EmailMe Form - St John's Church School Registration

Family Information
Mother's Name
First Last
Father's Name
First Last
Mother's Address

Street Address City State / Province / Region Postal / Zip Code Country / Region
Father's Address
(If different)

Street Address City State / Province / Region Postal / Zip Code Country / Region
Home Phone
### - ### - ####
Home Phone
### - ### - ####
Cell Phone
### - ### - ####
Cell Phone
### - ### - ####
Mother's Email
Father's Email
If parent's are divorced, who is the custodial parent?
Mother's Church Affiliation
Mother's Baptism Date
MM / DD / YYYY
Church and Location
Mother's
Confirmation/
Reception date
MM / DD / YYYY
Church and Location
Father's Church Affiliation
Father's Baptism Date
MM / DD / YYYY
Church and Location
Father's Confirmation/
Reception date
MM / DD / YYYY
Church and Location
Child Attending St. John’s Church School:
Name
First Last
M
F
Birthdate
MM / DD / YYYY
Grade
Baptism Date
MM / DD / YYYY
Church Name and Location
Type Name, Gender, Birthdate, Baptismal date and Location for additional children here