CCD Registration Form

Please submit by September 30, 2020.

You can also download a PDF version and drop in collection basket or mail to the parish. Please indicate CCD Registration and ATTENTION: DEBRA SILVA on envelope

Student’s full name

Street Address

City/State/Zip Code

Telephone (optional)

Date of Birth

School Attending (optional)

Grade Entering in August 2020 (optional)

Grade in CCD (optional)

Is your family registered in parish? (optional)

Church of Baptism and Date (optional)

(If not baptized here, and you have not yet done so, please include a copy of Baptismal Certificate with registration).

Church of First Communion and Date (optional)

All information is for CCD office use only.

Father’s Full Name (optional)

Father's Religion (optional)

Mother’s Full Name (optional)

Mother’s Maiden Name (optional)

Mother's Religion (optional)

Guardian/Foster Parent if any (optional)

Please indicate with whom the child resides (optional)

Emergency Contact Person and Telephone (optional)

Special Concerns or Needs (optional)

Please note in space below any special concerns or needs [learning disability, physical conditions, family problems, medications]. This information is confidential and will help us to better tend to your child in Christian education.