Office of Religious Education
Parents ____________________________________ Mom’s Maiden Name___________________
_________________________ Home Phone #_____________________
_________________________ Cell Phone (M) ____________________
_________________________ Cell Phone (D)__________________
Primary Email address _______________________________________
Emergency contact Name and # ___________________________________
** Use FIRST TIME REGISTRATION FORM for child new to our program.**
Registration Fee: $70.00 per child 3 or more children $150
Additional Fees First Rec./Comm. $40 Confirmation $75checks payable to St. Joseph REO
*Office Use only* Date rec’d ________ Amount ________ Cash _______ Check # _______
Saint Joseph 40 spring Street Lodi NJ 07644
973-779-8275 stjoelodireodre@
**Please provide us with an up to date photo of your child to give their teacher along with the class list**
Office Notes
Additional information
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
All certificates are on file _______
If not what’s missing:
_________________________________________________________________________
-----------------------
Returning 2016-17 Family Name (last name)_____________________________________
Child 1 ________________________ Grade _______ Birth Date____________
School Attends:________________ Special Needs:_______________________________
Sunday (grades 1-8) 10:00 – 11:15 ______ Tuesday (grades 1-8) 4:00-5:15 ______
Primary Address
Child 2 ________________________ Grade _______ Birth Date____________
School Attends:________________ Special Needs:_______________________________
Sunday (grades 1-8) 10:00- 11:15 _____ Tuesday (grades 1-8) 4:00-5:15 _____
Child 4 ________________________ Grade _______ Birth Date____________
School Attends:________________ Special Needs:_______________________________
Sunday (grades 1-8) 10:00-11:15 _____ Tuesday (grades 1-8) 4:00 -5:15 ______
Child 3 ________________________ Grade _______ Birth Date____________
School Attends:________________ Special Needs:_______________________________
Sunday (grades 1-8) 10:00-11:15 _____ Tuesday (grades 1-8) 4:00-5:15 _______
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