Course Registration Form

Course Registration Form

Student Registration Form

Classes Start Sunday October 12, 2025, God willing.
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Father's Name

First NameLast Name
Mother's Name

First NameLast Name
Father email address
example@example.com
Mother email address 2
example@example.com
Home (Main) Phone Number
Format: (000) 000-0000.
Father Mobile
Format: (000) 000-0000.
Mother Mobile
Format: (000) 000-0000.
Courses
YesNoOther
Allergies (Any Kind)Learning skillsMedical AlertOther
Please define Medical alert
Please define Learning skills
Please define Allergies:

Did the student receive the Sacraments of Initiation?

Rows	At St. Anthony's	Another Church	Not Yet
Baptized
Confirmed
Communion

Please Name & Location of the other Church
Denomination:
Please define Other Religious affiliation:
Additional Comments
Should be Empty: