Saint Charles Borromeo Religious Education and Formation

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Saint Charles Borromeo Religious Education and Formation
Sunday School Family Enrollment Form and Payment 2014-15
Family Name ____________________________________________
Father’s Name ________________________/_________________
First
Last
Mother’s Name _________________/______________/______________
First
Last
Maiden
Custodial Parent/Guardian’s Name ______________/______________
First
Last
Home Address ______________________________________________
Town ______________Zip__________Home Phone#______________
Cell Phone ____________ E-mail address _____________________
Emergency Contact_________________________ ________________
Person
Phone #
Child’s First Name/Last Name
Birth date
Age as of 10-1-14`
_______________/___________
_________
____________
______________/____________
_________
_____________
_____________/_____________
_________
_____________
Special Needs: If there is specific information about your child/ren which would
enable us to meet special needs or situations regarding class placement, please
indicate below. (i.e. physical, social, emotional, dietary, neurological, etc.)
Sunday School Tuition
3 year old program
4 year old program
5 year old program
$30.00
$45.00
$60.00
One child
Two children
Three or more
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