Update Registration Information

Please submit only information that is new. Submit more than once as necessary.

If you have any additional questions, please contact Mr. John Gernacy, Registrar at jjgernacy@mhsmi.org

(* = required field)
Submitter's Name*:
Submitter's E-mail*:
Student Name*
(First, M.I., Last):
Current Grade*:
Adviser's Name*:
.
Change From:
Change To:
Parent Name (Last, First):
Parents' Full Work Phone
ext.
ext.
Street Address:
Apartment # (if any):
City:
State:
Zip Code:
Full Home Phone:
E-Mail Address:

Effective Date*:
  



Mercy High School • 29300 W. 11 Mile Road • Farmington Hills, MI • 48336-1409
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