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St. John Neumann Religious Education Registration 2018-2019
Family Contact Information
Family Last Name
*
Email Address
*
Re-enter Email Address
*
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Home Phone Number
*
Mother's First Name
Mother's Maiden Name
Mother's Religion
Mother's Work Number
Mother's Cell Number
Father's First Name
Father's Last Name
Father's Religion
Father's Work Number
Father's Cell Number
Is there a
non-custodial parent?
*
Yes
No
Please fill out the below information for the non-custodial parent.
First Name
Last Name
Street Address
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
Phone Number
Email Address
Would the non-custodial parent like to receive separate mailings/communications regarding child(rens) faith enrichment?
*
Yes
No
Volunteer Information
WE NEED YOU. What can you do to help our children grow in faith? Check areas of interest here.
Good Shepherd Catechist
Good Shepherd Aide
Hall Monitor
Vacation Bible School Volunteer
Plan 6th Grade Grade Service
Plan 6th Grade Social Events
Ignite (middle school) Core Team
Ignite Office/Attendance Help
Ignite snack help
Help with planning 7th/8th Grade Service
Help with planning 7th/8th Grade Social Events
Encounter (high school) Core Team
Help with planning High School Service
Help with planning High School Social Events
Help with Encounter Lunch
Baking
Other Talents or Interests
Other Talents or Interests
Emergency Contact Information
Please enter two emergency contacts who are not parents.
1st Emergency Contact
First Name
*
Last Name
*
Relationship to Child
*
Phone Number
*
2nd Emergency Contact
First Name
*
Last Name
*
Relationship to Child
*
Phone Number
*
Parish Information
Are you registered parishioners at St. John Neumann?
*
Yes
No
Are you registered parishioners at Sts. John & Paul Parish?
*
Yes
No
If not, what parish does your family belong to?
*
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