St Andrews R.C.I.A Registration

Allergies/Med:

Name of Student

Birthday

Age

Home address

Email Address

*Best Phone#

What Sacraments are needed?

Baptism

Holy Eucharist

Confirmation

Emergency Phone

Emergency Contact

Sacramental History

Below fill out the accurate information and attach a copy of the certificate to your registration.

Baptism Church

Baptism Church Address

Date

First Communion Church

First Communion Curch Address

First Communion Date

When registration is received, you will be emailed a schedule of the classes and location along with other important information.

By signing below, you agree that the information provided is accurate and are accepting to follow the program to the fullest extent.

Signature

Date