Admissions
Admissions Inquiry Form

Thank you for your interest in Immaculate Conception & Our Lady of Perpetual Help School. We are excited to have you learn about our community. Please complete the following form  and submit it to our Admissions Office.

Student Information

* First Name
Middle Name
* Last Name
Suffix
Nickname/Preferred Name
* Gender
* Date of Birth
mm/dd/yyyy
* Mailing Address
* City
* State
* Postal Code
* Country
* Home Telephone
xxx-xxx-xxxx

Proposed Entry

* Grade of proposed entry
* Year of proposed entry

Current School

* School
* School Type
* Grade

Family Information (for household in which the student primarily resides)

Parent/Guardian #1 Information

* Relationship to applicant
* Title
* First Name
Middle Name
* Last Name
Suffix
* E-Mail
if not applicable, enter 'none@noemail.com'
Cell Phone
xxx-xxx-xxxx

Parent/Guardian #2 Information

Relationship to applicant
Title
First Name
Middle Name
Last Name
Suffix
E-Mail
Cell Phone
xxx-xxx-xxxx

When you are finished, please click "Submit" to complete this form.