Regis High School: REACH

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REACH Request an Application

Student Information

Legal first name:

Legal last name:

Is the prospective applicant a baptized Roman Catholic?

Date of Birth (format yyyy-mm-dd) :

Current grade

Current School:

Contact Information Household where the student primarily lives. Correspondence will be sent to this address.

Address:

City:

State:

Zip:

Country:

Geographical Area:

Primary Phone:

Primary contact phone number.

Primary Contact Email:

Please provide an e-mail address that is checked regularly by the parent(s) of the prospective student.

Parent / Guardian Information

Relation to student:

Title:

First name:

Last name:

Phone:

Email:

Relation to student:

Title:

First name:

Last name:

Phone:

Email:

How did you hear about us?

Additional Comments