ST. JAMES FAITH FORMATION - SETAUKET, NY
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New Student Registration Form
*
Indicates required field
Name
*
First
Last
Gender
*
.
Male
Female
Family Name (if different than above)
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Student's Date of birth
*
Home Phone
*
Parent's full name
*
Date of Birth
*
Occupation
*
Religion
*
Parent's Full Name
*
Mother's Maiden Name
*
Date of Birth
*
Occupation
*
Religion
*
Child resides with:
*
Both Parents
Father
Mother
Stepmother
Stepfather
Grandparents
Guardians
Other
If the child does not live with both birth parents, also include birth parent information
Name
*
Relationship
*
Address
*
City/Zip
*
Send courtesy copies?
*
Yes
No
Family Email
*
Email 2
*
Parent 1
*
Cell Phone
*
Work Phone
*
Okay to text
*
Yes
No
Cell provider
*
Parent 2
*
Cell Phone
*
Work Phone
*
Okay to text
*
Yes
No
cell provider
*
Emergency Name/Relationship
*
Phone Number
*
Student's FULL baptismal name
*
Grade & School in September 2024
*
Level in Faith Formation 2024-25
*
Does the student have any
Special Needs
(Physical, Learning,Food Allergy, etc.)?
Please list here
*
Baptism
Year
*
Church
*
City/State
*
Certificate
*
.
No
Yes
First Penance
Year
*
Church
*
City/State
*
Certificate
*
Yes
No
First Communion
Year
*
church
*
city/state
*
Certificate
*
Yes
No
Submit
Home
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Contact
Calendar
ENROLLMENT
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Photos
Handbook
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WORKSHOP ATTENDANCE
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