Religious Education Program Form

Family Last Name

Home Phone: Cell Phone: Whose?

Father's Name Mother's Name

Mailing Address:

E-MAIL Address: I do not have e-mail

Child 1

Child 1 Grade

Last Name: First: Middle:

Date of Birth: Religious Ed Last Year? if yes, where?

Baptism Date: Name/location of Church:

Received: First Reconciliation YN First Communion: YN Confirmation: YN

Child 2

Child 2 Grade

Last Name: First: Middle:

Date of Birth: Religious Ed Last Year? if yes, where?

Baptism Date: Name/location of Church:

Received: First Reconciliation YN First Communion: YN Confirmation: YN

Child 3

Child 3 Grade

Last Name: First: Middle:

Date of Birth: Religious Ed Last Year? if yes, where?

Baptism Date: Name/location of Church:

Received: First Reconciliation YN First Communion: YN Confirmation: YN

Child 4

Child 4 Grade

Last Name: First: Middle:

Date of Birth: Religious Ed Last Year? if yes, where?

Baptism Date: Name/location of Church:

Received: First Reconciliation YN First Communion: YN Confirmation: YN