Enrollment Form for: Adult Classes & Bible Studies, RCIA, Baptism Class, Catholic Preschool, CCD, Summer Sacraments & Vacation Bible School

Welcome to St. Patrick Catholic Church!

This is an enrollment form for: Adult Formation Classes, Baptism Class, Catholic
Preschool and CCD classes through St. Patrick Church. Complete the form for each
student you will be enrolling (you may enroll multiple at the same time).

An acknowledgement letter will be sent to you and a statement detailing the cost of the
class and a coupon you may use to send in your payment if needed.
Please contact the Parish Office if you have questions about cost. Adult classes may or
may not have a book fee associated with it, depending upon the type of class. No one is
ever denied the chance to heal, grow and practice their faith, because of financial
difficulties. This concern should not be an influence in a person�s decision to enroll in a
class.

If you have questions, you may find more information on the parish website:
www.stpatrickchurch.us or, you may contact the parish office for more information at:
(859) 356-5151 or email: stpatsemail@fuse.net.

Family Options	New Family		Update Existing Family
			- ID/Env

Instructions
Please select the class you would like to enroll your child or yourself into. Be sure to notice the year of enrollment is the correct one.

Head of Household
Title		Suffix
*First Name		*Last Name
*Middle Name		Nickname
Relationship		Maiden Name
Ethnicity		*Birth Date
*Gender	Female Male	Grade/Degree
Language		*Marital Status
	Phone Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
Phone 1		( ) - Unlisted
Phone 2		( ) - Unlisted
Email 1		Unlisted
		Send Email Instead of Mail When Possible
Email 2		Unlisted
		Send Email Instead of Mail When Possible

Spouse
Title		Suffix
First Name		Last Name
Middle Name		Nickname
Relationship		Maiden Name
Ethnicity		Birth Date
Gender	Female Male	Grade/Degree
Language		Marital Status
	Phone Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
Phone 1		( ) - Unlisted
Phone 2		( ) - Unlisted
Email 1		Unlisted
		Send Email Instead of Mail When Possible
Email 2		Unlisted
		Send Email Instead of Mail When Possible

Family Street Address
*Line 1
Line 2
*City
*State
*ZIP

Family Phone Numbers
	Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
*Primary		( ) - Unlisted
Other		( ) - Unlisted
Family Email Address
*Email		Unlisted
		Send Email Instead of Mail When Possible
Fee Total = $0.00
Family Remarks
Remarks

Student 1		Type
Title		Suffix
*First Name		*Last Name
*Middle Name		Nickname
Relationship		Maiden Name
Ethnicity		*Birth Date
*Gender	Female Male	*Grade/Degree
Language		*Marital Status
	Phone Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
Phone 1		( ) - Unlisted
Phone 2		( ) - Unlisted
Email 1		Unlisted
		Send Email Instead of Mail When Possible
Email 2		Unlisted
		Send Email Instead of Mail When Possible
Sacraments
*Baptism		Date	Place
*Reconcil		Date	Place
*1st Comm		Date	Place
*Confirm		Date	Place
*Marriage		Date	Place
Class Choices
*Class 1
Class 2
Student Remarks
General Remarks
*Health Problems

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