Register for our Open House at St. Benedict's Prep
Last Name *
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First Name *
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Date of Birth- Example (09/07/78) *
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Home Address *
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City- Zip Code Example (Newark - 07104) *
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State- *
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Current Grade *
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Current School *
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Phone number *
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Parent email address *
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Father's Name *
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Mother's Name *
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Open House Date- Dec. 9
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