Benedictine College Preparatory -> CadetNet -> Parent Portal -> School Documents and Forms -> 2012-13 Application for Readmissions

	Re-Enrollment Form
	Reenrollment_Form_2013.pdf (7)
	Click above to download a pdf file of the re-enrollment form. If you would like to submit electronically, fill out the form below.

2012-13 Application for Readmissions

Student's Grade for School Year 2013-14

Student's Last Name

Student's First Name

Student's Middle Initial

Student's Nickname

Home Address

Include City, State, Zip

Home Phone

Father's Name

Wife's Name

If different from below

Home Address

Include City, State, Zip

Home Phone

Father's Occupation/Title

Father's Cell Phone

Business Name

Business Address

Include City, State, Zip

Business Phone Number

Mother's Name

Husband's Name

If different from above

Home Address

Include City, State, Zip

Home Phone

Mother's Occupation/Title

Mother's Cell Phone

Business Name

Business Address

Include City, State, Zip

Business Phone Number

Are both parents living?

	Yes
	No

If no, please specify

Are parents divorced?

Yes No

Are parents separated?

Yes No

Who has legal custody of the student?

Who is responsible for finances?

E-mail for school distribution

2nd E-mail for school distribution

Church or Parish student now attends

Emergency Contact

Emergency Phone

Contact relationship to student/family

Confirm Application?

This will serve as your electronic signature.

Yes