• Salutation --None--Mr.Mrs.Ms.Mr. & Mrs.Dr.Prof.Msg.Fr.Sr.

  First Name

  Last Name

  Parent/Guardian: --None--ParentGrandparentGuardianOther

  Phone 1:

  Phone 2:

  Email

  Street

  City

  State/Province

  Zip

  Best Way to Contact: --None--EmailPhone 1Phone 2Mobile Phone

  Preferred Language: --None--EnglishSpanishOther

  Child's Name:

  Date of Birth:

  Child's Current Grade: --None--Pre-KUPKPre-K 3Pre-K 4K123456789101112

  Current School Name:

  Applying for Grade: --None--Pre-KK123456789101112

  Academic Year of Interest: --None--2017-20182018-2019

  Additional Children Information:

  Heard About Touring Tuesday: --None--AdvertisementBannerFlyers Around NeighborhoodFriend/FamilyOnlineParent AmbassadorChurch BulletinReceived Information in the MailRegional Marketing SpecialistTouring TuesdayOther

  School Interested In 1 Text:

  Region: --None--DutchessManhattanNortheast BronxNorthwest/South BronxRocklandStaten IslandUpper CountyCentral WestchesterUlster/Sullivan/OrangeN Westchester/PutnamNot Applicable

  Lead Source --None--Baptismal RecordCCDOpen HouseOtherParishPhoneReferralTouring TuesdayWalk InSchool WebCornerstoneBR CatholicCYOTADs AdmissionSmartSmart ReRegistration

  Inquiry/Comments