St. Patrick's Church CCD Registration 2017 - 2018

The deadline for registration is ***SUNDAY, JULY 2, 2017***

If you have any questions about this registration form, please email me at sisterop@stpatrickcolumbus.org or feel free to call me at 614-240-5912.

CCD CLASSES BEGIN ON SUNDAY, SEPTEMBER 10, 2017.

In Christ,

Sister Leonarda Zielinska, O.P.

* Required

Jesus Christ, Teacher
CCD REGISTRATION FEES
1 Student: $125
2 Students: $150
3 Students or More: $175

Please make checks payable to "St. Patrick's Church" with "CCD Fees" in the memo line. Please drop off checks to Parish Office for Sr. Leonarda Zielinska, O.P., D.R.E.

or mail checks to:

St. Patrick's Church
Attn.: Sr. Leonarda Zielinska, O.P.
280 N Grant Ave.
Columbus, OH 43215

You may also pay with credit card at the parish office.

A $25 late fee will be added if the DEADLINE of SUNDAY, JULY 2, 2017 is missed.

Family Information
Last Name
Your answer
Father's Name
Your answer
Mother's Name
Your answer
Primary Email
***Parent responsible for communications with St. Patrick's
Your answer
Secondary Email
Your answer
Home Phone
(with area code)
Your answer
Father's Cell Phone
(with area code)
Your answer
Mother's Cell Phone
(with area code)
Your answer
Best Number to call in case of emergency on a Sunday morning
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zipcode
Your answer
Is your family registered as parishioners of St. Patrick Church?
First Student/Child
Student First Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-18 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend?
If the child is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017)
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
Second Student/Child
Please register additional students in the sections below.
Student Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-18 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend?
If the student is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017)
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
Third Student/Child
Student Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-17 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend?
If the student is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017)
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
Fourth Student/Child
Student Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-18 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend?
If the student is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017).
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
Fifth Student/Child
Student Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-18 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend?
If the student is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017)
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
Sixth Student/Child
Student Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-18 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend
If the student is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017)
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
Seventh Student/Child
Student Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-18 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend
If the student is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017)
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
Eighth Student/Child
Student Name
Your answer
Student Last Name (Optional)
Your answer
Student Grade Level 2017-18 School Year
Note: For CGS - 4, all children must be age 4 by September 1, 2017.
What School Does This Student Attend?
If the student is home schooled or attends a non-traditional school, please indicate this as well.
Your answer
Student Age
(as of September 1, 2017)
Your answer
Student Date of Birth
(month/day/year)
MM
/
DD
/
YYYY
Sacramental Preparation
Yes
No
Has this child been Baptized?
Is this child to receive 1st Reconciliation this year? (traditionally 2nd grade)
Is this child to receive 1st Holy Communion this year? (traditionally 2nd grade)
Is this child to receive Confirmation this year? (traditionally 6th grade)
Learning and Attention Challlenges
Blessed Margaret's Children (BMC) is a ministry at St. Patrick's for children with special needs (i.e. those on IEPs). If you would like to enroll your child in this program, please indicate so and someone from the BMC program will contact you.
Yes
No
Does this child have any learning or attention challenges?
Does this child use an Individual Education Plan (IEP)?
Would you like to enroll your child in the BMC program?
Important Medical Information
In the box provided, please indicate any medical information you think your child's catechist should know (allergies, dietary, diabetic, gluten-free, etc.)
Your answer
Additional Notes
In the box provided, please include any notes regarding your child's challenge, special need, family situation, etc. that you think would be helpful for his or her catechists to know.
Your answer
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