Registration NEW




	This page was last edited on: Friday, May 23, 2008 03:41:05 PM

Tuition $65 - 1 child $80 - 2 Children $100 - 3 or more Please return by 5/31/07
Good Shepherd Spiritual Formation NEW-REGISTRATION FORM FOR 2007-2008 (please complete all parts as directed if you checked "new information" or "not enrolled" on the previous page)
Family Name:
	Father	Mother
First Name
Last Name
Home Address
Cross Street
City
State
Zip
Home Phone
Work Phone
Mobile Phone
E-Mail
Religion
PARENTS ARE: Married Separated Divorced Single Widowed Send Mail to: Father Mother Both Other (fill out below) Other Name: (Mr. Mrs. Ms) Other Address Other City State Zip
Children live with (click one): Both Father Mother Other
If divorced, who has custody rights (click one) Father Mother Other
Would you be interested in being a catechist/teacher? What Level?
Name of person who has authority to pick-up my children & agree to any emergency medical treatment in case parent/guardian cannot be reached: Name Relationship Phone
STUDENT INFORMATION
Family Name
CHILD #1 Registering for level: First Name Last Name Sex Male Female Date of Birth Name of School for 2006-2007 Baptism Date: Church: City/State: First Reconciliation Date: Have not received First Reconciliation First Communion Date: Have not received First Communion Confirmation Date: Have not received Confirmation List any allergies and/or learning needs we should know:

CHILD #2 Registering for level: First Name Last Name Sex Male Female Date of Birth Name of School for 2006-2007 Baptism Date: Church: City/State: First Reconciliation Date: Have not received First Reconciliation First Communion Date: Have not received First Communion Confirmation Date: Have not received Confirmation List any allergies and/or learning needs we should know:

CHILD #3 Registering for level: First Name Last Name Sex Male Female Date of Birth Name of School for 2006-2007 Baptism Date: Church: City/State: First Reconciliation Date: Have not received First Reconciliation First Communion Date: Have not received First Communion Confirmation Date: Have not received Confirmation List any allergies and/or learning needs we should know:

CHILD #4 Registering for level: First Name Last Name Sex Male Female Date of Birth Name of School for 2006-2007 Baptism Date: Church: City/State: First Reconciliation Date: Have not received First Reconciliation First Communion Date: Have not received First Communion Confirmation Date: Have not received Confirmation List any allergies and/or learning needs we should know:

and turn into the Spiritual Formation Office with your Registration Fee

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