2018-2019 RE-REGISTRATION Form
Saint Thomas Aquinas Religious Education
1719 Post Road, Fairfield, CT 06824
Office: (203) 2551984 Fax: (203) 256- 9305
FAMILY REGISTRATION INFORMATION (please print)DUE: JULY 12, 2018
Family Last Name: ______Family Home Phone: ______
Street______City______Zip: ______
Mother’s Last Name: ______Mother’s Maiden Name: ______
Mother’s First Name: ______Mother’s Cell: ______
Mother’s Home Phone:______Mother’s Work Phone: ______
Father’s Last Name: ______Father’s First Name: ______
Father’s Home Phone:______Father’s Work Phone:______Father’s Cell: ______
Marital status: Married ______Divorced ______Single ______
EMERGENCY CONTACT (other than parent) Name:______
Relationship to child/ren:______
Emergency Contact Home Phone:______Emergency Contact Work Phone: ______
Emergency Contact Cell Phone: ______
I grant permission to STA Rel Ed staff/volunteer to act on my behalf in case of emergency: ______Signature
Class schedules:
Grade 1 (Dwight, Jennings, Mill Hill, Sherman, Burr, Private schools) Tuesdays 4:15 to 5:15 p.m.
Grade 1 (Mckinley, Holland Hill, Stratfield, N.Stratfield, Osborn Hill, Riverfield) Wednesdays 4:15 to 5:15 p.m.
Grade 2 (all schools) Thursdays 4:15 to 5:15 p.m.Homeschool is not an option for grade 2.
Grade 3 (Dwight, Jennings, Mill Hill, Sherman, Burr, Private schools) Tuesdays 4:15 to 5:15 p.m.
Grade 3(Mckinley, Holland Hill, Stratfield, N.Stratfield, Osborn Hill, Riverfield) Wednesdays 4:15 to 5:15 p.m.
Grade 4(Dwight, Jennings, Mill Hill, Sherman, Burr, Private schools) Tuesdays 4:15 to 5:15 p.m.
Grade 4 (Mckinley, Holland Hill, Stratfield, N.Stratfield, Osborn Hill, Riverfield) Wednesdays 4:15 to 5:15 p.m.
Grade 5(Dwight, Jennings, Mill Hill, Sherman, Burr, Private schools) Tuesdays 4:15 to 5:15 p.m.
Grade 5(Mckinley, Holland Hill, Stratfield, N.Stratfield, Osborn Hill, Riverfield) Wednesdays 4:15 to 5:15 p.m.
Grade 6 (all schools) Mondays 6:00 to 7:00 p.m.
Grades 7 and 8 (all schools) Mondays from EITHER 4:15 to 5:15 p.m. OR Mondays from 6:00 to 7:00 p.m.* Please indicate preference below.
Homeschool is not an option for grades 7 and 8.
CHILD/REN Re-REGISTRATION INFORMATION
1.______
First Name Middle Name Last Name Date of Birth Gender (M/F)
______
Name of School Attending * Grade in 2018-19 Do you plan to Homeschool CCD (Y/N)?
*If this child is entering grade 7 or grade 8 indicate (√) preferred class time on Mondays: 4:15 to 5:15 _____ OR 6:00 to 7:00 ____
Does this child have any special needs that we need to be made aware of? If so, please indicate: ______
Will this child bring an epi-pen to Religious Ed? ______Yes _____ No
2.______
First Name Middle Name Last Name Date of Birth Gender (M/F)
______
Name of School Attending * Grade in 2018-19 Do you plan to Homeschool CCD (Y/N)?
Does this child have any special needs that we need to be made aware of? If so, please indicate: ______
Will this child bring an epi-pen to Religious Ed? ______Yes _____ No
*If this child is entering grade 7 or grade 8 indicate (√) preferred class time on Mondays:4:15 to 5:15 _____ OR 6:00 to 7:00 _____
3.______
First Name Middle Name Last Name Date of Birth Gender (M/F)
______
Name of School Attending * Grade in 2018-19 Do you plan to Homeschool CCD (Y/N)?
*If this child is entering grade 7 or grade 8 indicate (√) preferred class time on Mondays: 4:15 to 5:15 _____ OR 6:00 to 7:00 _____
Does this child have any special needs that we need to be made aware of? If so, please indicate: ______
Will this child bring an epi-pen to Religious Ed? ______Yes _____ No
NEW CHILD (not previously registered)
1.______
First Name Middle Name Last Name Date of Birth Gender (M/F)
______
Name of School Attending * Grade in 2018-19 Do you plan to Homeschool CCD (Y/N)?
*If this child is entering grade 7 or grade 8 indicate (√) preferred class time on Mondays: 4:15 to 5:15 _____ OR 6:00 to 7:00 ____
Does this child have any special needs that we need to be made aware of? If so, please indicate: ______
Will this child bring an epi-pen to class? ______Yes _____No
Was this child baptized at Saint Thomas Aquinas Parish? Yes_____ No_____
Please include a copy of new child’s baptismal certificate if child was not baptized at STA parish.
………………………………………………………………………………………………………………………………………………………………………………………………………………
Fees and Payment: Please include payment with this form. Checks are made payable to: St. Thomas Aquinas Parish
Tuition: 1 child= $175.002 children= $ 285.00 3 or more children= $ 380.00
Please add Sacramental fee of $60.00 for each child in grade 2, and $75.00 for each child in grade 8.
- Tuition assistance is available. Please see DRE for Tuition Assistance Form.
- Tuition is waived for volunteers. Volunteers must be at least 18 years of age and be VIRTUS trained and certified.
+______Child/ren tuition for year
+______sacramental fee/s
Would you like to make an optional donation to the STA Religious
EducationTuition Assistance Program? (Any amount is appreciated!) +______donation amount (optional)
= $______TOTAL
Photo Disclaimer: I give STA Religious Ed Program permission to use my child’s photo on the STA Rel Ed Facebbok page ______Signature