Program : Adult Education PREP Program First Name : Last Name : Gender : Male Female Date of Birth : Date of Baptism : Place of Baptism : Church of Baptism Address : Note * If your child was not baptized at St. Paul Church, please provide a copy of Baptismal Certificate to St. Paul Religious Ed Office prior to the start of Classes. Thank you. School : Grade in September : 1 2 3 4 5 6 7 8 Address : City : State : alabama alaska alberta american samoa arizona arkansas armed forces americas armed forces europe armed forces pacific british columbia california colorado connecticut delaware district of columbia federated states of micronesia florida georgia guam hawaii idaho illinois indiana iowa kansas kentucky louisiana maine manitoba marshall islands maryland massachusetts michigan minnesota mississippi missouri montana nebraska nevada new brunswick newfoundland new hampshire new jersey new mexico new york north carolina north dakota northern marianas islands northwest territories nova scotia ohio oklahoma ontario oregon palau pennsylvania prince edward island province du quebec puerto rico rhode island saskatchewan south carolina south dakota tennessee texas utah vermont virginia virgin islands washington washington, d.c. west virginia wisconsin wyoming yukon territory Zip : Phone : Work Phone : Email : Father : Mother : Mother's Maiden Name : Father's Religion : Mother's Religion : Special concerns: (allergies, learning issues etc.) : Emergency Contact Name : Phone : Registred in parish last year : Yes No Number of children : 0 1 2 3 4 5