| Old St. Mary's Family Religious Education Program Enrollment Form 2007-2008 |
| Today's Date ________________________ Child's Name ____________________________________________Date of Birth _____________ Age ____ Grade in School ____ School ________________________________________________ Mother's Name _______________________________________Catholic? _____Yes _____ No Father's Name ________________________________________Catholic? _____Yes _____ No Address __________________________________________________________________________ Home Phone__ ____________________________ Work Phone(s) _________________________ Email address(es) _________________________________________________________________ Is there anything we should know about your child, i.e. learning disability, food allergy, etc.? ______ _________________________________________________________________________________ Please indicate which Sacraments your child has received: Baptism _____ Reconciliation _____ Eucharist _____ Confirmation _____ Please complete a separate form for each child to be enrolled in the program and enclose the fees for one year with your enrollment: $75 for the first child and $55 for each additional child. Send enrollment materials to: Ms. Maryann Cushing Old St. Mary's Church 1500 S. Michigan Avenue Chicago, IL 60605 Number of enrollment forms enclosed: _____ Total fees enclosed: $_____ Classes are held Sunday mornings in the school classrooms from 9:30-10:45. |