Bishop Ludden School Entrance Scholarship Exam - Syracuse, NY | Bishop Ludden Junior-Senior High School

Student Name*

First Middle Last

Male
Female

Date of Birth (MM/DD/YYYY)*

Student's Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Is your student Catholic?*

Yes
No

*Religion has NO effect on acceptance. For internal use only.

If yes, with what Syracuse Diocesan parish is your family registered?

Race

*Race has NO effect on acceptance. For internal use only.

Ethnicity

*Ethnicity has NO effect on acceptance. For internal use only.

School Currently Attending*

School District of Residence

Current Grade Level*

Grade Applying For*

School Year Applying For*

Brief Reason For Leaving*

Applicant Has:*

504 Plan
IEP Plan
N/A

Student Resides with:*

If other, please list:

Parent/Guardian #1*

First Last

Alumni

Yes
No

*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Relationship to Student

Email

Phone

Parent/Guardian #2

First Last

Alumni

Yes
No

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Relationship to Student

Email

Phone

Emergency Contact 1- If Mother and Father Cannot Be Reached

First Last

Relationship to Student

Phone

Emergency Contact 2- If Mother and Father Cannot Be Reached

First Last

Relationship to Student

Phone

Student's Most Recent Report Card*

Please submit a copy of your student's most recent report card.

How did you first become interested in Bishop Ludden?*

Word of Mouth
Visited our website
Visited us in person (open house, private tour)
Postcards, Letters
Social Media (Facebook, Instagram, Twitter)

Application Fee*

Price: $30.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Online Application

Admissions

Event

Time of Event

Start

End

Event

Time of Event

Start

End

Event

Time of Event

Start

End

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