| Religious Education Registration Form |
Student's Last Name__________ First____________Middle_________Birthday_______________
Address__________________City__________________Zip__________ Phone______________
Email address___________________________________________
Grade Going Into____________________
Father's Last Name ____________First________________Middle__________Religion_________
Mother's Maiden Name__________First________________Middle_________Religion__________
Are you registered in this Parish?_____________
Mass attendance: Regular:________________ Occasionally:__________Never:____________
Child's Sacramental Record: Baptism: Date______________ Church:_____________________
First Communion: Date:________________Church:___________________________
List names of other children in the family:______________________________________________
Please give any significant information pertinent to your child's participation in religion class.
If your child was not baptized at Our Lady of Mercy, please supply a copy of Baptismal record.
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