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RE Form

- Religious ED

Required: 1 form per child.
The family must be registered Parishioners (to register click here)
Religious Education Registration Form
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- Child's Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address REQUIRED Please fill out this field. Please enter valid data.
- 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.
- Birth Date REQUIRED Please fill out this field. Please enter valid data.
- Place of Birth REQUIRED Please fill out this field. Please enter valid data.
- School/CCD grade REQUIRED Please fill out this field.
- Father's Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Religion Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Work Phone Number Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Occupation
- Mother's Information
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Maiden Name Please enter valid data.
- Religion Please enter valid data.
- Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Work Phone Number Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Occupation
- Emergency Contact
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relation REQUIRED Please fill out this field. Please enter valid data.
- Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Child's Baptism
- Date REQUIRED Please fill out this field. Please enter a date.
- Church Please enter valid data.
- 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.
- Child's First Reconciliation
- Date REQUIRED Please fill out this field. Please enter a date.
- Church Please enter valid data.
- 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.
- Child's First Eucharist
- Date REQUIRED Please fill out this field. Please enter a date.
- Church Please enter valid data.
- 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.
- Special Notes For Catechist
  Please add any notes that the catechist teaching your child needs to know (e.g. medications, allergies, special learning needs)
- Is your child is in 3rd grade or higher and has NOT received the Sacrament of Baptism, Reconciliation and First Eucharist? Please indicate this here and let your child’s teacher know. REQUIRED Please fill out this field.
- Photo Disclaimer:
  By checking below, I agree to give permission for my son/daughter to be photographed realizing that the photo may be published in a newsletter or bulletin boards or other publications FOR THE CHURCH OR DIOCESE USE ONLY.
  I Agree Please select this field.
- Mass Attendance
  I will, to the best of my ability, ensure that my child will attend 11:30 AM Sunday Mass on a weekly basis. Please select this field.
- Tuition100.0
Total:

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Our Lady of Mount Virgin

Garfield, NJ

RE Form

Religious Education Registration Form