St. John Vianney Church
CCD Registration
Family Information
Please use proper upper/lower case for all fields.
Names will appear on class rosters, attendance sheets, etc. as entered here.
Family Name:  
(Last Name Only!!)  
   
Family Phone:
   (10 numeric digits)
         
  MUST USE THIS PHONE NUMBER FOR ALL STUDENTS IN FAMILY!!
Address 1:      
Address 2:  
City:     
State:      
Zip Code:           
Primary E-mail:            
 Re-enter Primary Email:           
Secondary E-mail:       
Re-enter Secondary Email:       
Family Registered at SJV:  
Plesae enter the following information as appropriate for your household.
Father/Guardian Mother/Guardian
First Name: First Name:
Last Name: Maiden Name:
Religion: Last Name:
Cell Phone:     Religion:

  

Cell Phone:    
Please check your information before submitting.