Saint Paul Chong Hasang Office of Religious Education

CCD Registration (STUDENT INFORMATION)

Date: _________________

All NEW Registrants AND First Communion Students must attach a copy of Birth and Baptism Certificates.
All Confirmation Students must attach a copy of Birth, Baptism, and First Communion Certificates.

FAMILY NAME: ________________________________            

STUDENT’S NAME:  (please print full legal name)                                           Gender: M [     ]   F [     ]

____________________________________________________________________________________________
Last                                                            First                                                          Middle 

Age _____   Date of Birth   ______________   Place of Birth (City, ST): _______________________________
                                            (MM-DD-YYYY)  

                                                                                                                          (Office Use Only:   Certificate   [    ] )

School Grade This Year:   ______   School: _______________________________________________________

Food Allergies, Medications & Special Needs:  ___________________________________________________

__________________________________________________________________________________

SACRAMENTS RECEIVED:

BAPTISM:   DATE:   ________________  CHURCH:  _______________________________________________

STREET ADDRESS:  _________________________________________________________________________

CITY:  ________________________________________ STATE:  ______   ZIP CODE: ________________

                                                                                                           (Office Use Only:   Certificate   [    ] )

RECONCILIATION: DATE:   _____________  CHURCH:  ____________________________________________

STREET ADDRESS:  _________________________________________________________________________  

CITY:  ________________________________________ STATE:  ______   ZIP CODE: _________________
 

                                                                              (Office Use Only:   Certificate   [    ] )

EUCHARIST: DATE:   _______________  CHURCH:  _______________________________________________

STREET ADDRESS:  _________________________________________________________________________

CITY:  ________________________________________ STATE:  ______   ZIP CODE: _________________
 

                                                                              (Office Use Only:   Certificate   [    ] )