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Registration for Mercy Academy's Placement Test

Required

Student's Namerequired
First Name
Preferred Name (optional)
Middle
Last Name
Must contain a date in M/D/YYYY format
Does your student have a diagnosed learning difference?
Must contain a date in M/D/YYYY format

 

Primary Contact's Namerequired
First Name
Last Name
Secondary Contact's Namerequired
First Name
Last Name
Parents' Marital Statusrequired
Did student's mother attend Mercy?
Mother's Information
First Name
Maiden Name
Graduation Year
Does student have a sister attending Mercy now?
Sister's Name
First Name
Last Name
Graduation Year
Has student had a sister previously attend Mercy?
Sister's Name
First Name
Last Name
Graduation Year (if applicable)
Does student have any other relatives who graduated from Mercy?

 

Do you plan to utilize Mercy's bus service?

 

Where do you plan to attend high school?