St. John Vianney Church
CCD Registration
Returning Student Information
Use this form only if student was in SJV CCD after September 2011

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 BE THE SAME NUMBER USED ON FAMILY PAGE!!!
         
 Student information:  For Special Needs Student class on Sunday
morning, call Kim Stack at 410-535-4395
to register.
First Name:       
Middle Name:       
Last Name:       
Nick Name:   Grade in School:       
       CCD Grade:          
Birthdate:
      mm/dd/yyyy
         
                         
       
Requested Session:      
NOTE: Grades K - 7 are Sunday Morning or Monday Night
              Grades 8 & 9 are only on Wednesday Night
Student's E-mail and Cell Phone (the older students may have these) 
E-mail Address:       
Re-enter E-mail:        
Cell Phone:
(10 numeric digits)
      
Does student have a school IEP, LEP, SLP, or 504 plan?          
Learning disabilities or allergies:    (If not applicable, enter: None)    

Please check your information before submitting.