ST. MALACHY ROMAN CATHOLIC CHURCH
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St. Malachy's CCD Family/Student Information for 2021-2022 School Year
Please fill in the following information.
Father's Information
Father's Name
*
First
Last
Father's Work Phone
*
Father's Cell Phone
*
Father's Home Phone
*
Father's Email Address
*
Mother's Information
Mother's Name
*
First
Last
Mother's Work Phone
*
Mother's Cell Phone
*
Mother's Home Phone
*
Mother's Email Address
*
Marital Status: Check One.
*
Single
Married
Separated
Divorced
Widowed
Emergency Contact Information (If unable to contact parents)
Emergency Contact Name
*
First
Last
Emergency Cell Phone
*
Emergency Home Phone
*
Emergency Work Phone
*
Relationship
*
Home/Mailing Address
*
Line 1
Line 2
City
State
Zip Code
Country
Mailing Address (If different from home)
*
Line 1
Line 2
City
State
Zip Code
Country
Child's Information - Child 1
*
Indicates required field
Child 1: First Name
*
Child 1: Middle Name
*
Child 1: Last Name
*
Child 1: Birth Date (MM/DD/YYYY)
*
Child 1: Birth Place
*
Child 1: School Grade
*
Child 1: Sacraments (Check if Received)
*
Baptism
Reconciliation
Eucharist
Confirmation
Child 1: Special Needs: (Allergies, Medical Concerns, Etc.)
*
Child's Information - Child 2
Child 2: First Name
*
Child 2: Middle Name
*
Child 2: Last Name
*
Child 2: Birth Date (MM/DD/YYYY)
*
Child 2: Birth Place
*
Child 2: School Grade
*
Child 2: Sacraments (Check if Received)
*
Baptism
Reconciliation
Eucharist
Confirmation
Child 2: Special Needs: (Allergies, Medical Concerns, Etc.)
*
Child's Information - Child 3
Child 3: First Name
*
Child 3: Middle Name
*
Child 3: Last Name
*
Child 3: Birth Date (MM/DD/YYYY)
*
Child 3: Birth Place
*
Child 3: School Grade
*
Child 3: Sacraments (Check if Received)
*
Baptism
Reconciliation
Eucharist
Confirmation
Child 3: Special Needs: (Allergies, Medical Concerns, Etc.)
*
Submit
Home
Live Mass
Religious Education
Religious Education Signup Forms
Ministries
Faith Community Nurse Ministry
Liturgical Ministries
Ministries of Community
Ministries of Prayer
Organizations
Catholic Daughters of the Americas
Guadalupe Society
Knights of Columbus
St. Vincent de Paul Society
Sacrament Preparation
Proclaim the Good News
About Us
Contact Us
Parish Calendar