Religious Education Programs – Online Registration

- Please complete this form in full with one exception…For new students enrolling in Sacramental Preparation programs, you must complete the “Sacramental Information” on this form below and provide a copy of your child/teen’s birth certificate and baptism certificate. Returning students who have already submitted this information can disregard the sacrament portion of the registration form.
  
  For questions, please email rosie.roope@gmail.com
- Who should register?
  
  Sunday School (Pre-K & K)
  
  Elementary Grades 1-5 Religious Ed & Sacramental Prep for First Holy Communion
  
  Confirmation Year I
  
  Confirmation Year II
  
  RCIA for Adults & Children over the age of 7 (Becoming Catholic)
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Student Information:
  
  Class
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Any Nicknames?: Please enter valid data.
  
  Family Email Viewed Most Often: REQUIRED Please fill out this field. Please enter an email address.
  
  If in Confirmation, Teen's Email (optional) REQUIRED Please fill out this field. Please enter an email address.
  
  Address REQUIRED Please fill out this field.
  
  City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Birthdate Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Status
  
  Are you a current registered parishioner? Yes No
  
  Your Parish Please enter valid data.
  
  School Attending Please enter valid data.
  
  Grade in the Fall:
  
  Family Information
  
  Adults, if you are registering yourself in preparation of Baptism, Communion or Confirmation, please be sure to fill out parent information as well.
  
  Mother
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Mother's Religion Please enter valid data.
  
  Mother's Maiden Name Please enter valid data.
  
  Father
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Father's Religion Please enter valid data.
  
  Lives with
  
  If other, please specify name, relationship & contact phone:
  
  Sacramental Information
  
  New incoming students enrolling for sacramental preparation, please be sure to provide a copy of your baptism certificate to our office by the first class date.
  
  Has the Student ever been Baptized? REQUIRED Please fill out this field.
  
  Church of Baptism (full name): Please enter valid data.
  
  Full address of church Please enter valid data.
  
  Date of Baptism Please enter a date.
  
  Has the student received Holy Communion? REQUIRED Please fill out this field.
  
  Date of Communion Please enter a date.
  
  Church of Holy Communion: Please enter valid data.
  
  Full address of church Please enter valid data.
  
  Has the student been Confirmed? REQUIRED Please fill out this field.
  
  Date of Confirmation Please enter a date.
  
  Church of Confirmation: Please enter valid data.
  
  Full address of church Please enter valid data.
  
  Emergency Contact & Medical Information
  
  If student is under 18, please list those (other than parents/guardians) who will be dropping off and/or picking the student up from classes.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Emergency Contact Full Name
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Relationship Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Doctor's Name Please enter valid data.
  
  Doctor's Phone Maximum 20 characters Please enter a phone number.
  
  Does the student have any allergies (medications, foods, etc)?
  
  Does the student have any medical concerns or special needs, including medications being used?
  
  Saint Francis Xavier welcomes you to our community and we appreciate the time you took to fill out our application. Please double check the application for any errors and when complete, click the SUBMIT button below.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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