CFF | Student Registration Form
Starts Fall 2022- to June 2023
Student Name
First Name
Middle Name
Last Name
Gender
Please Select
Male
Female
N/A
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
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1924
1923
1922
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Year
Grade Level
Check all the Sacraments that this child has already COMPLETED
*
Baptism
1st Reconciliation
1st Communion
Confirmation Year 1
Sacrament Program to be completed this year
Baptism
1st Communion / 1st Reconciliation
Confirmation Year 1
Confirmation Year 2
New student (He/she has never been in St. Agnes Program)
Parent 1 Name
First Name
Last Name
Parent 2 Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Email Contact
example@example.com
House Number
Parent's emergency contacts - list the 2 best ways to reach you quickly and please be specific. For example: Roger (Dad) best to text at 415-555-6789; Gina (Mom) best to call her mobile 650-555-1234. *
Please inform us if your child has any special needs. Ex: allergies, medications, learning differences, request for emotional or behavioral support, or physical limitations.
Baptism Certificate Copy (Only needed if the child is completing a sacrament this year).
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Registration Payment - NOTE!!!* If you wish to pay by check, leave all the following check boxes on the form empty, click submit and just send your check directly to the Parish.*If paying online with PayPal, please select the payment amount for the number of children you are enrolling. Select the appropriate boxes for sacramental fees and/or non-parishioner rate if applicable. PayPal will open upon submitting. You do not need a PayPal account to pay through this resource, a credit or debit card will work.
Please Select
One Child (un niño) $ 150.00
Two Children (dos niños) $ 200.00
Three + Children $ 250.00
Sacraments Registration Fees
Please Select
1st Reconciliation & First Communion $ 75.00
Confirmation Year 1 $ 75.00
Confirmation Year 2 $ 75.00
Solicito Ayuda Financiera (Beca) Solo puedo aportar $ 50.00
Solicito Ayuda Financiera (Beca) aporto por dos niños(as) $ 75.00
Solicito Ayuda Financiera (Beca) por 3 niños(a) $ 100.00
Submit Now pay later / Enviar Ahora page despues Free
If some reason, you are not able to pay now, please submit your application and give your check or cash to Sr. Teresa Malave.
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