Registration Forms

Sacred Heart~Saint John Nepomuk~St. Joseph Parishes
Registration for All grades preschool thru grade 11
Please PRINT ALL information
Student Information:(Fill in one line per child attending, circle where needed)
First and last Name Gender DOB Grade School Sacraments Received(circle)
_ _M/F_ / / Baptism/Reconciliation/Eucharist
M/F __/___/___ Baptism/Reconciliation/Eucharist
M/F __/___/___ Baptism/Reconciliation/Eucharist
M/F __/___/___ Baptism/Reconciliation/Eucharist
M/F __/___/___ Baptism/Reconciliation/Eucharist
Grades 7-11: which session wiil you attend? (circle) Wednesday night Sunday Morning
Family Information:
Family Surname:__________________________Home Phone:____________________
Child’s (ren)Address____________________________________City______________Zip________
Father’s Name________________________________________________________________
Last First Middle
Religion:_______________________Parish:________________________________________
Sacraments received: Baptism___Reconciliation_____Eucharist____Confirmation____
Email Address:______________________________________cell phone:_________________
Home address If different from child(ren)_________________________________________________
Occupation:_________________________________Employer:__________________________
Mother’s Name:_______________________________________________________________
Maiden First Middle
Religion:_______________________Parish:_________________________________________
Sacraments received: Baptiism___Reconciliation___Eucharist____Confirmation____
Email Address:___________________________cell phone:__________________
Home address if different from child(ren)___________________________________________
Occupation:________________________________Employer:__________________________
If there is a divorce or legal separation, which parent has legal custody of child?
( ) Father ( ) Mother
If neither parent has custody, who does have custody?
Any health or special needs info you want to share? ___________________________________________________________________________________
*Baptismal record is due upon registration if child is already baptized. If child was baptized here we have the record,(or if child already made 1st Communion here we have it)
If parent(s) are missing sacraments would you be interested in finding out about receiving? Yes/No
Return this form (if new information is needed or if child is new registration) to your Parish office Attention: Dan O'Connell, no later than Sept. 7. If you have computerized form already in this mailing, just return that with registration fee.