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CCD Registration Form

- Religious Education

Registration Fee: $40.00 one child
$55.00 two children
$65.00 three or more children

Please make checks payable to St. John Paul II Parish. Mail to St. John Paul II Parish, Attn: Director of Religious Education, 697 Central Avenue, Pawtucket, RI 02861
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  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Address 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.
- Phone Number (Home) REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Phone Number (Cell) REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Grade Please enter valid data.
- School Attending Please enter valid data.
- Father's Name (First & Last) Please enter valid data.
- Mother's Name (First & Last) Please enter valid data.
- Mother's Maiden Name Please enter valid data.
- Guardian's Name (If other than parents) Please enter valid data.
- Guardian's Relationship Please enter valid data.
- Emergency Contact Please enter valid data.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Special Concerns
- Sacraments Received
  
  Baptism (year & date) Please enter valid data.
  
  Parish Please enter valid data.
  
  City & State Please enter valid data.
- Sacraments Received
  
  First Communion (year & date) Please enter valid data.
  
  Parish Please enter valid data.
  
  City & State Please enter valid data.
- Sacraments Received
  
  Reconciliation (year & date) Please enter valid data.
  
  Parish Please enter valid data.
  
  City & State Please enter valid data.
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