School of Religion (CDC) Form

School of Religion (CDC) Form

Student's Name *

First

Last

Gender *

• Male
• Female

Name of School Attending *

Grade *

Is your child a Special Ed. Student? *

• Yes
• No

Date of Birth *

Has the student received the Sacrament of Baptism *

• Yes
• No

If yes, what Church

Date

Has the student received the Sacrament of First Communion *

• Yes
• No

If yes, what Church

Date

Has the student attended CCD Classes before? *

• Yes
• No

If yes, what Church

Date

Father's Name *

First

Last

Father's Religion *

Mother's Name *

First

Last

Mother's Religion *

Guardian's Name (if applicable)

First

Last

Home Address *

Home Phone *

Emergency Contact *

First

Last

Emergency Contact Number *

Are parents/guardians registered in this Parish? *

• Yes
• No

Envelope #

If the child lives with someone other than the natural parents, or if there are other special circumstances, or if your child has any special medical conditions, please describe:

Parent Email Address *

Brother/Sister in School

Grade

Brother/Sister in School

Grade

Brother/Sister in School

Grade

Comment

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