Online Inquiry - Holy Family Regional Catholic School

Applicant Information

First Name

Middle Name

Last Name

Gender

Date of Birth

Address 1

Address 2

City

State

Zip (98765)

Phone (555-555-5555)

Email

Present School

School Type

Present Grade

Grade Applying For

Student Background

* Please provide any specific information about your student that you feel would be of interest to our school. For example: Any special talents, academic abilities, IEP needs, Co-curricular Interests etc.

Additional Information

Religion

Parish

* SCHOOL-DIST

* Home Situation

If Other (Home Situation):

Parental rights - legal custody

Parental rights - physical custody

Program IEP or IU-ER

Program 504

Family Information

Relationship to Student

First Name

Middle Name

Last Name

Address 1

Address 2

City

State

Zip (98765)

Home Number (555-555-5555)

Mobile Number (555-555-5555)

Email

Employer

Work Phone (555-555-5555)

Holy Family Regional Catholic School

Online Inquiry Form