Religious Education Registration

2011-2012

Classes Begin Sunday September 25, 2011 – 8:30 – 9:45 a.m.

Religious Education Registration Form

Child's First Name:(required)
Child's Last Name: (required)
Date of Birth: (required)
Age: (required)
School:(required)
Grade Attending in Fall 2011:(required)
Home Street Address:(required)
City, State:(required)
Zip Code:(required)
Home Phone:(required)
Parent's E-Mail Address:(valid email required)
Father's Full Name:
Father's Address:
Father's Daytime Phone:
Father's Evening Phone:
Mother's Full Name: (Maiden)
Mother's Address:
Mother's Daytime Phone:
Mother's Evening Phone:
Was your child registered last year in our program? (required)

New Registration

If this is a new registration, fill out info. below:
Was your child baptized:(required)
If yes, where was your child baptized? (Church/Date)
Has your child received First Confession?
If yes, where did your child receive First Confession? (Church/Date)
Has your child received First Communion?(required)
If yes, where did your child receive First Communion? (Church/Date)

Payment

How would you like to submit your payment? [To avoid lines at registration we recommend that you pay prior to September 25th] (required)
Online
By Mail
In Office
At Registration

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