Registration / Matricula

Family Last Name / Apellido de la Familia

Envelope # / Num. de Sobre

Todays Date

Home Address / Domicilio

City / Cuidad

Zip / Zona Postal

Home Phone / Telefono (casa)

Mother's First Name / Primer Nombre de la Madre

Mother's Last Name / Apellido de la Madre

Religion

Mother is the the primary parent to contact / La madre es el contacto primario del joven.

Yes / Si

No

Mother's Work Phone / Telefono del Trabajo de La Madre

Cell / Celular

Mother's Email / Correo Electronico de la Madre

Mother's Full Maiden Name / Nombre Completo de Soltera de la Madre

Father's First Name / Primer Nombre del Padre

Father's Last Name / Apellido del Padre

Religion

Father is the the primary parent to contact / El padre es el contacto primario del joven.

Yes / Si

No

Father's Work Phone / Telefono del Trabajo del Padre

Cell / Celular

Father's Email / Correo Electronico del Padre

Please provide the following, if applicable / Favor de proveer lo sigiuente, si aplicable

Children live with / jovenes viven con :

Languages spoken at home / Idiomas que se hablan en casa

Which language do you prefer to receive communications / Idioma preferido

We attend Mass (in person or online) / Asistimos a misa (en el templo o en linea)

Number of Children to Register

Student's First Name / Primer Nombre del Joven

Student's Last Name / Apellido del Joven

Date of Birth / Fecha de Nacimiento (mm-dd-yy)

Sex / Sexo

M

F

Student's email address

Student's cell

Church of Baptism / Parroquia del bautismo

Baptism Date / Fecha bautismal

Copy of Baptismal Certificate / Copia del certificado bautismal

Church of First Communion / Parroquia de 1ra Comunion

First Communion Date / Fecha de 1ra Comunion

Copy of 1st Communion Certificate / Copia del certificado de 1ra Comunion

Grade in September 2020 / Grado en el septiembre del 2020

School / Escuela

2020-2021 Stage in Confirmation Preparation / Paso en la preparacion para confirmacion

1st year / 1er ano (9th - 11th grades)

2nd year / 2do ano (10th - 12th grades)

Already Confirmed / Ya Confirmado (11th - 12th grades)

Are there any chronic conditions or illness that the staff should be aware of for this student? / Existe alguna condicion cronica o enfermedad de la cual el equipo de catequesis debe tener en cuenta?

Yes / Si

No

If yes, please explain / Si hay, favor de explicar

I understand that for the year 2020-2021, the sessions are planned to take place in online videoconference sessions only. Each session will be 60-90 minutes in length and will meet roughly weekly from October 2020 through to April 2021.

Yes / Si

No

For the online sessions, my children have access to the following (check all that apply)

Desktop computer

Laptop

Tablet

For the online sessions, my children have access to the following internet access

Wireless home internet

Wired home internet

Mobile data / hotspots