St. Catherine of Siena Parish

Religious Education Program

3460 Tennessee St.

(707) 647-4445 FAX #(707) 647-4441

Registration Form for the 2016-2017 Rel. Ed. School Year

Two consecutive years attendance is required for Sacrament preparation.

New Student Registrations are by appointment only.

Please attach your student’s Birth Certificate, Baptism Certificate and First Holy Communion Certificate (if not already on file) and a Registration Fee of $80.00 for one child and $60.00 for each additional child in grades 1 – 8. For each 2nd Year Confirmation Class registration the three fees (the Registration Fee, the December Retreat Fee and the Spring Diocesan Fired-Up Conference Fee) are combined for an all inclusive total of $275.00.

Please note: Registrations turned in after Aug. 31, 2016 must add a $30.00 late fee.

Classes for grades 1 – 5 (& 6th FHC) are held on Mondays from 4:00pm – 5:15pm.

Classes for grades 6 – High School are held on Mondays from 7:00pm – 8:15pm.

2nd Year Confirmation Class for gr. 9 and up are held on Mondays from 7pm to 8:30pm.

(Classes will run from September 19, 2016 through May 15, 2017.)

Student’s Last Name Student’s First Name Age in Sept. 2016

Male / Female

Date of Birth Place of Birth (circle one)


School Attending in September 2016 Student’s Grade in Sept. 2016

Home Address

City State Zip Code

Mother’s Daytime Phone # Father’s Daytime Phone # Home / Evening Phone #

Parent email address:

Mother’s First and Last Name Mother’s Maiden Name Mother’s Religion

Father’s First and Last Name Father’s Religion

> If your child has any special learning needs, please note:

> If your child has any allergies or medical concerns, please note:

> In case of emergency during the time when your child will be in class,

whom should we contact?

Name Phone Numbers

> Who does this child reside with? ( ) Mother and Father

( ) Mother only ( ) Mother and Step-Father ( ) Mother Deceased

( ) Father only ( ) Father and Step-Mother ( ) Father Deceased ( ) Other ______

> Language spoken at home

> Additional Information:

(side 1 of 2)

Religious Education History

> Number of years in St. Catherine’s Religious Education Program or School:

> List all other siblings you are enrolling in St. Catherine’s Religious Education Program:

Name Age Name Age

Name Age Name Age

> How long have you been registered as members of our parish?

Sacramental Information

> Please complete the information for all sacraments that this child has already received:

·  Baptism:


Date of Baptism Name of Church

Church City State Denomination (Catholic, ….)

·  First Holy Communion:

Year Received Name of Church

Church City State

·  First Reconciliation (Penance/Confession):

Year Received Name of Church

Church City State

·  Confirmation:

Year Received Name of Church

Church City State

Parent Responsibilities: 1. Participate as registered members of St. Catherine’s

Parish (supporting both financially and spirituality)

2. Attend Mass together regularly at St. Catherine’s

3. Attend all meetings for Parents

4. Drop off and pick up students on time!

Parent Signature ______Date ______

(side 2 of 2)