346 East Mount Pleasant Ave., Livingston, New Jersey07039

ST. RAPHAEL PARISH

346 East Mount Pleasant Ave., Livingston, New Jersey07039

CHURCH - (973) 992-9490 RELIGIOUS EDUCATION – (973) 992-9496

Email –

REGISTRATION FORM FOR SCHOOL YEAR 2014/2015

Grades 1 through 7

Kindergarten available on Sunday only

Family Name Home Tel.# E-Mail

Address

To whom and with what title should mail be addressed?

Emergency Contact & Phone # ______

Father’s Name Religion

Mother’s Name Religion

Mother’s Maiden Name

Are You A Registered Member of St. Raphael’s Parish?

Days Requested For Rel. Ed.:Yes __No __

Sun. 10:00 – 11:15 AM______If No – To What Parish do you belong?

Wed. 6:15 – 7:30 PM______

*Summer Program______Summer Dates: June 30th – July 3rd , July 7th – July 10th

Home Instruction______ NOTE: If “No” is checked, your name does not appear in our current

Parish Directory YOU ARE NOT A REGISTEREDPARISHIONER.

Please check with the parish office if you are unsure of your registration status.

*Summer Registrants Please Note – If you are not a registered & parish supporting parishioner, you child will be wait-listed until June 9th, 2014 at which time you will be informed regarding class availability.

Child’s FULL Name Gender Birth Date Grade Baptism Place & Date 1st Reconciliation Church & Date 1st Eucharist Church & Date

In Sept 2014

1.

2.

3.

4.

Please specify if child(ren) have any special need such as medical/learning etc.

Where did child(ren) participate in Religious Education last year if not at our Parish?

Parent’s/Guardian’s Signature______

Date______

For Office Use Only

Amt. due:______Amt. Paid:______Balance Due:______

Check # ______M.O.#______Cash: ______

SAINT RAPHAEL RELIGIOUS EDUCATION

973-992-9496

FAMILY TUITION PLAN FOR THE YEAR 2014/2015

Registered Parishioners – One Child $80.00 – Two Children $135.00 – Three or More $185.00

($185.00 Maximum fee for three or more children)

Non-Registered Families– One Child $130.00 – Two Children $205.00 – Three or More $255.00

($255.00 Maximum fee for three or more children)

If your name does not appear in the current Parish Directory–YOU ARE NOT REGISTERED!

Please check with the parish office if you are unsure of your parish registration status.

NEW STUDENTS: If Child was NOT baptized at St. Raphael’s, a copy

of his/her baptismal certificate is required to register for Religious Education.

Please attach a copy to this form, complete all forms and return with payment.

RETURNING STUDENTS: After May 9th a late fee of $25.00 is to be added in order to re-register.

Address______City______,Zip______

Home Telephone Number______

Child’s Full NameGrade Entering in Sept. 2014

1.

2.

3.

4.

Check #______Cash______Late Fee______Amount Enclosed______

Parents and Guardians:

Each family is requested to help with Religious Education in some way. Please put you name

beside you choice(s).

Catechist (leads weekly or summer sessions) ______

Aide (assists Catechist in weekly or in summer sessions) ______

Substitute (takes class when a Catechist is absent) ______

First Eucharist Catechist (5 Saturday Morning sessions Mar-May) ______

First Reconciliation Catechist (4 Saturday morning sessions Oct-Nov) ______

Summer Religious Education – Organize, obtain &/or serve snacks ______