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FAMILY INFORMATION
GENERAL ITEMS FOR THE WHOLE FAMILY AS A GROUP
Since our database is organized by family, we ask for one legal name under which all other names will appear. Thus, we ask for the last name as it appears on legal identification, such as a driver’s license.
Identification Last Name ______
Address ______City ______State _____ Zip ______
Email ______Phone ______(circle one) Mobile Home Work
Emergency Contact Name ______Phone ______
At this present moment, please check the one that applies: Married ____ Separated ____ Divorced ____ Single ____
If married: Were you married by a Catholic priest / in the Catholic Church? Y __ N __ Anniversary Date ___ / ___ / _____
Are you registered in another parish?Y __ N __ If yes, Parish Name ______City, State ______
Are you Winter Resident?Y __ N __ If yes, during approximately what dates do you live there? From ___ / ___ To ___ / ___
Second Address ______City ______State _____ Zip ______
MEMBERS INFORMATION
ITEMS SPECIFIC TO EACH FAMILY MEMBER: Next, we need information about each individual.
Head of Family
This individual will be listed first in the database. If a husband and wife are both registered in the parish, the database defaults to the husband here (don’t ask us why!). Thus, if you’re registering both husband and wife, list the husband here (to help avoid software errors).
Full Name (First Middle Last) ______Maiden Name ______
Date of Birth ___ / ___ / _____ State/Country of Birth ______Primary Language ______
Gender M ___ F ____Religion ______
Check mark all the sacraments that have been received. Baptism ___ Communion ___ Confirmation ___
If baptized, where? Church of Baptism ______Place ______Year ______
Email ______Best Phone ______(circle one) Mobile Home Work
Occupation ______Employer ______
Relationship to Children: Birth Father ___ Birth Mother ___ Step-Parent ___ Other ___ Explain ______
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MEMBERS INFORMATION (cont.)
ITEMS SPECIFIC TO EACH FAMILY MEMBER: Please complete page 1 of this form before filling in below.
Spouse
Full Name (First Middle Last) ______Maiden Name ______
Date of Birth ___ / ___ / _____ State/Countryof Birth ______Primary Language ______
Gender M ___ F ____Religion ______
Check mark all the sacraments that have been received. Baptism ___ Communion ___ Confirmation ___
If baptized, where? Church of Baptism ______Place ______Year ______
Email ______Best Phone ______(circle one) Mobile Home Work
Occupation ______Employer ______
Relationship to Children: Birth Father ___ Birth Mother ___ Step-Parent ___ Other ___ Explain ______
Child 1 Full Name (First Middle Last) ______
Date of Birth ___ / ___ / _____ State/Country of Birth ______Primary Language ______
Gender M ___ F ____Religion ______
Check mark all the sacraments that have been received. Baptism ___ Communion ___ Confirmation ___
If baptized, where? Church of Baptism ______Place ______Year ______
Do you have a copy of the Baptismal Certificate? Y __ N __ If no, do you have a copy of the Birth Certificate? Y __ N __
If First Communion received, where? Church ______Place ______Year ______
If Confirmation received, where? Church ______Place ______Year ______
Email (if applicable) ______Phone(if applicable) ______
School ______Grade Upcoming Year ______
If this child has any Special Needs or Learning Disabilities, be sure to list it/them on Form D3.
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MEMBERS INFORMATION (cont.)
Child 2 Full Name (First Middle Last) ______
Date of Birth ___ / ___ / _____ State/Country of Birth ______Primary Language ______
Gender M ___ F ____Religion ______
Check mark all the sacraments that have been received. Baptism ___ Communion ___ Confirmation ___
If baptized, where? Church of Baptism ______Place ______Year ______
Do you have a copy of the Baptismal Certificate? Y __ N __ If no, do you have a copy of the Birth Certificate? Y __ N __
If First Communion received, where? Church ______Place ______Year ______
If Confirmation received, where? Church ______Place ______Year ______
Email (if applicable) ______Phone(if applicable) ______
School ______Grade Upcoming Year ______
If this child has any Special Needs or Learning Disabilities, be sure to list it/them on Form D3.
Child 3 Full Name (First Middle Last) ______
Date of Birth ___ / ___ / _____ State/Country of Birth ______Primary Language ______
Gender M ___ F ____Religion ______
Check mark all the sacraments that have been received. Baptism ___ Communion ___ Confirmation ___
If baptized, where? Church of Baptism ______Place ______Year ______
Do you have a copy of the Baptismal Certificate? Y __ N __ If no, do you have a copy of the Birth Certificate? Y __ N __
If First Communion received, where? Church ______Place ______Year ______
If Confirmation received, where? Church ______Place ______Year ______
Email (if applicable) ______Phone(if applicable) ______
School ______Grade Upcoming Year ______
If this child has any Special Needs or Learning Disabilities, be sure to list it/them on Form D3.
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MEMBERS INFORMATION (cont.)
Child 4 Full Name (First Middle Last) ______
Date of Birth ___ / ___ / _____ State/Country of Birth ______Primary Language ______
Gender M ___ F ____Religion ______
Check mark all the sacraments that have been received. Baptism ___ Communion ___ Confirmation ___
If baptized, where? Church of Baptism ______Place ______Year ______
Do you have a copy of the Baptismal Certificate? Y __ N __ If no, do you have a copy of the Birth Certificate? Y __ N __
If First Communion received, where? Church ______Place ______Year ______
If Confirmation received, where? Church ______Place ______Year ______
Email (if applicable) ______Phone(if applicable) ______
School ______Grade Upcoming Year ______
If this child has any Special Needs or Learning Disabilities, be sure to list it/them on Form D3.
Child 5 Full Name (First Middle Last) ______
Date of Birth ___ / ___ / _____ State/Country of Birth ______Primary Language ______
Gender M ___ F ____Religion ______
Check mark all the sacraments that have been received. Baptism ___ Communion ___ Confirmation ___
If baptized, where? Church of Baptism ______Place ______Year ______
Do you have a copy of the Baptismal Certificate? Y __ N __ If no, do you have a copy of the Birth Certificate? Y __ N __
If First Communion received, where? Church ______Place ______Year ______
If Confirmation received, where? Church ______Place ______Year ______
Email (if applicable) ______Phone(if applicable) ______
School ______Grade Upcoming Year ______
If this child has any Special Needs or Learning Disabilities, be sure to list it/them on Form D3.
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PROGRAM INFORMATION
ON THIS FORM YOU WILL LEARN ABOUT OUR RELIGIOUS EDUCATION PROGRAM.
As Religious Education registration is now dependent upon Parish Registration, we ask that you match the Family Name given on Form A on all forms, so that everything goes together. Also, in an effort to be more efficient and environmentally friendly, we will be using email for almost all communications. Please provide the best address that will be checked and read on a regular basis.
Family Name ______Best Email ______
Program Basics
Religious Education Sessionstake place on Tuesday and Wednesday evenings 5:30-6:45pm as follows.
Tuesday Evenings: Grades 1 – 6, Confirmation (High School), and RCIY (Rite of Christian Initiation for Youth)
Confirmation sessions are split alphabetically so that young people meet every other Tuesday.
Other date responsibilities apply; Confirmation program information will be given.
RCIY applies to any young person Grade 6 – 12 who has not received Communion.
Wednesday Evenings: Grades 1 – 8
Communion Preparationby Diocesan guideline requires two years of formation. A first year of basic catechesis involves attendance in regular Religious Education sessions (those listed above) combined with small additional elements for Communion specific learning. The second year then continues the basic sessions but intensifies the Communion preparation with additional requirements like an additional preparation book and a retreat day.
Confirmation Preparation by Diocesan guideline requires two years of formation. A first year of basic catechesis involves attendance in regular Religious Education sessions (those listed above) combined with additional expectations of broader church community participation, specifically through Youth Ministry. The second year then continues the basic sessions and Youth Ministry participation but intensifies the Confirmation preparation with additional requirements like a retreat day. If your child attends Bishop Verot Catholic High School, while you are not required to attend the same sessions as Religious Education students, there is a Confirmation preparation process for which you need to register and pay the sacramental preparation fee.
Registration Fees provide almost all the financial support for our program and go directly to covering materials like textbooks, classroom supplies, and program equipment. Per family registration fees for this year are as follows:
Families with 1 Child: $45.00
Families with 2 Children: $90.00
Families with 3 or more Children: $100.00
Due to the extra program elements required to provide appropriate preparation for the reception of Sacraments, we also request a sacrament preparation fee be collected. These fees are collected per child, so if you have multiple children preparing to receive sacraments, you will be assessed multiple Sacrament Preparation fees.
First Year Sacrament Preparation Fee: $10.00 (per child)
Second Year Sacrament Preparation Fee: $20.00 (per child)
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PROGRAMREGISTRATION
ON THIS FORM YOU WILL REGISTER YOUR CHILDREN INTO OUR RELIGIOUS EDUCATION PROGRAM.
Child 1
Full Name ______Grade ______Day: Tues ___ Wed ___ BVHS ___
(Bishop Verot High School)
Religious Education History:
Will this be the first time this child is in Religious Education?Y __ N __
Was this child in Religious Education last year?Y __ N __ If yes, where?here ___ other______
Anything else to share about the child’s background or history with Religious Education?______
______
Sacramental Preparation:
If the child is in Grades 1-5 and has NOT received Communion, check ___ First Communion
If the child is in High School and needs the Sacrament of Confirmation, check ___ Confirmation
If the child is in Grade 6 or older and needs the Sacrament(s) of Baptism or Communion, check ___ RCIY
If any of the three above are checked, is this the First Year ____ orSecond Year ____ of preparing for this sacrament?
Child 2
Full Name ______Grade ______Day: Tues ___ Wed ___ BVHS ___
(Bishop Verot High School)
Religious Education History:
Will this be the first time this child is in Religious Education?Y __ N __
Was this child in Religious Education last year?Y __ N __ If yes, where?here ___ other______
Anything else to share about the child’s background or history with Religious Education?______
______
Sacramental Preparation:
If the child is in Grades 1-5 and has NOT received Communion, check ___ First Communion
If the child is in High School and needs the Sacrament of Confirmation, check ___ Confirmation
If the child is in Grade 6 or older and needs the Sacrament(s) of Baptism or Communion, check ___ RCIY
If any of the three above are checked, is this the First Year ____ orSecond Year ____ of preparing for this sacrament?
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PROGRAMREGISTRATION
ON THIS FORM YOU WILL REGISTER YOUR CHILDREN INTO OUR RELIGIOUS EDUCATION PROGRAM.
Child 3
Full Name ______Grade ______Day: Tues ___ Wed ___ BVHS ___
(Bishop Verot High School)
Religious Education History:
Will this be the first time this child is in Religious Education?Y __ N __
Was this child in Religious Education last year?Y __ N __ If yes, where?here ___ other______
Anything else to share about the child’s background or history with Religious Education?______
______
Sacramental Preparation:
If the child is in Grades 1-5 and has NOT received Communion, check ___ First Communion
If the child is in High School and needs the Sacrament of Confirmation, check ___ Confirmation
If the child is in Grade 6 or older and needs the Sacrament(s) of Baptism or Communion, check ___ RCIY
If any of the three above are checked, is this the First Year ____ orSecond Year ____ of preparing for this sacrament?
Child 4
Full Name ______Grade ______Day: Tues ___ Wed ___ BVHS ___
(Bishop Verot High School)
Religious Education History:
Will this be the first time this child is in Religious Education?Y __ N __
Was this child in Religious Education last year?Y __ N __ If yes, where?here ___ other______
Anything else to share about the child’s background or history with Religious Education?______
______
Sacramental Preparation:
If the child is in Grades 1-5 and has NOT received Communion, check ___ First Communion
If the child is in High School and needs the Sacrament of Confirmation, check ___ Confirmation
If the child is in Grade 6 or older and needs the Sacrament(s) of Baptism or Communion, check ___ RCIY
If any of the three above are checked, is this the First Year ____ orSecond Year ____ of preparing for this sacrament?
VOLUNTEER INTEREST FORM
We can only provide quality formation for your child
thanks to the generous help provided by our excellent volunteers.
Would you consider joining them?
While I wish I could help, I cannot at this time.
Here are ways you can help:
In the large boxes above, please indicate your interest in a position.
You can either place a check mark or put numbers (1-first choice, 2-second choice, etc.).
Day(s) you can help: Tuesdays Wednesdays
NAME: ______
Email: ______
Phone: ______
Is this a mobile phone? yes noCan we text you? yes no
Once you fill out this form, we will contact you to discuss next steps.
Thank you for considering becoming a part of our program!
PROGRAMFEES WORKSHEET
ON THIS FORM YOU WILL DETERMINE YOUR FAMILY’S FEES FOR THE RELIGIOUS EDUCATION PROGRAM.
Family Name ______
Step 1Registration Fee (one fee per family) – skip if only registering a BVHS student
Place the correct amount for your family on the line $______
1 child$45.00
2 children$90.00
3+ children$100.00
Step 2Sacramental Fee (one fee per child) – if BVHS student, check here _____
Number of Children in First Year of Preparation ______X $10.00 = $ ______
Number of Children in Second Year of Preparation ______X $20.00 = $ ______
Step 3Total FeesAdd the three numbers above to determine your family total $______
Step 4Payment Today - $______
Cash _____Check #______Credit Card circle: Visa MC
Receipt # ______
Step 5Remaining Balance $ ______
Step 6Payment PlanningWe offer you the opportunity to pay a balance flexibly through the year.
How would you like to pay the remaining balance? Indicate payment amounts totaling your balance:
October$ ______
November$ ______
December$ ______I agree to this monthly payment plan for my balance.
January$ ______
February $ ______Signed ______
March$ ______
April$ ______Dated ______
ExampleThe Andrews Family has two children, one in fourth grade who hasn’t received Communion yet and one in seventh grade who has. The Andrews kids attended St. Andrew Religious Education sessions last year. Thus, the fourth grader is in the Second Year of Sacramental Preparation for Communion. Their worksheet would look like this:
Step 1: $90.00Step 6: October$20.00
Step 2: 1 x $20.00 = $20.00 November$0
Step 3: $110.00 December $0
Step 4: - $30.00 January$10.00
Step 5: $80.00February$30.00
March$20.00