CCD Registration K-9- &#034;Payment at time of registration&#034;

Email (all communication sent through Email) REQUIRED Please fill out this field. Please enter an email address.

Father's Full Name REQUIRED Please fill out this field. Please enter valid data.

Father's Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Street REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Mother's Full Name (Maiden Name) REQUIRED Please fill out this field. Please enter valid data.

Mother's Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Street REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Emergency Contact REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Phone # REQUIRED Please fill out this field. Please enter valid data.

Student Lives with REQUIRED Both Parents Mother Father Guardian Please fill out this field.

Choice of day for CCD Class REQUIRED Grade K-6_ Sunday_ 8:45am-9:45am Grade 1-6_ Monday_ 4:15pm-5:15pm Grade 7-8_ Tuesday_ 7:15pm-8:15pm Grade 9_Sunday_5:30pm-6:30pm Please fill out this field.

Email REQUIRED Please fill out this field. Please enter an email address.

Payment REQUIRED 125.0 – One Student in Grade K-9 225.0 – Two Students in Grades K-9 275.0 – Three or more students in grades K-9 Please fill out this field.

St. Peter the Apostle

Parsippany, NJ

CCD Registration K-9- "Payment at time of registration"