Registration Form

Family Information

Father's First & Last Name REQUIRED Please fill out this field. Please enter valid data.

Mother's First and Last Name REQUIRED Please fill out this field. Please enter valid data.

Mother's Maiden Name REQUIRED Please fill out this field. Please enter valid data.

Address REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Preferred Session REQUIRED Please fill out this field.

Tuition REQUIRED Please fill out this field.

Scrip Program Our family participates in the Scrip Program

I will volunteer by being a (select one): REQUIRED Catechist Adult Aide Office Staff Hall Monitor Gym Monitor Traffic Control Please fill out this field.

Child Information #1

Child's First and Last Name REQUIRED Please fill out this field. Please enter valid data.
Date of Birth REQUIRED Please fill out this field. Please enter valid data.
Gender REQUIRED Male Female Please fill out this field.
School REQUIRED Please fill out this field. Please enter valid data.
School Grade (Fall 2019) REQUIRED Please fill out this field. Please enter valid data.
Number of years of prior religious education REQUIRED Please fill out this field. Please enter valid data.
Church/School where religious education was taught REQUIRED Please fill out this field. Please enter valid data.
Please list any behavioral or medical concerns your child may have:
Sacramental Information
NOTE: If the child is a returning student and the Religious Ed Office has his/her sacramental information, you do not need to enter it again.
Baptismal Date Please enter valid data.
Name/Address of Church where child was baptized Please enter valid data.
First Penance Date Please enter valid data.
Name/Address of Church where child received First Penance Please enter valid data.
First Eucharist Date Please enter valid data.
Name/Address of Church where child received First Eucharist Please enter valid data.

Child Information #2

Child's First and Last Name Please enter valid data.
Date of Birth Please enter valid data.
Gender Male Female
School Please enter valid data.
School Grade (Fall 2019) Please enter valid data.
Number of years of prior religious education Please enter valid data.
Church/School where religious education was taught Please enter valid data.
Please list any behavioral or medical concerns your child may have:
Sacramental Information
NOTE: If the child is a returning student and the Religious Ed Office has his/her sacramental information, you do not need to enter it again.
Baptismal Date Please enter valid data.
Name/Address of Church where child was baptized Please enter valid data.
First Penance Date Please enter valid data.
Name/Address of Church where child received First Penance Please enter valid data.
First Eucharist Date Please enter valid data.
Name/Address of Church where child received First Eucharist Please enter valid data.

Child Information #3

Child's First and Last Name Please enter valid data.
Date of Birth Please enter valid data.
Gender Male Female
School Please enter valid data.
School Grade (Fall 2019) Please enter valid data.
Number of years of prior religious education Please enter valid data.
Church/School where religious education was taught Please enter valid data.
Please list any behavioral or medical concerns your child may have:
Sacramental Information
NOTE: If the child is a returning student and the Religious Ed Office has his/her sacramental information, you do not need to enter it again.
Baptismal Date Please enter valid data.
Name/Address of Church where child was baptized Please enter valid data.
First Penance Date Please enter valid data.
Name/Address of Church where child received First Penance Please enter valid data.
First Eucharist Date Please enter valid data.
Name/Address of Church where child received First Eucharist Please enter valid data.

Saint Joseph Parish

York, PA

Registration Form