REGISTRATION FORM
(Permission to print)
Mail to: St. Joseph CCD, 8420 Belair Road, 21236
[410-256-1630, ext 151]
Fee: (DUE WITH THIS FORM) (Make check payable to St. Joseph Church)
5 I am a Registered Parishioner
Fee: $75.00 for 1 child, $100.00 for 2 or more children (in the same family)
5 I am not registered with St. Joseph Parish
Fee: $125.00 for 1 child, $150.00 for 2 or more children (same family)
REGISTRATION DEADLINE: Aug 26th (Late Fee: an additional $10.00)
(Want to register with St. Joseph’s, please check here ____ and a Registration Packet will be mailed to you.)
STUDENTS TO BE ENROLLED IN THE CCD PROGRAM:
Kindergarten to 8th Grade ONLY
(9th grade+, the 2nd year of the Confirmation Program--register thru Youth Ministry Program)
1. STUDENT NAME (last)_____________________________(first)____________________________
DATE OF BIRTH: ______ AGE: ____ BOY?___, GIRL?___ Grade entering in FALL______
Baptized Catholic?___yes ___no, 1st Communion?___yes ___no, 1st Reconciliation?___yes ___no
Was this child registered in St. Joseph's CCD or HomeStudy Program last year? ____yes, ____no
Ø If “no”, where was this child registered? _____________________________________________________
2. STUDENT NAME (last)_____________________________(first)____________________________
DATE OF BIRTH: ______ AGE: ____ BOY?___, GIRL?___ Grade Entering in FALL______
Baptized Catholic?___yes ___no, 1st Communion?___yes ___no, 1st Reconciliation?___yes ___no
Was this child registered in St. Joseph's CCD or HomeStudy Program last year? ____yes, ____no
Ø If “no”, where was this child registered? _____________________________________________________
3. STUDENT NAME (last)_____________________________(first)____________________________
DATE OF BIRTH: ______ AGE: ____ BOY?___, GIRL?___ Grade Entering in FALL______
Baptized Catholic?___yes ___no, 1st Communion?___yes ___no, 1st Reconciliation?___yes ___no
Was this child registered in St. Joseph's CCD or HomeStudy Program last year? ____yes, ____no
Ø If “no”, where was this child registered? _____________________________________________________
Parent/Guardian Names:
(last)_____________________________________________(first)___________________________(religion)___________
(last)_____________________________________________(first)___________________________(religion)___________
(Child lives with: ____both parents, ____Mother, ____Father, ____Guardian)
ADDRESS:_____________________________________________________________________ZIP____________
Telephone:(home)______________________________________(emp)___________________________________
In case of emergency, if you cannot be reached, whom should we call?
(Name, Tele #, Relationship to child):
__________________________________________________________________________________________________
OPTIONAL HomeStudy PROGRAM (See the Web site for more details.)
Complete above and check here ____________, if you want your child(ren) to be enrolled in HomeStudy.
HomeStudy PROGRAM FEE:
[Registered- $40.00 for 1 child, $65.00 for 2 or more children]
[Not Registered- $50.00 for 1 child, $75.00 for 2 or more children]
(If registering one child in CCD and another in HomeStudy, the CCD Family Fee applies)
NOTE: Changes cannot be made once this Form is received. If you have any special class requests,
or if your child has any special needs or medical conditions, please check and note them here:
_________________________________________________________________________________