ST. KATHARINE DREXEL CATHOLIC CHURCH
RELIGIOUS EDUCATION REGISTRATION FORM FOR 2022-2023
Students Quantity
One students
Two students
Three students
Date
*
Family Last Name
*
Primary Language
*
Home Address
*
City
*
Zip
*
Mother’s e-mail address
*
Father’s e-mail address
*
Father’s/Guardian Name
*
Cell Phone
*
Religion
*
Mother’s/Guardian Name
*
Cell Phone
*
Religion
*
Children Live with;
*
Select children live with
Both Parents
Mom
Dad
Other
Marital Status
*
Select marital status
Married
Separated
Divorced
Other
Emergency Contact Name (other than parents):
*
Cell Phone
*
1.- Student
Type
First Communion 1 year
First Communion 2 year
Confirmation 1 year
Confirmation 2 year
Scripture Class
Certificate Baptims
Cerficate Communion
Name:
*
Gender:
*
Boy
Girl
Religion:
*
Birthdate
*
Place of Birth:
*
Is your child Baptized?:
*
Yes
No
Received First Communion?:
*
Yes
No
Grade in August 2022
*
School:
*
Cell Phone
*
Any physical, medical, or learning conditions please indicate below:
SESSION: (Must indicate 1st, 2nd, and 3rd Choice)
MONDAY 5:15 p.m - 6:30 p.m
TUESDAY 3:30 p.m. - 4:45 p.m.
TUESDAY 5:15 p.m. - 6:30 p.m.
WEDNESDAY 5:15 p.m. - 6:30 p.m.
THURSDAY 5:15 p.m. - 6:30 p.m.
2.- Student
Type
First Communion 1 year
First Communion 2 year
Confirmation 1 year
Confirmation 2 year
Scripture Class
Certificate Baptims
Cerficate Communion
Name:
*
Gender:
*
Boy
Girl
Religion:
*
Birthdate
*
Place of Birth:
*
Is your child Baptized?:
*
Yes
No
Received First Communion?:
*
Yes
No
Grade in August 2022
*
School:
*
Cell Phone
*
Any physical, medical, or learning conditions please indicate below:
SESSION: (Must indicate 1st, 2nd, and 3rd Choice)
MONDAY 5:15 p.m - 6:30 p.m
TUESDAY 3:30 p.m. - 4:45 p.m.
TUESDAY 5:15 p.m. - 6:30 p.m.
WEDNESDAY 5:15 p.m. - 6:30 p.m.
THURSDAY 5:15 p.m. - 6:30 p.m.
3.- Student
Type
First Communion 1 year
First Communion 2 year
Confirmation 1 year
Confirmation 2 year
Scripture Class
Certificate Baptims
Cerficate Communion
Name:
*
Gender:
*
Boy
Girl
Religion:
*
Birthdate
*
Place of Birth:
*
Is your child Baptized?:
*
Yes
No
Received First Communion?:
*
Yes
No
Grade in August 2022
*
School:
*
Cell Phone
*
Any physical, medical, or learning conditions please indicate below:
SESSION: (Must indicate 1st, 2nd, and 3rd Choice)
MONDAY 5:15 p.m - 6:30 p.m
TUESDAY 3:30 p.m. - 4:45 p.m.
TUESDAY 5:15 p.m. - 6:30 p.m.
WEDNESDAY 5:15 p.m. - 6:30 p.m.
THURSDAY 5:15 p.m. - 6:30 p.m.
Comments
*
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