PRE Registration

ST. ANn PRE Registration form

St. Ann PRE Student Registration Form

Please complete the following to enroll your student for the 2022-2022 school year.

Click Submit Form to send this information to St. Ann Church.

*Required fields

Form's Instructions
Please complete all information as accurately as possible.

		If you have any questions please contact Katie Dyer at katie.dyer@stannbartlett.org

Adult 1
Title		Suffix
*First Name		*Last Name
Middle Name		Nickname
*Relationship		Maiden Name
*Birth Date
*Gender	Female Male
*Language		*Marital Status
*Rel to Stdnt

Spouse/2nd Adult
Title		Suffix
First Name		Last Name
Middle Name		Nickname
Relationship		Maiden Name
Birth Date
Gender	Female Male
Language		Marital Status
Rel to Stdnt

Family Street Address
*Line 1
Line 2
*City
*State
*ZIP

Family Phone Numbers
*Primary		( ) - Unlisted
Other		( ) - Unlisted
Family Email Address
*Email		Unlisted
Fee Total = $0.00

Student 1
Title		Suffix
*First Name		*Last Name
Middle Name		Nickname
Ethnicity		*Birth Date
*Gender	Female Male	*Grade (2021-22)
*Language
*School
*Lives With
Sacraments
Baptism		Date	Place
First Comm		Date	Place
Student Remarks
Health Problems
*Can Be Picked-Up By

Emergency Contact -NOT PARENTS

*First Name		*Last Name
*Relationship
Address
Emergency Contact Phone Number
*Primary		( ) - Unlisted
Other		( ) - Unlisted
Email Address
Email

Click Submit Form to send this information to St. Ann Church.

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St. Ann Church

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St. Ann Church