2020-2021 CCD Registration
Welcome! Please fill out the questions below in order to register for the 2020-2021 CCD year. We are asking all families to register this year in order to update our database with current contact information and make sure that all students from each family are included. If you have any questions, please email stmarkjnre@cox.net
Family Information - Parent's First and Last Names *
Family Information - Mailing Address *
Family Information - Phone Numbers (please list names and phone numbers, with primary contact first) *
Family Information - Email Addresses (please list names and emails, with primary contact first) *
Family Information - Emergency Contact Info. (name, phone number and relationship to student) *
Student # 1 Information - First & Last Name *
Student #1 Information - Birthdate *
MM
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DD
/
YYYY
Student #1 Information - Grade Level *
Student #1 Information - Please check all that have been completed.
Student #1 Information - Please provide any information on special needs (medical, learning, etc.)
Do you have another child? *
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