If you are new to our program please fill this form in completely. If you are a returning applicant, we need your name and any changes from last year, including any new students.

Office of Religious Education - St. Philip Church
Janice Gray, Director of Religious Education (DRE) - phone 269-962-9506

Financial Information: Registration is $40 per student or $70 maximum per family. Payment is due by the beginning of the school year. Scholarships are available by calling the DRE.

Choose the registration type:

Father's Last Name   

Father's First Name   

Street Address       City   

State       ZIP   

Home Phone       Cell Phone   

Email   

Parish Currently Registered   
Mother's Last Name   

Mother's First Name   

Street Address (If different from father's)       City   

State       ZIP   

Home Phone (If different from father's)   

Cell Phone   

Email   

Parish Currently Registered (If different from father's)   
Choose the Student's Grade:     Students's School District   

Student resides with:

Student's First Name       Students's Middle Name   

Students's Last Name   

Date of Birth       Date of Baptism   

Place of Baptism   

Date of First Communion   

Place of First Communion   

Student will:

Special Needs/Learning Disabilities? Please explain:
Choose the Student's Grade:     Students's School District   

Student resides with:

Student's First Name       Students's Middle Name   

Students's Last Name   

Date of Birth       Date of Baptism   

Place of Baptism   

Date of First Communion   

Place of First Communion   

Student will:

Special Needs/Learning Disabilities? Please explain:
Choose the Student's Grade:     Students's School District   

Student resides with:

Student's First Name       Students's Middle Name   

Students's Last Name   

Date of Birth       Date of Baptism   

Place of Baptism   

Date of First Communion   

Place of First Communion   

Student will:

Special Needs/Learning Disabilities? Please explain:
Choose the Student's Grade:     Students's School District   

Student resides with:

Student's First Name       Students's Middle Name   

Students's Last Name   

Date of Birth       Date of Baptism   

Place of Baptism   

Date of First Communion   

Place of First Communion   

Student will:

Special Needs/Learning Disabilities? Please explain:
Choose the Student's Grade:     Students's School District   

Student resides with:

Student's First Name       Students's Middle Name   

Students's Last Name   

Date of Birth       Date of Baptism   

Place of Baptism   

Date of First Communion   

Place of First Communion   

Student will:

Special Needs/Learning Disabilities? Please explain:
Choose the Student's Grade:     Students's School District   

Student resides with:

Student's First Name       Students's Middle Name   

Students's Last Name   

Date of Birth       Date of Baptism   

Place of Baptism   

Date of First Communion   

Place of First Communion   

Student will:

Special Needs/Learning Disabilities? Please explain: