Parishioner On-line Religious Education form

Today's Date REQUIRED Please fill out this field. Please enter a date.

Section for Parent/Guardian Information

Family Last Name REQUIRED Please fill out this field. Please enter valid data.

Father's Name

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Catholic REQUIRED Yes No Please fill out this field.

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Mother's name

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Catholic? REQUIRED Yes No Please fill out this field.

Mother's maiden name REQUIRED Please fill out this field. Please enter valid data.

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Custodial Parent if different from above

First Name Please enter valid data.

Last Name Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Emergency Contact

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

No child who is a parishioner is ever denied Religious Formation if the family is truly in need. If there is a financial problem, please let us know below that you need assistance.

Registered Parishioner Tuition REQUIRED Please fill out this field.

Is your child being confirmed this year? REQUIRED 60.0 – Yes 0.0 – No Please fill out this field.

Classes for Grades 1-4 will meet on Tuesday from 4:15 to 5:30

Classed for Grades 5-8 will meet on Thursday from 6:00 to 7:15

Do you agree to these class dates and times?

I agree Please select this field.