are the Parents/Guardians the same as First Student?* Yes No Parent/Guardian 1's Information for Sixth StudentRelation to Sixth Student* Father Mother Guardian Other Parent/Guardian 1's Full Name* First Last Parent/Guardian 1's Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Parent/Guardian 1's Home Phone*Parent/Guardian 1's Cell PhoneWould you like to receive text messages to this phone number?* Yes No Parent/Guardian 1's Work PhoneParent/Guardian 1's Place of Employment* Parent/Guardian 1's Email* Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address?* Yes No Parent/Guardian 1's Religion* Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Parent/Guardian 2's Information for Sixth StudentRelation to Sixth Student Father Mother Guardian Other Parent/Guardian 2's Full Name First Last Same as Parent/Guardian 1's Address? Yes Parent/Guardian 2's Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Same as Parent/Guardians 1's Home Phone? Yes Parent/Guardian 2's Home PhoneParent/Guardian 2's Cell PhoneWould you like to receive text messages to this phone number? Yes No Parent/Guardian 2's Work PhoneParent/Guardian 2's Place of Employment Parent/Guardian 2's EmailMajority of communication is done via email. Enter Email Confirm Email Would you like to receive the weekly newsletter to this email address? Yes No Parent/Guardian 2's Religion Catholic Other Stepparent (if applicable) Stepparent Phone (if applicable)Stepparent Email (if applicable) Enter Email Confirm Email Other Children in Household (not attending All Saints Catholic School)If there are no other children in the household, please click "Next" at the bottom of the page.Other Child #1Other Child #1 Name Other Child #1 SexMaleFemaleOther Child #1 Birthdate MM slash DD slash YYYY Other Child #2Other Child #2 Name Other Child #2 SexMaleFemaleOther Child #2 Birthdate MM slash DD slash YYYY Other Child #3Other Child #3 Name Other Child #3 SexMaleFemaleOther Child #3 Birthdate MM slash DD slash YYYY Other Child #4Other Child #4 Name Other Child #4 SexMaleFemaleOther Child #4 Birthdate MM slash DD slash YYYY GrandparentsPlease provide grandparents information, so that we can contact them for Grandparents Day, our Annual Fund and other ASCS events. Grandparent Name First Last Grandparent Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Grandparent Email Enter Email Confirm Email Second Grandparent Name First Last Second Grandparent Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Second Grandparent Email Enter Email Confirm Email Emergency InformationParent/Guardian Contact Order*Please list the order in which the parents or guardians should be contacted in the case of an emergency and the phone number.If a parent cannot be reached, in case of my child(ren)'s illness, my child(ren) may be picked up by the following individuals (listed in order of preference).Emergency Contact #1 Name*Please list someone other than parents. First Last Emergency Contact #1 Phone*Emergency Contact #1 Relationship* Emergency Contact #2 Name*Please list someone other than parents. First Last Emergency Contact #2 Phone*Emergency Contact #2 Relationship* Emergency Contact #3 NamePlease list someone other than parents. First Last Emergency Contact #3 PhoneEmergency Contact #3 Relationship Physician/Hospital InformationFamily Physician Name* Family Physician Phone*Hospital Preference in case of emergency:*Faculty & Staff will use discretion regarding when a rescue squad should be requested.If necessary, the child may be taken to the following Hospital/Medical Center. Aurora Medical Center - Kenosha Froedtert - Pleasant Prairie (St. Catherine's) Other Consent InformationImage Consent and Authorization*I, and on behalf of my minor children listed herein, hereby (1) grant All Saints Catholic School permission to use, adapt, reproduce, distribute, publically perform and display, in any form, my and my child’s (children’s) images, likenesses, voices, names throughout the world, by incorporating them into any promotional material, brochures, print advertising, print material, photo exhibits, videos, and/or any other media for commercial, informational, educational, advertising, or any other related pursuits of All Saints Catholic School and the Archdiocese of Milwaukee; and (2) waive any right to compensation for said uses by All Saints Catholic School or the Archdiocese of Milwaukee as set forth herein. Yes No Contact Information Consent*I consent to having my contact information shared with organizations within the Archdiocese of Milwaukee such as high schools and parishes. Yes No Mobile Classroom Permission*My child/children are eligible to participate in school-sponsored activities that will take place under the guidance and supervision of employees from All Saints Catholic School. The locations for these activities may include: a park, fire station, nursing home, or other relevant location within walking distance from the school building any of our ten supporting parish sites; within walking distance or by bus St. Joseph Catholic Academy by bus for special events Yes No TuitionResponsible Parent/Guardian for Tuition* Mother Father Both Other How do you intend to pay your 2023-24 Tuition?* I plan to pay my tuition in installments with the first payment due July or August 2023 (depending on the plan selected) utilizing the FACTS Tuition Payment Plan. I plan to pay my tuition in full by Wednesday, June 21, 2023 All Saints Catholic School utilizes the FACTS tuition payment plan. NEW family: you will need to set up a FACTS account. RETURNING family who previously did not use FACTS, you will need to set up a FACTS account. RETURNING family who has previously used FACTS, your payment plan will remain the same as in past years unless you request a change through the ASCS business office. PLEASE NOTE: Your enrollment is not complete until you enroll in FACTS at factsmgt.com. Digital SignatureBy typing my name and email address, I understand that I am "signing" this form, as the parent or legal guardian, and that if any of the information contained herein is determined to be false, this registration form will be considered void. I /We agree to assume responsibility for all tuition and other expenses of the student(s) while attending All Saints Catholic School (ASCS). I/We also give permission to ASCS to request and receive all pertinent records from my/our children’s current school if applicable. A confirmation email will be sent to the email entered below to verify that your submission was received.Your Name*Please enter the name of the person completing this enrollment form. First Last Your Email* Enter Email Confirm Email Today's Date* MM slash DD slash YYYY Tuition Deposit Payment* I will pay online via Paypal (includes a minimal processing fee) I will pay online via Credit Card (includes a minimal processing fee) I will send my check to the office New Family One-Time Registration Fee (non-refundable)* Price: New Family One-Time Registration Fee (non-refundable)* Price: New Family One-Time Registration Fee (non-refundable)* Price: Tuition Deposit* Price: Total Online PaymentConvenience Fee Price: $3.30 Convenience Fee Price: $3.30 Total Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Credit CardCard Details Cardholder Name PhoneThis field is for validation purposes and should be left unchanged. 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