St. John the Baptist/St. Joseph’s

Faith Formation Program

427 Franklin Street ~ Schenectady, NY 12305

374-9148

Fax: 374-9149

Email: dasimone@aol.com

2007-08 Registration Form

Student Information

St. John the Baptist Parish ________ St. Joseph’s Parish ________

Student’s Name __________________________________________

Student’s Email __________________________________________

Student’s Date of Birth __________________________________

Student’s City/State/Country of Birth ___________________

Student’s Current Age _______________

Student’s School: ____________________________

Grade Student will be entering in September: ___________

Student’s Talents: (music, art, writing, reading): _____________

Student’s Hobbies: __________________________________

Student’s Sports involvement__________________________

ANY ALLERGIES OR MEDICAL CONDITIONS WE SHOULD BE MADE AWARE OF? ______________________________ ______________________________________________

Sacrament Information

Student’s Church of Baptism: ______________________

Address of Church: ____________________________

Date of Baptism: _____________________________

Student’s Church of First Eucharist:________________

Student’s Church of First Reconciliation: ______________

Please return form either by mail (address above), or put in the church collection addressed to: Donna Simone, Religious Education Coordinator, or bring to Parish Center.

THANK YOU!

Donation suggestion: $25.00 for 1 student, $50.00 for 2 students and $75.00 for 3 or more students (This is a donation request. Payment is NOT required.)

Parent/Guardian Information

Mother’s Name ________________________Religion _______________

Maiden Name___________________

Address: _________________________________________________

_________________________________________________________

Mother’s Email: _________________________________________

Phone __________________________Cell Phone___________________

Place of Employment: ________________________________________

Daytime Phone # of Mother: ___________________________________

Father’s Name ________________________Religion _______________

Address: _________________________________________________

________________________________________________________

Father’s Email: _____________________________________________

Phone __________________________Cell Phone___________________

Place of Employment: ________________________________________

Daytime Phone # of Father: ___________________________________

Volunteer Information

Teacher: __________________________Baking _________________

Substitute Teacher: _________________Service Projects: _________