Loyola High School

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About the Student

Legal Name

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Middle

Last

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Preferred Name

Date of Birth

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School Type

Current School

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Current Grade

Interested in Grade

for the Fall of

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About the Parent/Guardian

Name

Title

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Middle

Last

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Preferred Name

Relationship to Student

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Number

Secondary Phone (xxx-xxx-xxxx)

Type

Number

Email

Mailing Address

Is either parent a full time employee at a Catholic School?

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Name of School

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