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

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