PREP Registration 2019-20
Submit before August 10. Fee: 1st child- $85, 2nd child- $55, 3rd child- $45. Non-parishioner - $100/child Mail checks to

St. Ann Church PREP
435 S. 6th St.
Emmaus PA 18049

OR go to St. Ann's online payment portal to pay by direct debit from your bank account or with a credit card:
www.osvonlinegiving.com/4658
Scroll down to PREP option

* means an answer is required. Enter NA if not applicable.

THIS FORM IS NOT COMPLETE UNTIL YOU HIT SUBMIT AT THE END. IF YOU ARE REGISTERING FEWER THAN 4 CHILDREN, SCROLL THROUGH, CLICK ON NEXT, AT THE END HIT SUBMIT.

Email address *
Father's Name
First *
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Last *
Your answer
Mother's Name
First Name *
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Last Name *
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Maiden Name *
Your answer
Address
Street *
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City *
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State *
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Zip *
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Home Phone *
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Cell Phone *
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Email Address *
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