Test Page

Parent Information

Parent Information - Father*

First Last

Father's Religion*

Religion

Father's Phone Number*

Father's Email*

Enter Email Confirm Email

Parent Information - Mother*

First Last

Mother's Religion*

Religion

Mother's Phone Number*

Mother's Email*

Enter Email Confirm Email

Family Address*

Street Address Address Line 2 City State ZIP Code

Have you fully registered each member of your family through REALM?*

Yes

No

Not Sure

Who is authorized to pickup student after class (name & telephone numbers)*

Add more rows by selecting "+"

Emergency Contact - Name*

First Last

Emergency Contact - Phone Number*

Parental Shared Custody Information

//Make this a question// - Are both parents

Do both parents have legal custody?*

Yes

No

Is custody evenly shared?

Yes

No

Consent*

I have read and understand the parental shared custody information (below)

If parents are separated or divorced, a copy of the custody agreement pertaining to the Faith Formation of the Student must be kept on file with our 'Mini' Faith Formation Department.

Guardian Information

This section is only required if someone other than the parent is enrolling the student.

Guaridan Information - If not parent

First Last

Relationship to student

Guardian Email

Enter Email Confirm Email

Guardian Phone Number

Guardian Address

Street Address Address Line 2 City State ZIP Code

Have you fully registered each member of your family through REALM?

Yes

No

Not Sure

Volunteer Opportunity

Please consider being a volunteer with our program!

Catechist

Aide

Substitue Catechist

Aide to Coordinator

Clerical

Retreat/Event Chaperone

Setup/Clean-up for Event

I am interesting in...(Check all that apply)

Tuition & Sacramental Fees

Tuition - One student = $65.00 Two Students = $120.00 Three or more Students = $170.00 Sacramental Fees - First Holy Communion = Tuition + $50.00 (per student) Confirmation = Tuition + $50.00 (per student) Payments can be made via REALM (https://onrealm.org/StFrancesXavierCabrini/)

Tuition*

Sacramental Fees

Online agreement Signature*

By selecting this box, I acknowledge that I am responsible for reading through hand-out material and paying for tuition & sacramental fees

Tuition & Sacramental Fees can be paid via REALM (https://onrealm.org/StFrancesXavierCabrini/)

Student Information

Student Name*

First Last

Date of Birth*

Age

As of September 1, 2021

Place of Birth (City/State/Country)

Current School

Grade (2021-2022 School Year)

Is the student Baptized?*

Yes

No

Baptism Parish, City & State

Please deliver a copy of the Certificate of Baptism to our Faith Formation Department

Has the student received first Holy Communion?*

Yes

No

First Holy Communion - Parish, City & State

Has the student received the Sacrament of Confirmation?*

Yes

No

Confirmation - Parish, City & State

Was the student enrolled in a Faith Formation Program Last Year?*

Yes

No

Faith Formation Last Year - Parish, City & State

How many years of Faith Formation has the student received?

Student Number 2

((being built))

Comments

This field is for validation purposes and should be left unchanged.

'Mini' Faith Formation Program: 2021-2022 | Online Registration Form

Parent Information

Parental Shared Custody Information

Guardian Information

Volunteer Opportunity

Tuition & Sacramental Fees

Student Information

Student Number 2