PRE Registration

ST. ANn PRE Registration form

St. Ann PRE Student Registration Form

Please complete the following to enroll your student for the 2020-2021 school year

*Please note that you may register now even if you are not able to pay any registration fees. We
do not want to prevent anyone from attending PRE for monetary reasons

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

Head of Household
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 (2020-21)
*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

ST. ANn PRE Registration form

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St. Ann Church