Parish Religious Education Program Family Registration 2018-2019

First Child's Name*

First NameLast Name

First Child's Ethnicity*

Hispanic/LatinoNon-Hispanic/LatinoPrefer not to answer

First Child's Race*

First Child's School*

First Child's Public School Grade in 2024-2025*

What grade will your child attend THIS year?

Level of PREP First Child COMPLETED LAST Year (2023-2024)*

First Child's Date of Birth*

Date

First Child's Place of Baptism (Church and City, State)

First Child's Year of Child's Baptism

Year of First Child's First Reconciliation

Year of First Child's First Eucharist

Is this child allergic to anything? If yes, please explain.*

Select all statements that are applicable to this child.

Child has an IEPChild has a 504 PlanChild has specific learning needs, but not an IEP or 504 planChild has accelerated learning plan

Please provide any information that will help us provide the best classroom experience for your child.

Second Child's Name*

First NameLast Name

Second Child's Ethnicity*

Hispanic/LatinoNon-Hispanic/LatinoPrefer not to answer

Second Child's Race*

Second Child's School*

Second Child's Public School Grade in 2024-2025*

What grade will your child attend THIS year?

Level of PREP Second Child COMPLETED LAST Year (2023-2024)*

Second Child's Date of Birth*

Date

Second Child's Place of Baptism (Church and City, State)

Year of Second Child's Baptism

Year of Second Child's First Reconciliation

Year of Second Child's First Eucharist

Is this child allergic to anything? If yes, please explain.*

Select all statements that are applicable to this child.

Child has an IEPChild has a 504 PlanChild has specific learning needs, but not an IEP or 504 planChild has accelerated learning plan

Please provide any information that will help us provide the best classroom experience for your child.

Third Child's Name*

First NameLast Name

Third Child's Ethnicity*

Hispanic/LatinoNon-Hispanic/LatinoPrefer not to answer

Third Child's Race*

Third Child's School*

Third Child's Public School Grade in 2024-2025*

What grade will your child attend THIS year?

Level of PREP Third Child COMPLETED LAST Year (2023-2024)*

Third Child's Date of Birth*

Date

Third Child's Place of Baptism (Church and City, State)

Year of Third Child's Baptism

Year of Third Child's First Reconciliation

Year of Third Child's First Eucharist

Is this child allergic to anything? If yes, please explain.*

Select all statements that are applicable to this child.

Child has an IEPChild has a 504 PlanChild has specific learning needs, but not an IEP or 504 planChild has accelerated learning plan

Please provide any information that will help us provide the best classroom experience for your child.

Fourth Child's Name*

First NameLast Name

Fourth Child's Ethnicity*

Hispanic/LatinoNon-Hispanic/LatinoPrefer not to answer

Fourth Child's Race*

Fourth Child's School*

Fourth Child's Public School Grade in 2024-2025*

What grade will your child attend THIS year?

Level of PREP Fourth Child COMPLETED LAST Year (2023-2024)*

Fourth Child's Date of Birth*

Date

Fourth Child's Place of Baptism (Church and City, State)

Fourth Child's Year of Child's Baptism

Year of Fourth Child's First Reconciliation

Year of Fourth Child's First Eucharist

Is this child allergic to anything? If yes, please explain.*

Select all statements that are applicable to this child.

Child has an IEPChild has a 504 PlanChild has specific learning needs, but not an IEP or 504 planChild has accelerated learning plan

Please provide any information that will help us provide the best classroom experience for your child.

Please indicate your fee payment option:*

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Parish Religious Education Program Family Registration 2024-2025