RELIGIOUS EDUCATION - Nativity of Our Lord Catholic Church

REGISTRATION FORMPlease fill out one form per child.CLASS OPTIONSTuesdays 4:30-5:30pm, Grades: pre-K* - 3Tuesdays 6:30-7:30pm, Grades: pre-K - 8Wednesdays 4:30-5:30pm, Grades: pre-K - 8Wednesdays 6:30-7:30pm, Grades: pre-K - 5*Your child is able to sign up for our pre-K sessions if he or she will be four years old before September 1, 2013.STUDENT INFORMATIONName: Last First MiddleAddress City ZipDate of Birth Age Sex M / FEntrance Grade Fall 2013 (circle one): Pre-K 1 2 3 4 5 6 7 8Baptized? Y / N Received First Penance? Y / N Received First Eucharist? Y / NAllergies/Special needs:PARENT/GUARDIAN INFORMATIONFather/Guardian NameHome PhoneCell PhoneMother/Guardian NameHome Phone (same ) Cell PhonePrimary EmailPROGRAM FEESOne/First Child: $75 Each Additional Child: $20Payment Options Full Payment Payments from September 2013-April 2014Scholarships are available (50% and 100%) - Contact Mark Thomason or Diane IrbyOFFICE USE ONLY Date Check # Amount