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Thank you for your interest in Holy Names High School. We are excited to have you learn about our community. Please complete the following form in order to receive the requested information.

Student Information
*	First Name		*	Last Name
	Middle Name			Nickname
*	Mailing Address		*	City
*	State		*	ZIP Code
*	Date of Birth (mm/dd/yyyy)			Email Address
	Religious Affiliation
	Racial/Ethnic Background	Select One African African-American African-American/Asian African-American/Caucasian African-American/Ethiopian African-American/Latina Asian/Caucasian African-American/Native-American Asian/Pacific Islander Asian Caucasian Ethiopian Euro-American Filipina Filipina/Caucasian Hispanic/Latina Indian Latina Latina/Caucasian Latina/Native America/Alaskan Multi-racial Native American NativeAmerican/Caucasian Native American/Latina Other
Proposed Entry to Holy Names High School
*	Grade
Current School
*	School Name		*	Current Grade
Parent/Guardian (Primary Contact)
*	Relationship to Student
*	First Name		*	Last Name
Parent/Guardian Address (if different from student)
	Mailing Address			City
	State			ZIP Code
*	Telephone		*	Email Address
Request