* 2. Student

* 3. Home Address

* 4. Date of Birth (MM/DD/YYYY)

* 5. Home Phone

* 6. Home Phone Type

* 7. Ethnicity

* 8. Residency Status

* 10. Current School

* 11. Religious Affiliation

* 12. Parent Email Address

* 13. Mother/Stepmother/Guardian

* 14. Father/Stepfather/Guardian

* 15. Parent Cell Phone

* 16. Parent Work Phone

* 19. As a member of the National Cristo Rey Network, Verbum Dei's Corporate Work Study Program (CWSP) provides students with real world job experiences and allows them to earn a portion of the cost of their education. It is an integral part of their educational experience at Verbum Dei High School. A positive attitude and a commitment to high standards of responsibility and behavior are required. Due to the requirements of the Work Study Program, all applicants must be 14 years of age by September 1 of the school year.

I certify that the applicant will be legally able to work in the US by the beginning of his freshman year.

* 20. Please send me the Admissions Application Packet in: