Update Registration Information

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

If you have any additional questions, please contact Registrar Mrs. Colleen Rozman at cmrozman@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*: