Enrollment Application

Legal Name*
First Middle Last
Preferred First Name
Gender*
Applying for enrollment in grade:*
- 9
- 10
- 11
- 12
Current School*
Current School City, State, Zip*
Previous schools the applicant has attended:
School Name Dates of Enrollment City, State, Zip
Date of Birth*
Date Format: MM slash DD slash YYYY
City and State of Birth*
Student's Primary Address*
Street Address Address Line 2 City State ZIP Code

No Post Office Box numbers
If Catholic, at what Parish are you registered?
Ethnicity
- Hispanic/Latino
- Non-Hispanic/Latino
Race
- American Indian or Alaskan Native
- Black or African American
- Asian
- Hispanic
- White
- Multi-racial
- Native Hawaiian or Pacific Islander

Check all that apply:
- Mother is deceased
- Father is deceased
- Parents are separated/divorced
Student lives with:*
Father/Guardian Information
Father's Name*
First Last
Father's Email
Father's Phone Number
Father's Address (If different from the student)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Name of step-mother (if applicable)
First Last
Mother/ Guardian Information
Mother's Name*
First Last
Mother's Email
Mother's Phone Number
Mother's Address (If different from the student)
Street Address Address Line 2 City State ZIP Code
Name of step-father (if applicable)
First Last
Please list any siblings of applicant
Name Grade Current School
Please list the names of any RMHS graduates in the applicant's family
Name Class Year Relationship

Consent*
- I agree to the following:
This application for admission has been completed in its entirety by a parent or legal guardian. I give permission for Reitz Memorial High School to contact my student's current school, or past schools, for the purposed of completing the admission process. This would include, but not limited to, information regarding attendance, academic progress, discipline, and tuition status. I also understand that a $100, non-refundable, registration fee is required to complete my student's Application for Admission.
Application Submitted By:*
Date Submitted*

School Name	Dates of Enrollment	City, State, Zip

Name	Grade	Current School

Name	Class Year	Relationship

Father/Guardian Information