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St. Ann's Religious Education
Pre-Registration Form

Parish Information:
Members of St. Ann's Church: Yes No (If NO, please give the name of your Church)

Parent Information:
Father's Name:
Home Phone:
Father's Employer:
Business Phone: Ext. E-mail Address:
Marital Status:

Mother's Name:
Home Phone:
Mother's Employer:
Business Phone: Ext. E-mail Address:
Mother's Maiden Name:
Marital Status:

Mailing Address:
Street: Apt. #:
City: State: Zip:

Child lives with

If OTHER (i.e. Legal Guardian, etc.), provide detailed information below):

Emergency Information:
Emergency Contact Person (other than parent)
Relationship                     Phone
Occupation          Place of Employment

If enrolling multiple children please enter information of each child:

Child's Name:       Student is: Returning New Birthdate: Current School:
Grade Entering:    Catholic Baptism: Yes No
Church of Baptism: Date of Baptism:
City & State:

If your child is to receive any Sacraments in the year 2006-2007, please put a check next to the appropriate Sacrament(s) below:
Baptism       1st Eucharist/Penance      Confirmation

Child's Name:       Student is: Returning New Birthdate:   Current School :
Grade Entering:    Catholic Baptism: Yes No
Church of Baptism: Date of Baptism:
City & State:

If your child is to receive any Sacraments in the year 2006-2007, please put a check next to the appropriate Sacrament(s) below:
Baptism       1st Eucharist/Penance      Confirmation

Child's Name:       Student is: Returning New Birthdate: Current School:
Grade Entering:    Catholic Baptism: Yes No
Church of Baptism: Date of Baptism:
City & State:

If your child is to receive any Sacraments in the year 2006-2007, please put a check next to the appropriate Sacrament(s) below:
Baptism       1st Eucharist/Penance      Confirmation

Additional Information
Please list any special needs, medications, allergies and/or disabilities that may pertain to your child/children. This space may also be used for any questions or comments.

(Please type "none" if you have no additional information/questions/comments)

Survey for Parent Support:

Please check as many items which you can participate in. Mahalo!
Special Events (Excursions/Parent Sessions/Potluck Setup & Cleanup, etc.)
Office/Clerical Staff
Instructional Aide
Other

When you have completely filled in this form, click on "Submit" and the information will be sent to St. Ann's Religious Education Office. Incomplete forms will not be processed.

When your information is received, the Religious Education Office will contact you. Parents must attend one of the Registration dates on August 133th & 20th to pick up student registration packet(s) and make payment. Classes begin August 27th.

(No child will be refused registration because of cost)

St. Ann's Religious Education Pre-Registration Form

St. Ann's Religious Education
Pre-Registration Form