2017-2018 NEW FAMILY REGISTRATION
New families only
Saint Thomas Aquinas Parish Religious Education
1719 Post Road, Fairfield, CT. 06824 Office: (203)255-1984 FAX: (203) 256-9305
DUE JULY 31, 2017
Please Print:
______
FAMILY Last Name Address Street City/State Zip
______ Mother’s Last Name Mother’ First Name Mother’s MAIDEN Name (required) Mother’s Email
______
Mother’s Home Phone Mother’s Work Phone Mother’s Cell Phone
______
Father’s Last Name Father’s First Name Father’s Email
______
Father’s Home Phone Father’s Work Phone Father’s Cell Phone
Additional address of Parent (If different): ______
Father’s Religion: ______Mother’s Religion: ______
Marital Status: Married ___ Single ___ Divorced ___ Separated ___ Mother or Father deceased ______
Church and place of Marriage (name of church, City/State):______
EMERGENCY CONTACT: (person to call during class time, other than parent)
Name: ______Relationship to child/ren: ______
Home phone: ______Cell phone: ______
I grant permission to St. Thomas Aquinas Religious Ed. Staff/Volunteer to act on my behalf in case of emergency:
______
Signature of Parent/Guardian
Fees and Payment:Please include payment (cash or check) with this form.
Mail check (or deliver) to: Saint Thomas Aquinas Religious Education, 1719 Post Road, Fairfield, CT 06824
Tuition:$175.00 - 1 Child$285.00 - 2 Children $380.00 - 3 or moreChildren
Please add sacramental fee of $60.00 for each child in grade 2, and $75.00 for each child in grade 8.
Tuition is the same amount for Homeschooled students.
Please make check payable to: Saint Thomas Aquinas Parish
Tuition/s+ ______
Sacramental fee/s (if applicable) + ______
Optional donation to the St. Thomas Aquinas
Religious Education Tuition Assistance Program +______ (any amount is appreciated)
Total = $______
Please consider volunteering. Tuition, (not sacramental fee) is waived for volunteers. Volunteers must be at least 18 years of age AND be VIRTUS trained and certified. Please see Director of Religious Education or office assistant for VOLUNTEER Form.
CLASS SCHEDULES: Mondays: Grade 8 (all schools) 7:15pm-8:15pm Mondays: Grades 6 and 7(all schools) 6:00pm -7:00pm
Tuesdays: Grades 1, 3, 4 and 5 (Dwight, Jennings, Mill Hill, Sherman, Burr, and Private schools) 4:15pm-5:15pm
Wednesdays: Grades 1, 3, 4 and 5 (McKinley, Holland Hill, Stratfield, N. Stratfield, Osborn Hill, and Riverfield) 4:15pm-5:15pm
Thursdays: Grade 2 (all schools) 4:15pm-5:15pm
We will need copies ofBaptismal Certificates for each child enrolled, plus any additionalsacramental information (First Penance, First Eucharist dates, etc.) for older children.Please use back of form if more space is needed.
Child/ren Registration Information *Homeschool is not an option for grades 2, 7, and 8
______Date of Birth:______Gender ____
1. Child’s First Name Middle Name Last Name (Month/Day/Year)
School attending: Grade in 2017-18:____Do you plan to Homeschool* (Y/N)? ____
Baptism______
(Month/Day/Year) Church Name Church Address City State
Eucharist______
(Month/Day/Year) Church Name Church Address City State
Reconciliation______
(Month/Day/Year) Church Name Church Address City State
Please note special needs (allergies, learning, social, physical, EPI-PEN, etc.):______
______Date of Birth:______Gender ___
2. Child’s First Name Middle Name Last Name (Month/Day/Year)
School attending: Grade in 2017-18: ____ Do you plan to Homeschool* (Y/N)? ____
Baptism______
(Month/Day/Year) Church Name Church Address City State
Eucharist______
(Month/Day/Year) Church Name Church Address City State
Reconciliation______
(Month/Day/Year) Church Name Church Address City State
Please note special needs(allergies, learning, social, physical, EPI-PEN, etc.):______
______Date of Birth:______Gender ____
3. Child’s First Name Middle Name Last Name (Month/Day/Year)
School attending: Grade in 2017-18: ____ Do you plan to Homeschool* (Y/N)? ____
Baptism______
(Month/Day/Year) Church Name Church Address City State
Eucharist______
(Month/Day/Year) Church Name Church Address City State
Reconciliation______
(Month/Day/Year) Church Name Church Address City State
Special request for classroom placement (for carpooling purposes, etc.):______
We will do our best to honor requests received by the registration deadline. Requests received after the deadline are not guaranteed.
Photo disclaimer: I give the Saint Thomas Aquinas Religious Education Program permission to use my child/ren’s photo on the STA Religious Ed Facebook page
bulletin boards, and/or other publications for the Church or Diocese use only: ______
Signature of Parent/Guardian