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STUDENT INFORMATION
Student First Name *
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Student Last Name *
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Student Preferred Name *
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Student Email Address *
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Current Grade Level *
Entering Grade Level *
Year of Entry *
Current Grade Point Average *
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Current School Name *
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Current School Location (city, state) *
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Academic Interests 1 *
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Extracurricular Interests 1 *
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Extracurricular Interests 3 *
Please tell us more about your child, so that we can better serve your family in the admission process.
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PARENT/GUARDIAN 1 INFORMATION
Relation to Student *
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Parent/Guardian 1 Title (Mr. / Mrs.) *
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Parent/Guardian 1 First Name *
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Parent/Guardian 1 Home Phone
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HOUSEHOLD INFORMATION
Street Address *
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Country
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ADDITIONAL INFORMATION
If any relative has attended Pope John XXIII Middle School, please list his/her name, relation to applicant, and years attended
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