Mercy High School Application Form

* Application due December 20 in order to be notified in the first round of decisions which will be postmarked on January 20. Applications received after December 20 will be reviewed on a rolling basis and notification letters will be postmarked after January 20.

Most fields are required; please fill out as many as possible.

Applicant's Name: *

Applicant's Birthdate: *

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Applicant's Address: *

Address 2:

City: *

State/Province/Region: *

Zip Code/Postal Code: *

Country:

Email: *

Phone: *

Grade to be Enrolled: * - Select -Freshman (9th)Sophomore (10th)Junior (11th)Senior (12th)

Current Grade: *

Current School: *

Current School City: *

Applicant's Religion:

Family Place of Worship:

Mother's Name: *

Mother's Work Phone:

Father's Name: *

Father's Work Phone:

Applicant Lives With: * - Select -Mother and FatherMotherFatherGuardianOther

If "Other" please specify:

If applicant's MOTHER graduated from Mercy...

Mother's Grad. Year:

If applicant's GRANDMOTHER graduated from Mercy...

Grandmother Grad. Year:

Grandmother's Name:

How did you hear about Mercy High School?:

Briefly state the reasons why you want to attend Mercy High School:

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