Cathedral Prep Program
2019/20 Registration Form
Name: *
Address: *
Date of Birth: *
Home Phone: *
Parent's Cell Phone: *
Student's Cell Phone: *
Parent's Email: *
Student's Email: *
Mother's (Guardian) Full Name: *
Father's (Guardian) Full Name *
Siblings Name & age:
Parish: *
Letter of recommendation is required: Please contact your pastor and have him mail a letter to the Vocations Office: Name of Pastor: *
High School: *
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: *
Parent's Signature
Date: *
In Case of an Emergency: Please call - Name & Phone Number (Relationship to you) *
Medical Information: Has the student been diagnosed with any physical or psychological condition? *
If Yes, please specify the nature of the condition: *
Can the student swim? *
Allergies? (Please list)
Medications? (Please list) *
Is the student currently taking any medications, herbs or vitamins? *
Please list the name and dosage: *
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