St. Paul of Tarsus 2011 - 2012 Religious Education Registration Form

Submit by June 30, 2011 to avoid Late Fee

Please click on and print these off before filling out this registration:

Class Schedule for 2011-2012

Fee Schedule for 2011-2012

Today's Date :

Member of St. Paul's?

Yes
No

Envelope #

If no, where are you registered?

Family's Last Name:

Father's First Name:
Mother's First Name:

Street Address:
City:
Zip:
Home Phone:

Email Address:
Emergency Phone:
Father's Cell Phone:
Father's Work Phone:
Father's Occupation:
Mother's Cell Phone:
Mother's Work Phone:
Mother's Occupation:

Marital Status:

Married
Separated
Divorced
Widowed
Single

1st Child
Child's First Name:

Child's Last Name if Different from Family Last Name:
Birth Date:
Church and Date of Baptism:
Grade this September 2011:

Check only one:

Early Childhood Program
School Classroom Program - Monday
School Classroom Program - Tuesday
Level 7 Summer Program
Confirmation Program
Whole Community Program (Home Teach)

List any physical conditions, disabilities, and /or allergies:
Indicate classroom and/or teacher preference (if desired):

2nd Child

Child's First Name:

Child's Last Name if Different from Family Last Name:
Birth Date:
Church and Date of Baptism:
Grade this September 2011:

Check only one:

Early Childhood Program
School Classroom Program - Monday
School Classroom Program - Tuesday
Level 7 Summer Program
Confirmation Program
Whole Community Program (Home Teach)

List any physical conditions, disabilities, and /or allergies:

Indicate classroom and/or teacher preference (if desired):

3rd Child
Child's First Name:

Child's Last Name if Different from Family Last Name:
Birth Date:
Church and Date of Baptism:
Grade this September 2011:

Check only one:

Early Childhood Program
School Classroom Program - Monday
School Classroom Program - Tuesday
Level 7 Summer Program
Confirmation Program
Whole Community Program (Home Teach)

List any physical conditions, disabilities, and / or allergies:
Indicate classroom and/or teacher preference (if desired):

4th Child

Child's First Name:

Child's Last Name if Different from Family Last Name:
Birth Date:
Church and Date of Baptism:
Grade this September 2011:

Check only one:

Early Childhood Program
School Classroom Program - Monday
School Classroom Program - Tuesday
Level 7 Summer Program
Confirmation Program
Whole Community Program (Home Teach)

List any physical conditions, disabilities, and /or allergies:
Indicate classroom and/or teacher preference (if desired):

Indicate here if you have a child in need of a sacrament BUT ONLY if they are beyond the grade / level in which the sacrament is received:	Baptism First Penance First Communion Confirmation
Child's Name:

Age:

If you are willing to serve our program in any of the following areas, check the box and indicate the level in the following text area:

as a Catechist in level
as a Substitute in level

as an Aide in the classroom in level
as a Helper at the school or at church in level

“Registered Active” and ”Non-active” Families:

If you actively volunteer here at St. Paul’s, indicate this below. Areas of active ministry could be, but are not limited to:

Catechist, Lector, Eucharistic Minister, Choir, Gardener

Ministry you volunteer in:

Comments:

Upon submission of this form, I agree to bring my child/children to class on time, to personally supervise homework assignments, and to attend scheduled sessions during the year. I am personally responsible for my child/children while they are attending classes, and will accompany them both into and from the classrooms / buildings. I will attend Mass weekly with my child/children, understanding that attendance at Mass is an integral part of religious formation.

I also agree to allow my child/children be photographed for class project purposes and/or published bulletin articles which may include other media.