Nativity of Mary Parish

313 East Wall Street - Janesville, WI 53545
Phone: (608) 752-7861

Religious Ed. Registration Form

- Religious Ed

Registration Fees K - Confirmation: $80 per child, maximum of $160 per family
Sacramental fee for Reconciliation & First Eucharist: $50 (includes 2 books & chalice)
Confirmation Retreat Fee: $65

Fees can be paid in one lump sum or billed twice a year. They can also be paid with a credit card or ACH automatic withdrawal. Contact Arwen Twitchett in the parish finance office for details. (752-7861 ext. 11)

Difficulties or hardships with fees should never stand in the way of your child's education. Please contact the rectory for information.
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- FAMILY INFORMATION
  
  Needed basic family information
  
  Mother's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Catholic? REQUIRED
  Is the mother Catholic?
  Please fill out this field.
  
  Mother's Address REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Name REQUIRED Please fill out this field. Please enter valid data.
  
  Catholic? REQUIRED
  Is the father Catholic?
  Please fill out this field.
  
  Father's Address REQUIRED Please fill out this field. Please enter valid data.
  
  Father's Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Child(ren)'s Address REQUIRED Please fill out this field. Please enter valid data.
  
  email address: REQUIRED Please fill out this field. Please enter valid data.
  
  Cell Phone: Please enter valid data.
  
  If parents live separately, to whom should information be sent? REQUIRED Please fill out this field.
- NAMES OF CHILDREN WHO WILL BE ATTENDING RELIGIOUS ED THIS YEAR
  
  First Child REQUIRED Please fill out this field. Please enter valid data.
  
  2015 -16 Grade in School REQUIRED Please fill out this field. Please enter valid data.
  
  Already Baptised? REQUIRED Please fill out this field.
  
  First Reconciliation? REQUIRED Please fill out this field.
  
  First Eucharist? REQUIRED Please fill out this field.
  
  Already Confirmed? REQUIRED Please fill out this field.
  
  Second Child Please enter valid data.
  
  2015 - 16 Grade in School Please enter valid data.
  
  Already Baptised?
  
  First Reconciliation?
  
  First Eucharist?
  
  Already Confirmed?
  
  Third Child Please enter valid data.
  
  2015 - 16 Grade in School Please enter valid data.
  
  Already Baptised?
  
  First Reconciliation?
  
  First Eucharist?
  
  Already Confirmed?
  
  Fourth Child Please enter valid data.
  
  2015 - 16 Grade in School Please enter valid data.
  
  Already Baptised?
  
  First Reconciliation?
  
  First Eucharist?
  
  Already Confirmed?
  
  My child(ren) attend these parish/public school(s) REQUIRED Please fill out this field.
  
  I am interested in helping as a
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