Resurrection Catholic Church PreschoolPlease complete the form below to register your child for preschool at Resurrection Catholic Church. A non-refundable registration fee of $100 for new students or $75 for returning students is required at the time of registration. If you would prefer to pay by check, then please click here to complete the offline registration.Child's InformationName* First Middle Last NicknameGender*MaleFemaleBirthdate* MM DD YYYY Mother's InformationMother's Name* First Last Mother's Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work/Cell Phone*Father's InformationFather's Name* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work/Cell Phone*Contact InformationTo whom should correspondence be sent?*Email Address* Preschool RequirementsChildren must be 3 years old by September 1st to be admitted into the 3 year old class.Children must be 4 years old by September 1st to be admitted into the 4 year old class.All children must be toilet-trained by the start of school.Birthdays after September 1st will be considered on individual basis and a probationary period will apply.Please check one in each of the columnColumn A*Resurrection Parishioner (Registered)Catholic Family From Another ParishNeither of the AboveColumn B*Sibling of Child Currently Enrolled in SchoolSibling of Child Formerly Enrolled in SchoolStudent New to the ProgramParish Name*Please enter the name of the parish where you are currently registered.Select a Class:*Three year old class - Tues/Thurs 9:30-12:00 ($205/month)Four year old class - Mon/Wed/Fri 9:30-1:00 ($305/month)Four year old class - Mon-Fri 9:30-1:00 ($505/month)Registration Fee*(due at time of registration & non-refundable)New Student ($100 per year)Returning Student ($75 per year)An additional Activity Fee of $50/year is due in SeptemberPayment InformationEnter your payment information below for the non-refundable registration fee which is required to complete your registration.Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name Total Due at Registration $0.00 This iframe contains the logic required to handle Ajax powered Gravity Forms.
