2024-2025 NEW STUDENT Online Registration Form

Email REQUIRED Please fill out this field. Please enter an email address.

Student First Name REQUIRED Please fill out this field. Please enter valid data.

Student Last Name REQUIRED Please fill out this field. Please enter valid data.

I plan to attend Beckman Catholic in 2024-2025. REQUIRED Yes No I am undecided and need more information. Please contact me. Please fill out this field.

Student Date of Birth REQUIRED Please fill out this field. Please enter a date.

Grade in 2024-2025 REQUIRED Please fill out this field.

Mother First Name REQUIRED Please fill out this field. Please enter valid data.

Mother Last Name REQUIRED Please fill out this field. Please enter valid data.

Father First Name REQUIRED Please fill out this field. Please enter valid data.

Father Last Name REQUIRED Please fill out this field. Please enter valid data.

Contact Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Parent Email REQUIRED Please fill out this field. Please enter an email address.

Parent Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Student's Current School REQUIRED Please fill out this field. Please enter valid data.

Will the student be in band? REQUIRED Yes No Please fill out this field.

Will the student be in chorus? REQUIRED Yes No Please fill out this field.

Will the student be in FFA? REQUIRED Yes No Please fill out this field.

Are you Catholic? REQUIRED Yes No Please fill out this field.

What church do you belong to? (N/A if none) REQUIRED Please fill out this field. Please enter valid data.