St Thomas Church - New Family Religious Education Registration

Previously Registered	Religious Education Registration Grades K to 8th School Year:___________ St. Thomas - P.O. Box 3, Underhill Center, Vt 05490-0003 (802) 899-4770
Family Name:	Father's Name:	Mother's Name:
Mailing Address:	Street Address:
City:		Zip:
Home Phone:	Emergency Phone:

Child's Name:		Grade:
Child's Name:		Grade:
Child's Name:		Grade:
Child's Name:		Grade:
New Child's Name:		Date of Birth:
Grade:	Gender: Male / Female	Place of Birth:
Date of Baptism:	Name of Church:	Church Address:
Date of First Communion:	Name of Church:	Church Address:
Child's Special Interests:
Any Allergies?
Previous Religious Instruction: Yes / No	Where?

* Use Back for additional registrations

How can you assist the Religious Education Program?

Catechist	Party/Project Leader	Substitute Teacher	Classroom Helper
Office Help	Cleanup after class	Other:_____________________

Registration Fee is $30 (1 child), $50 (2 children) or $60 per family
Make Checks payable to: St. Thomas Church and include payment with this application!

Signature:__________________________________________________ Date: ___________________

For Office use only:

Date Received:

Check Number:

Amount Received: