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St Mary's Parish
Carolina, RI
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PEP Student Registration
Registration for 2018-2019
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Parent /Guardian Information
Family Name
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Father's Name
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Mother's Name
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Mother's Maiden Name
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Number of Children to be Registered
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Child 1
First Name
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Last Name
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Birth Date
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Grade Child will be Entering this Fall
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Date of Baptism
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Church/Parish where Baptised
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City and State where Baptised
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Date of First Eucharist
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Church/Parish where First Eucharist was Received
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City and State where First Eucharist was received
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Child 2
First Name
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Last Name
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Birth Date
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Grade Child will be Entering this Fall
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Date of Baptism
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Church/Parish where Baptised
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City and State where Baptised
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Date of First Eucharist
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Church/Parish where First Eucharist was Received
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City and State where First Eucharist was received
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Child 3
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Last Name
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Birth Date
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Grade Child will be Entering this Fall
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Date of Baptism
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Church/Parish where Baptised
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City and State where Baptised
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Date of First Eucharist
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Church/Parish where First Eucharist was Received
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City and State where First Eucharist was received
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Child 4
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Last Name
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Birth Date
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Grade Child will be Entering this Fall
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2
3
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7
8
9
10
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Date of Baptism
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Church/Parish where Baptised
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City and State where Baptised
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Date of First Eucharist
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Church/Parish where First Eucharist was Received
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City and State where First Eucharist was received
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Child 5
First Name
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Last Name
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Birth Date
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Grade Child will be Entering this Fall
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1
2
3
4
5
6
7
8
9
10
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Date of Baptism
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Church/Parish where Baptised
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City and State where Baptised
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Date of First Eucharist
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Church/Parish where First Eucharist was Received
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City and State where First Eucharist was received
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Child 6
First Name
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Last Name
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Birth Date
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Grade Child will be Entering this Fall
None
1
2
3
4
5
6
7
8
9
10
Please list any allergies or special circumstances.
Date of Baptism
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Church/Parish where Baptised
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City and State where Baptised
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Date of First Eucharist
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Church/Parish where First Eucharist was Received
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City and State where First Eucharist was received
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