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Regina High School Application
This is the application for Regina High School.
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Student Information
Student's First Name:
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Your answer
Student's Middle Name:
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Your answer
Student's Last Name:
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Your answer
Student's Date of Birth:
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MM
/
DD
/
YYYY
City/State of Birth:
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Your answer
Applying for Grade:
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9th
10th
11th
12th
Academic Start Year:
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2019-2020
2020-2021
Latino/Hispanic?
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Yes
No
Ethnicity:
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Prefer Not To Answer
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Multi-Racial
Religion:
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Your answer
Place of Worship:
Your answer
Primary Home Address:
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Your answer
City:
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Your answer
State:
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Your answer
Zip Code:
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Your answer
Parents are:
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Married
Separated
Divorced
Never Married
Single Parent
Single Parent (Spouse Deceased)
First Parent or Guardian in Primary Household
First Name:
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Your answer
Last Name:
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Your answer
Relationship to Student:
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Mother
Father
Stepmother
Stepfather
Grandmother
Grandfather
Guardian
Primary Phone:
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Your answer
Secondary Phone:
Your answer
Primary Email:
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Your answer
Employment Status:
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Employed
Self-Employed
Student
Home Parent
Not Employed
Retired
Other
Title/Occupation:
Your answer
Employer:
Your answer
Business Address:
Your answer
High School Attended:
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Your answer
College Attended:
Your answer
Second Parent or Guardian in Primary Household
First Name:
Your answer
Last Name:
Your answer
Relationship to Student:
Mother
Father
Stepmother
Stepfather
Grandmother
Grandfather
Guardian
Clear selection
Primary Phone:
Your answer
Secondary Phone:
Your answer
Primary Email:
Your answer
Employment Status:
Employed
Self-Employed
Student
Home Parent
Not Employed
Retired
Other
Clear selection
Title/Occupation:
Your answer
Employer:
Your answer
Business Address:
Your answer
High School Attended:
Your answer
College Attended:
Your answer
Sibling Information
Does applicant have any brothers attending a Catholic High School?
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Yes
No
How many siblings, if any, does the applicant have?
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Your answer
Please list any siblings names, ages, grades, and schools.
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Your answer
Legacy
Does the applicant have any sisters that currently attend Regina High School?
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Yes
No
Does the applicant have any sisters who did attend Regina High School but are now graduated?
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Yes
No
Did the applicant's mother attend Regina High School?
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Yes
No
School History
School District of Residence:
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Your answer
Current Grade:
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Your answer
School Name:
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Your answer
Grades Attended:
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Your answer
Please list any other schools the applicant has attended:
Your answer
Student Questionnaire
These questions are to be completed by the student.
Please describe your academic interests and detail any academic achievements for which you have been honored:
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Your answer
What interests you about attending Regina High School?
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Your answer
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