Enrollment Form for: Adult Classes, RCIA, Catholic Preschool, CCD, Summer Sacraments & Vacation Bible School

Welcome to St. Patrick Catholic Church!

 This is an enrollment form for: Adult Formation Classes, Catholic Preschool and CCD
 classes through St. Patrick Church. Complete the form for each student you will be
 enrolling (you may enroll multiple at the same time).

 An acknowledgement letter will be sent to you and a statement detailing the cost of the
 class and a coupon you may use to send in your payment if needed.
 Please contact the Parish Office if you have questions about cost. Adult classes may or
 may not have a book fee associated with it, depending upon the type of class. No one
 is ever denied the chance to heal, grow and practice their faith, because of financial
 difficulties. This concern should not be an influence in a personís decision to enroll in a
 class.

 If you have questions, you may find more information on the parish website:
 www.stpatrickchurch.us or, you may contact the parish office for more information at:
 (859) 356-5151 or email: stpatsemail@fuse.net.
Click Submit Form to send this information to St. Patrick Church.
*Required fields
Instructions Please select the class you would like to enroll your child or yourself into.

Student 1 Type
  Title Suffix
*First Name *Last Name
*Middle Name Nickname
  Relationship Maiden Name
  Ethnicity *Birth Date
*Gender Female   Male Grade/Degree
  Language Marital Status
Phone Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1 Unlisted
Send Email Instead of Mail When Possible
  Email 2 Unlisted
Send Email Instead of Mail When Possible
Sacraments
*Baptism Date Place
   Reconcil Date Place
   1st Comm Date Place
   Confirm Date Place
   Marriage Date Place
Class Choices
*Class 1
Student Remarks
  General Remarks
*Health Problems

Family Options  New Family  Update Existing Family
        - ID/Env  

Head of Household
  Title Suffix
*First Name *Last Name
*Middle Name Nickname
  Relationship Maiden Name
  Ethnicity Birth Date
*Gender Female   Male Grade/Degree
  Language *Marital Status
Phone Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1 Unlisted
Send Email Instead of Mail When Possible
  Email 2 Unlisted
Send Email Instead of Mail When Possible

  Spouse
  Title Suffix
  First Name Last Name
  Middle Name Nickname
  Relationship Maiden Name
  Ethnicity Birth Date
  Gender Female   Male Grade/Degree
  Language Marital Status
Phone Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
  Phone 1 ( ) - Unlisted
  Phone 2 ( ) - Unlisted
  Email 1 Unlisted
Send Email Instead of Mail When Possible
  Email 2 Unlisted
Send Email Instead of Mail When Possible

Family Street Address
*Line 1
  Line 2
*City
*State
*ZIP

Family Phone Numbers
Note: If you would like to receive a text message when your parish sends a quick communication, select your provider from the Description drop-down list. Standard text messaging rates apply.
*Primary ( ) - Unlisted
  Other ( ) - Unlisted
Family Email Address
*Email Unlisted
Send Email Instead of Mail When Possible
Family Remarks
  Remarks


Click Submit Form to send this information to St. Patrick Church.
 ↻ 

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St. Patrick Church