Routt Catholic High School

Email Address *

First Name

Last Name

Birthday

Month / Day

Student Name (First and Last)

Parent/Guardian 1 Name (First and Last)

Parent/Guardian 2 Name (First and Last)

Father's Name (First and Last)

Parent/Guardian 1 Cell Number

Parent/Guardian 2 Cell Number

Parent/Guardian 1 E-mail

Parent/Guardian 2 E-mail

Student Mailing Address

Street Address Address Line 2 City State/Prov/Region Postal/Zip Country

Where does this student currently attend school?