St. Theresa of Lisieux Parish -

Religious Education Registration Form A

 

 

 

If your child is entering FIRST GRADE or a NEW STUDENT to our Religious Education Program, please complete both Form A and Form B. 

 

 

Family Name: _________________________________________________________________

 

Address: _____________________________________________________________________

                       Street                                                   Town                                         Zip +4

 

Home Phone: _____________________              E-Mail: ______________________________

 

 

Please list family members.  (Kindly include last name if different from family name.)

 

Adults: _____________________________   Work phone: _________   Cell phone: _________

 

             _____________________________   Work phone: _________   Cell phone: _________

 

                                                                                                                                    (as of Sept. 2011)

Children: ___________________________    School ____________________    Grade _____

 

                 ___________________________     School ____________________    Grade _____

 

                 ___________________________     School ____________________    Grade _____

 

 Please list any special needs you may have: ________________________________________

 

“Generations of Faith” Preparation Sessions

Please list 1st & 2nd choices of Preparation Session you plan on attending with your family. Preparation Sessions

are being filled on a first come first serve basis.

                                                                                                      

      _____   Monday          6:00 pm                                            _____    Tuesday        6:00 pm

                   Thursday        4:00 pm                                            _____    Saturday      9:00 am

      _____   Friday             6:00 pm                                            

 

      _____   Number of family members attending Generations of Faith Prep Sessions.

 

 

Home Study for Grades 1- 8

____   We would like to participate in the Home Study Program. Each student will receive a

            textbook which must be completed and returned to the Religious Education Office.

 

Religious Education Fees

Tuition paid by June 9th:  $75 for 1 child, $125. For 2 children, $160 for 3 children or more

Tuition paid after June 9th:  $100 for 1 child,   $150 for 2 children,   $185 for 3 or more children

First Communion Sacramental Program Additional Fee: $25 per student.

 

 

AMOUNT ENCLOSED: ________________________     Cash (   )         Check (  )

(Please make checks payable to: St. Theresa Parish, 470R Boston Rd. Billerica, MA 01821

_____I request a fee reduction/waiver form. (Must be completed and returned to the REO.

 

For Office Use:  Date Received _______   Initials_______    Amount Paid_______     Ck# ________

 

 

 

 

Religious Education Form B

Please complete this portion only for First Grade or

New to St. Theresa’s Religious Education Program

 

Child’s Date of Birth ____________________                

 

Child’s Name ______________________________________________________________  Boy (  )     Girl  (  )

                              Last                                First                                   Full Middle

 

Parent’s Name __________________________________________________________________

                              Last                                First                                   Mr/Ms/Mrs

 

Address_______________________________________________________________________

                           Street     or      PO Box                             Town                                                 Zip + 4

 

 

Home Phone __________________    Work/Cell _____________________      Which Parent _________

 

 

E-Mail Address:  _______________________________________________            Which Parent __________

                                                         (Please Print) 

 

Is your family registered in our parish?  Yes: ____   No: ____   If you are not a registered (or not sure if you are officially registered) member of St. Theresa Parish, please call the rectory during office hours (Monday –Thursday 10 am – 3 pm) 978-663-8816.

 

 

School Attending September 2011_______________________________________

 

 

School Grade September 2011 ___________                     Religious Education Grade Sept. 2011 _____________

 

 

Mother                  (First) _____________________    (Maiden) __________________ Religion ______________

 

 

Father                   (First) _____________________    (Last) _____________________ Religion ______________

 

 

Step-Mother         (First) _____________________     (Maiden) __________________ Religion______________

 

 

Step-Father          (First) _____________________      (Last) ____________________  Religion______________

 

 

Church of Marriage ___________________________________________________________________________

                                                               Church                                                        City

 

Child’s Baptism ______________________________________________________________________________

                                        Church                                    City                                                      Date

(If child was not baptized at St. Theresa’s, a Baptismal Certificate is required at time of Registration.)

 

 

Child’s First Communion ________________________________________________________________________

                                                    Church                                           City                                             Date

 

Has child received First Reconciliation (Penance/Confession)?             (   ) Yes         (   ) No

 

Has child had any previous religious education?      (  )   Yes           (  ) No

 

How Much?__________________________________    Parish ________________________       City___________