Open House Information Request

Parent/Guardian First Name:*

Parent/Guardian Last Name:*

Address:*

City:*

State:*

Zip Code:*

Home Telephone Number:

Cell Phone Number:

E-mail Address:*:

Names of Children:

First Name:

Middle Name:

Last Name:

Date of Birth:

Expected Date of Entry:

Grade in School at Entry:

First Name:

Middle Name:

Last Name:

Date of Birth:

Expected Date of Entry:

Grade in School at Entry:

First Name:

Middle Name:

Last Name:

Date of Birth:

Expected Date of Entry:

Grade in School at Entry:

What makes you interested in Butler Catholic School?:

Did anyone refer you?

How did you learn about the BCS Open House? Please check all that apply.:
BannerChurch BulletinSocial MediaAdvertisementPosterRadioMailed InvitationReferred by a BCS Family
Other: