APPLICATION FOR ADMISSION

Applying for grade 9 10 11

Please print or type

Full Name ___________________________________________________________________________________________________

Last First Middle

Name you prefer to use ______________________________________________________________________________________________

East Fordham Road
Bronx, NY 10458-5175 Address ______________________________________________________________________________________________________
Number & Street Apt.
Tel (718) 367-7500
Fax (718) 367-7598 _________________________________________________________________________________________________________________________________________________________________
www.fordhamprep.org City State Zip

Admissions Office Phone ( ___________ ) _______________________________ E-mail _________________________________________________

(718) 584-8367
Name of Parent or Guardian_________________________________________________________________________________
(if different from applicant)

Birthdate ________________________________________________ Place of Birth _____________________________________________

Religion _________________________________________________ Place of Worship ________________________________________

Current School ___________________________________________________________ ❑ Catholic ❑ Public ❑ Private

Address ______________________________________________________________________________________________________
Number & Street

_________________________________________________________________________________________________________________________________________________________________
City State Zip

Phone ( ________________ ) _____________________________ E-mail _____________________________________________________

Principal __________________________________________________________Grades Attended ________________________

OTHER CHILDREN IN FAMILY

Name Age School Grade

_____________________________________________________ ________________ _________________________ __________

_____________________________________________________ ________________ _________________________ __________

_____________________________________________________ ________________ _________________________ __________

_____________________________________________________ ________________ _________________________ __________

_____________________________________________________ ________________ _________________________ __________

_____________________________________________________ ________________ _________________________ __________

Father’s Full Name _________________________________________________________________________________________________________________
Last First Middle

Address ________________________________________________________________________________________________Phone __________________________________________

Number & Street Apt.

____________________________________________________________________________________________________________ E-mail __________________________________________

City State Zip

Schools Attended:

High School _______________________________________________________________________________________________________________________________________________

Name City/State

College __________________________________________________________________ Grad. School __________________________________________________________

Religion _______________________________________________________ Occupation _______________________________________________________________________

Bus. Name_________________________________________________________________________________________________________________________________________________

Address__________________________________________________________________________________________________Phone___________________________________________

Mother’s Full Name _________________________________________________________________________________________________________________

Last First Middle

Address ________________________________________________________________________________________________Phone __________________________________________

Number & Street Apt.

____________________________________________________________________________________________________________ E-mail __________________________________________

City State Zip

Schools Attended:

High School _______________________________________________________________________________________________________________________________________________

Name City/State

College _____________________________________________________________________ Grad. School __________________________________________________________

Religion ___________________________________________________________ Occupation _________________________________________________________________________

Bus. Name__________________________________________________________________________________________________________________________________________________

Address__________________________________________________________________________________________________Phone___________________________________________

Check Where Appropriate:

❑ Lives with both parents ❑ Lives with Father ❑ Parents Divorced ❑ Mother Deceased
❑ Lives with Mother ❑ Lives with Guardian(s) ❑ Parents Separated ❑ Father Deceased
❑ Other
RELATIVES WHO HAVE ATTENDED OR ARE CURRENTLY ATTENDING FORDHAM PREP:
Name Relationship Class
___________________________________________________ ___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________ ___________________________________________________
___________________________________________________ ___________________________________________________ ___________________________________________________

Fordham Preparatory School admits students of any race, religion, national or ethnic origin to all the rights, privileges, programs and activites
generally accorded or made available to students at the school. It does not discrimintate on the basis of race, religion national or ethnic origin
in the administration of its educational policies, admissions policies, scholarship programs, athletic and other school-administered programs.

PLEASE NOTE: In order for your application to receive full consideration, it is important that the final 7th and 1st
quarter eighth grade marks be sent to the Fordham Prep Admissions office.

X X
Signature of Father/Guardian Signature of Mother/Guardian Date