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  • Family and Contact Information

  • 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.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Father's Email REQUIRED Please fill out this field. Please enter an email address.
  • Father's Religion REQUIRED (Select One) Roman Catholic Catholic (other) Protestant Non-Christian Please fill out this field.

  • 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.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  • Mother's Religion REQUIRED (Select One) Roman Catholic Catholic (other) Protestant Non-Christian Please fill out this field.

  • Family Information

  • Child(ren) currently reside with: REQUIRED (Select One) Both Parents Mom Dad Other Please fill out this field.
  • If your child(ren) currently reside with someone other than the child's parent(s), please indicate below Please enter valid data.
  • If there are any non-custodial parents, please indicate below
  • Additional Email Address Please enter an email address.
  • Address REQUIRED Please fill out this field. Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Which Mass does your family usually attend? REQUIRED 5:00 pm Saturday Evening Vigil 8:00 am Sunday Morning 10:30 am Sunday Morning Please fill out this field.
  • How often does your family attend Mass? REQUIRED Weekly Bi-weekly Monthly Occasionally Please fill out this field.
  • Please indicate if you would like to participate in a parent group. Meetings are scheduled during religious education class times. REQUIRED (Select One) Yes No thank you. Please fill out this field.

  • Child(ren)'s Information

  • First Child
    • First Name REQUIRED Please fill out this field. Please enter valid data.

      Last Name REQUIRED Please fill out this field. Please enter valid data.
    • Child's Birthdate REQUIRED Please fill out this field. Please enter a date.
    • Child's Grade REQUIRED (Select One) First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade Please fill out this field.
    • Child's current school REQUIRED Please fill out this field. Please enter valid data.
    • Religious education option for First Child REQUIRED In-person Grade-Level Classes ($45 per student) Family Model with Monthly Group Meetings ($60 per family) Homeschool (grade based, $30 per student) Please fill out this field.
    • Please indicate if your child has any learning needs or food allergies in the space below:
  • Second Child
    • First Name Please enter valid data.

      Last Name Please enter valid data.
    • Child's Birthdate Please enter a date.
    • Child's Grade None First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade
    • Child's current school Please enter valid data.
    • Religious education option for First Child REQUIRED In-person Grade-Level Classes ($45 per student) Family Model with Monthly Group Meetings ($60 per family) Homeschool (grade based, $30 per student) Please fill out this field.
    • Please indicate if your child has any learning needs or food allergies in the space below:
  • Third Child
    • First Name Please enter valid data.

      Last Name Please enter valid data.
    • Child's Grade None First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade
    • Child's Birthdate Please enter a date.
    • Child's current school Please enter valid data.
    • Religious education option for First Child REQUIRED In-person Grade-Level Classes ($45 per student) Family Model with Monthly Group Meetings ($60 per family) Homeschool (grade based, $30 per student) Please fill out this field.
    • Please indicate if your child has any learning needs or food allergies in the space below:

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