Registration Form 2023-2024 School Year

Please complete the form below.

Applying For: *

Answer Required

Bishop McCort Catholic High School

The McCort Blended Academy

STUDENT INFORMATION:

Student's Name*

Answer Required

Social Security #

Answer Required

Home Address*

Answer Required

City*

Answer Required

State*

Answer Required

Zip Code*

Answer Required

Home Phone #*

Answer Required

Student Cell Phone #*

Answer Required

Student Religion

Answer Required

Parish

Answer Required

Student Email

Answer Required

Birth Date*

Answer Required

Birthplace

Answer Required

Legal & Educational Guardianship*

Answer Required

Shared Parental Custody, Single Household

Joint Custody, Multiple Households

Sole Custody, Biological Mother

Sole Custody, Biological Father

Sole Custody, Legal Guardian

Other:

List names and ages of brothers and sisters

Answer Required

SCHOOL DISTRICT INFORMATION:

Name of your current school

Answer Required

Public School District

Answer Required

Has the student/family previously inquired about admission to Bishop McCort?*

Answer Required

Have the student's current school records - including discipline reports - been requested to be sent to Bishop McCort?*

Answer Required

PARENT/GUARDIAN INFORMATION:

Mother's Full Name

Answer Required

Mother's Address (If not same as your home address)

Answer Required

Mother's Religion

Answer Required

Home Phone #

Answer Required

Work Phone #

Answer Required

Cell Phone #

Answer Required

Occupation

Answer Required

Place of Employment

Answer Required

Email Address

Answer Required

Father's Full Name

Answer Required

Father's Address (If not the same as your home address)

Answer Required

Father's Religion

Answer Required

Home Phone #

Answer Required

Work Phone #

Answer Required

Cell Phone #

Answer Required

Occupation

Answer Required

Place of Employment

Answer Required

Email Address

Answer Required

Guardian's Full Name

Answer Required

Guardian's Address (Complete of student doesn't live with parents)

Answer Required

Guardian's Religion

Answer Required

Home Phone #

Answer Required

Work Phone #

Answer Required

Cell Phone #

Answer Required

Occupation

Answer Required

Place of Employment

Answer Required

Email Address

Answer Required

EMERGENCY INFORMATION:

Who should be contacted in an emergency?

Answer Required

Phone #

Answer Required

Address

Answer Required

Student Sports Interest Survey

Girls Interest

Answer Required

Basketball (Winter)

Cheerleading

Cross Country (Fall)

Golf (Fall)

Soccer (Fall)

Softball (Spring)

Tennis (Fall)

Track & Field (Spring)

Volleyball (Spring)

Music Questionnaire

Do you want to become a member of the BMHS Band or Orchestra?

Answer Required

Band

Marching Band

Color Guard

Orchestra

Please fix the highlighted areas below before submitting.

Registration Form 2023-2024 School Year