Registration Form for Religious Instruction

REGISTRATION FORM FOR
RCIA, CCD, FIRST EUCHARIST, CONFIRMATION CLASSES

First Name
Last Name
Address
 
City
State
Zip Code
Email Address
Home Phone
Work Phone
Mobile Phone
   
  If a Minor
Parent's First Name
Parent's Last Name
  I am registering for:
CCD 1st Eucharist
RCIA Confirmation
 
CCD Student Registration
    ($175.00 per student)

Age          Grade this year

School attending this year

 

RCIA  Participants     (Adults seeking to join the Church)
    ($100.00 per student)

Age

What is your present religious affiliation?

 

First Eucharist or Confirmation Candidates
    ($125.00 per candidate)

Age          Grade this year

School attending this year

 School attended last year

If your child did not attend a Catholic School last year,
did he/she attend CCD classes?    Yes      No
     If yes, where?

Is your family enrolled as parishioners of
Immaculate Conception Jesuit Church?    Yes      No