PREP Registration

St. Joseph Catholic Church PREP Family Information

Family Information:

Father's Name:

Father's Phone:

Father's Emal:

Mother's Name:

Mother's Phone:

Mother's Email:

New Field:

Apt.:

City:

Zip Code:

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In the event of an emergency if we are unable to contact you, whom should we call?

Emergency Contact:

Relationship:

Emergency Contact Phone:

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A safe environment (family) program will be scheduled for each grade during the year. This program guides parents in talking with their children about relationships at age-appropriate levels with an aim at preventing bullying and child abuse. A parents MUST attend the class with their child or complete an opt-out form.

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Registration Fee $5.00

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PREP $25.00 Per Student

Number of Students:

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First Holy Communion $40.00 Per Student

Number of Students:

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Confirmation $170.00 Per Student

Number of Students:

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Student Information

Primary Phone Number:

Student Name:

Date of Birth:

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Please indicate which sacraments your student have received or is seeking. If the sacrament was not completed at St. Joseph please provide a copy of the appropriate certificate.

BAPTISM

Seeking

Completed

FIRST HOLY COMMUION

Seeking

Completed

CONFIRMATION

Seeking

Not Eligible

Allergies, Medical/Physical Conditions, any special assistance or concerns:

Family Information:

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