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REGISTRATION FORM 2011-2012
St. Mary of Mt. Carmel Religious Education
425 Central Avenue Long Prairie, MN 56347
(320)732-3478 www.stmaryslp.org
Date: ________________________
Parents’ Names: ______________________________
Father: ______________________________________
Mother: ______________________________________
Home Address of Child:
_________________________________________________________________________________________
Child lives with _____Father _____Mother _____Both Parents
Home Phone: ___________________________________________
Email address: ____________________________________________
Cell Phone Dad: ____________________________________________
Cell Phone Mom: ____________________________________________
Is your family registered at St. Mary of Mt. Carmel Parish? Yes/No
If not registered, in which parish or church are you a member? _____________________
Names and grades of children who will attend St. Mary of Mt. Carmel Religious Education in 2011-2012:
| Name |
Date of Birth |
Grade |
Baptism Date |
Reconcilation |
F. Communion |
Confirmation |
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TUITION FOR PARISHIONERS AND NON-PARISHIONERS:
First Child $45.00
Second Child $45.00
Third Child $35.00
Additional Children Free
Sacramental Fee (First Reconciliation, First Communion, and Confirmation) $25.00
Family maximum is $125.00 per year.
_______________________________________________ ________________________
Parent/Guardian Signature Date
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