*Required

St. Alphonsus CCD Registration

*Name:

Address:

City: State: Zip:

*Phone

*Email

Work Phone:     Cell:

Are you a registered member of Saint Alphonsus Parish?
YesNo

Father

Name:     Religion:

Mother

(w/ Maiden Name)
Name:     Religion:

List children who will attend CCD Grades K through 8

Classes will be held on Mondays, September - May, 6:00 - 7:15 PM
*** HOMESCHOOLING is available. Please indicate your preference below. ***

Child (1)

Name:      Birthday:      Grade:

School:     Church & Date of Baptism:

Child (2)

Name:      Birthday:      Grade:

School:     Church & Date of Baptism:

Child (3)

Name:      Birthday:      Grade:

School:     Church & Date of Baptism:

Child (4)

Name:      Birthday:      Grade:

School:     Church & Date of Baptism:

Child (5)

Name:      Birthday:      Grade:

School:     Church & Date of Baptism:

Please list special needs or instructions (including “Homeschooling”) for any of the above students: