Cathedral Prep Program
2018 Registration Form
Name: *
Your answer
Address: *
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Home Phone: *
Your answer
Parent's Cell Phone: *
Your answer
Student's Cell Phone: *
Your answer
Parent's Email: *
Your answer
Student's Email: *
Your answer
Mother's (Guardian) Full Name: *
Your answer
Father's (Guardian) Full Name *
Your answer
Siblings Name & age:
Your answer
Parish: *
Your answer
Letter of recommendation is required: Please contact your pastor and have him mail a letter to the Vocations Office: Name of Pastor: *
Your answer
High School: *
Your answer
Grade: *
I agree to abide by the rules of the Cathedral Prep and Understand that failure to do so will result in dismissal? *
Student's Signature: *
Your answer
Date: *
MM
/
DD
/
YYYY
In Case of an Emergency: Please call - Name & Phone Number (Relationship to you) *
Your answer
Medical Information: Has the student been diagnosed with any physical or psychological condition? *
If Yes, please specify the nature of the condition: *
Your answer
Can the student swim? *
Allergies? (Please list)
Your answer
Medications? (Please list) *
Your answer
Is the student currently taking any medications, herbs or vitamins? *
Please list the name and dosage: *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms