If you know a student who would benefit from a Central Catholic High School education, please tell us about her or him by completing this form.

Your Name

First Name

Last Name

Your Email

Your Phone

(###)

###

####

Are you a CCHS graduate?

Yes

If Yes, What Year?

Student Information

Name of the Student you are Referring

First Name

Last Name

Referring Student's Contact Information

i.e. Email, Phone Number, Mailing Address

Student's current school

Student's current grade

Student's activities and sports

What is your relationship to the student you are referring to CCHS?

Any additional information you would like to give