8^TH Grade Scholarship & Placement Exam Registration

(Class of 2011)

Fee is $10.00 for Registration & Lunch is Provided

Check-in: 8:00 a.m. / Testing begins @ 8:30 a.m.

STUDENT NAME:

GENDER: Male Female (Please Circle)

EMAIL:

HOME ADDRESS:

CITY/STATE/ZIP:

PHONE #:

PARENT(S) NAME:

EMAIL:

HOME ADDRESS:

CITY/STATE/ZIP

SCHOOL

CURRENTLY ATTENDING:

Mail this form with payment ($10) to:

Roncalli Catholic High School

Paulette Theisen (ptheisen@roncallicatholic.org)

Director of Admissions & Recruitment

6401 Sorensen Parkway

Omaha, NE 68152