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2022-2023 Registration Form
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* Indicates required question
Email
*
Your email
Program Choice:
*
Online Asynchronous Program (Lessons sent on Sunday Morning Bi-Monthly)
Family Last Name
*
Your answer
Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Father's Name (First and Last) and Religion
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Your answer
Father Phone Number
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Your answer
Mother's Name (First and Maiden) and Religion
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Your answer
Mother's Phone Number
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Your answer
Parents Living Together
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Yes
No
Marital Status
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Married
Widowed
Divorced
Single
Child #1 Last Name
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Your answer
Child #1 First Name
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Your answer
New or Returning Student to SFX RE Program (Child #1)
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New Student
Returning Student
Date of Birth (Child #1)
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MM
/
DD
/
YYYY
City of Birth (Child #1)
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Your answer
Grade for the 2022-2023 School Year (Child #1)
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Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Public School in 2022-2023 (Child #1)
*
Your answer
Medical Allergies (Child #1)
*
Your answer
Child #2 Last Name (If you don't have a second child, reply NA):
*
Your answer
Child #2 First Name (If you don't have a second child, reply NA):
*
Your answer
New or Returning Student to SFX RE Program (Child #2) - (If you don't have a second child, reply NA):
*
New Student
Returning Student
NA
Date of Birth (Child #2) (If you don't have a second child, reply 01/01/0001):
*
MM
/
DD
/
YYYY
City of Birth (Child #2)-(If you don't have a second child, reply NA):
*
Your answer
Grade for the 2022-2023 School Year (Child #2) - (If you don't have a second child, reply NA):
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
NA
Public School in 2022-2023 (Child #2)-(If you don't have a second child, reply NA):
*
Your answer
Medical Allergies (Child #2)-(If you don't have a second child, reply NA):
*
Your answer
Child #3 Last Name (If you don't have a third child, reply NA):
*
Your answer
Child #3 First Name (If you don't have a third child, reply NA):
*
Your answer
New or Returning Student to SFX RE Program (Child #3)- (If you don't have a third child, reply NA):
*
New Student
Returning Student
NA
Date of Birth (Child #3)-(If you don't have a third child, reply 01/01/0001):
*
MM
/
DD
/
YYYY
City of Birth (Child #3)-(If you don't have a third child, reply NA):
*
Your answer
Grade for the 2022-2023 School Year (Child #3) - (If you don't have a third child, reply NA):
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
NA
Public School in 2022-2023 (Child #3)- (If you don't have a third child, reply NA):
*
Your answer
Medical Allergies (Child #3)-(If you don't have a third child, reply NA):
*
Your answer
Child #4 Last Name (If you don't have a fourth child, reply NA):
*
Your answer
Child #4 First Name (If you don't have a fourth child, reply NA):
*
Your answer
New or Returning Student to SFX RE Program (Child #4) - (If you don't have a fourth child, reply NA):
*
New Student
Returning Student
NA
Date of Birth (Child #4)- (If you don't have a fourth child, reply 01/01/0001):
*
MM
/
DD
/
YYYY
City of Birth (Child #4)- (If you don't have a fourth child, reply NA):
*
Your answer
Grade for the 2022-2023 School Year (Child #4) - (If you don't have a fourth child, reply NA):
*
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
NA
Public School in 2022-2023 (Child #4)- (If you don't have a fourth child, reply NA):
*
Your answer
Medical Allergies (Child #4)- (If you don't have a fourth child, reply NA):
*
Your answer
Do you have a 5th child to register for the program? If so, we will contact you for further information.
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No
Yes
If any of your children are new to the program, a copy of your child/children's baptismal certificate is required in order to complete your registration.
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My child/ren were baptized at SFX
I will email a copy to
sfxreligioused@sfxlg.org
I will mail a copy (not the original) to: Attn: Religious Education, St. Francis Xavier, 124 N. Spring Ave, LaGrange, IL 60525
My child/ren are not baptized. Please contact me to discuss.
My child/ren attended last year and their baptismal certificates are already on file at SFX
Are you interested in becoming a Catechist? (Training and Materials will be provided and Incentive will be given)
*
Yes
No
Do You Have Any Questions or Concerns?
Your answer
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