Summer Enrichment Program Application

Please make sure your application is fully complete prior to submission. Once you submit your application, you will not be able to retrieve it. Please contact admissions@regis.org with any questions.
Student Information
Student First: (*)
Student Last: (*)
Date of Birth: (*)
Grade Level: (*)
School name: (*)
Home Address: (*)
City: (*)
State: (*)
Zip: (*)
Phone: (*)
Family Information
Parent/Guardian 1 First name: (*)
Parent/Guardian 1 Last name: (*)
Parent/Guardian 1 Phone (*)
Parent/Guardian 1 Email: (*)
Parent/Guardian 2 First name:
Parent/Guardian 2 Last name:
Parent/Guardian 2 Phone:
Parent/Guardian 2 Email:
Income Information (Optional)
Total Household Income:
Number of Dependents:
Upload Files
Please attach a copy of the student's Baptismal Certificate amd 6th Grade Report Card

  • Supported document types are .jpg and .pdf files.
  • Please be sure files are legible. Any uploaded files that are difficult to read will delay the application process.
Short Essay (*)
Please write a short essay (250 words max) answering the following question:
Why do you want to attend this summer enrichment program, and what do you hope to learn or gain from the experience?
Teacher Recommendation Please request a recommendation from a current 7th grade teacher who can speak to your character and suitability for the summer enrichment program.

Reference Name: (*)
Relationship to Applicant: (*)
Phone: (*)
Email: (*)