Father Lopez High School

Request for Admissions Packet

Student's Name: *

The full name of the student.

Parent's Names: *

The names of the student's parents or legal guardian(s).

Email:

Contact email address for the student.

Mailing and Contact Information

The mailing street address. *

,
mailing city *	mailing state *	mailing zip *

Home Phone: *

The home phone number of the student.

Cell Phone:

The cell phone number of the student.

School Information

Currently Enrolled School:

What school are you currently enrolled, if any?

What Grade would the student be entering at Father Lopez?:

What is the Student's Current GPA?:

The Student is Catholic:

What Sports and Extra Curricular Activities is the Student Interested In:

What Additional Information Would You Like To Know?:

How Did You Hear About Father Lopez?:

Security Code

Code: *

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